Struggling after witnessing death

[goodtime87]

It would be helpful for me to hear from anyone who has had a similar experience or who has greater knowledge of medicine than I, with regards to the following. I have tried to be clear and honest and I apologise if anyone finds the details distressing.

After a month spent in hospital and a quick decline in health, my grandmother was deemed too sick to recover and thus the correct option was to cease giving her oxygen and sustenance as it would have prolonged her life while her vital organs failed.

Before this step was taken, she was able to communicate albeit very poorly. Her senses were failing and she was in and out of sleep. There was at times recognition of us and what we were saying but her hearing and eyesight was much worse than it had been before she went in. She was somewhat delirious. She was able to tell us that she had pain in her feet (bedsores) and thumb (cannula was inserted there) and so I believe she had no major internal pains or else she would have indicated. She was not someone to suffer in silence.

The stage that followed was difficult. Without oxygen and drips/food, her condition changed quickly and she became almost entirely unresponsive. The doctors advised that with her body unable to absorb food and her organs failing, it was the humane option and that she would pass within hours. It was actually quite a bit longer.

We took turns to wait with her through an intensely difficult few days and nights when we were essentially waiting for her to pass away. She was unable to communicate. Her eyes were half open and she could only possibly hear us when we spoke to her and comforted her. She would whimper occasionally and every so often move her hands as if confused or uncomfortable. The doctors reassured us that she was not in pain but that her body was shutting down. At our request, she was given morphine.

I was there when she died. It was a traumatic thing to witness but more so because I fear that she was in pain. It was not an image of peaceful death that we had hoped for her after such a long life. She died slowly, breathing heavily, occasionally whimpering whilst all we could do was comfort her (not knowing if she could hear us or was in pain) and wet her dry mouth.

The doctors have assured us that she was not in pain and part of me wonders whether it was simply the ugly side of nature, seeing a person's body shut down and the brain impulses outlasting the other organs but I can't help feel a kind of guilt at the way it happened. The experience of seeing a woman fighting for life while we sat and watched and waited is hard to face. More so, after a long life and a long sickness, it seemed incredibly unjust to go out struggling and in what appeared to be distress.

I wonder if we could have asked for her to have been more heavily drugged to ease the passage but at the same time wonder if that would be unnatural and not in her best interests. I wonder is this the reality of old people dying? Is it often this way and not the peaceful closing of eyes that you see in films?

Whilst in time, I hope to be able to compartmentalise the grief and sense of loss that I feel with her not being here, I fear that my memories of her will be inseparable from the traumatic ending that I witnessed.

No medical knowledge, but I'm sorry for your loss.

I witnessed similar when my granny died. Not at all a simple closing of the eyes unfortunately. There was a certain limit of morphine and medication that could be given, and her passing took longer and not as peacefully as we were led to believe. We were also reassured y doctors that she couldn't feel any pain so I try to not dwell on it and hope they were right.

OP you're describing exactly what happened to my grandma in the summer.

We also requested morphing and a sponge to wet her mouth. It was very sad to witness but I found comfort in the fact that we were all with her at varying times during the few days it took until she passed.

The doctors assured us it was painless and best for her. But, yes it was a very hard time.

I'm sorry for your loss

Im sorry youve been through this but yes active dying is awful. Tv has a lot to answer for. Dying must be painful but things probably dont make much sense by then. If she was able to tell you about minor discomfort like bed sores. At least she wasn't in agony.

Exactly the same as my Dad, it was almost 30 years ago, but the sight of him whimpering in pain, weighing about 5 stone, will stay with me forever. A dog wouldn't be put through what that lovely kind and gentle man endured.

I'm so sorry for your loss x

Thanks to you all for your kind words and for sharing your thoughts. I think there probably usually is an extra hardship for those present in the final moments and it's not something you can really prepare for or forget. I think knowing that it is normal and we did everything we could is probably what we need to remember.

I have seen hundreds of deaths after a long time working in palliative care. If she had appeared unsettled I probably would have given a small dose of something to settle/ relax her which would also help with pain. Do you know if she had anything like that ?

I'm sorry for your loss goodtime87.

When DH died the final stage was probably about 36 hours. I don't believe he was in pain, he had a morphine syringe driver, and he was pretty unaware of everything except me.

It isn't something you'd want anyone to go through, and wouldn't put animals through it.

Personally I don't have bad memories of that time. I wish he hadn't died and that he hadn't had to suffer, but I'm glad that I was able to help him through those final hours.

The doctor asked her to squeeze his hand if she was in pain/if she was not in pain and he was satisfied that she was not. There was lots of moaning though and it was torturous for my mother to see as obviously, it looked like a person dying slowly in discomfort. We asked for her to be given morphine in case she was in pain. She was and she settled down after that. Even so, it was not an image of someone passing peacefully.

I have thought about it quite a bit and I consider it likely that any restlessness was akin to moving or talking in one's sleep. I know her organs were failing and that her brain was likely to still be a bit stronger and so perhaps that was visible in those movements. Earlier in the week when she had been lucid for periods, there were painful tests/tube insertions etc but she didn't remember them an hour or two later and so I don't believe she would have consciously been in pain. The doctors were convinced that it was as it should have been and that it was the normal process of a body shutting down. Though distressing, I have to believe this was simply a side of nature that you rarely have to witness.

DSis and I have supported our DF and DSF through the end of life 'pathway' this year. It was brutal and inhumane. In contrast my elderly and very poorly cat had a much more peaceful and dignified death. My condolences.

I watched my 31 year old sister die in hospital 20 years ago and it is etched in my memory. She died in hospital in Italy and I can confirm that you wouldn't wish that end on any animal let alone a human being. Hospitals in Catholic countries ( especially 20 years ago) did very little to alleviate suffering at the end : in case the extra morphine hurried death by a few hours. I asked for extra sedatives when it was obvious how distressed she was and to help with her symptoms which while not agony were incredibly difficult to deal with, with any dignity.

I was told they couldn't take the responsibility of it possibly depressing her breathing too much!!! She died a couple of hours later in a great deal of distress. My father left as he couldn't watch any more and was beside himself He asked me to stay with her.The only savings grace was it was not too drawn out ( only about 4-5 hours) but very unpleasant.

I have also seen two uncles die and their deaths were more like what happened with your grandmother. They seemed restless and not exactly peaceful but not in masses of distess.One had a very very loud breathing noise what I have heard is common. It sounded very distressing but my uncle did not seem overly distressed by it , more that we were. The deaths seemed like hard work to me, not peaceful exactly and more drawn out but not anything like my sister experienced.

I.am very sorry for your loss and hope you come to terms.with it.

I work in end of life care. I accept that this was a very difficult experience for you. At the end of our lives if we die in this way our organs begin to fail. Fluids are stopped because the body cannot absorb them and they begin to pool in the lungs. Often ppl suddenly become unable to swallow food without choking and this is a sign they are often on the cusp. No longer able to safely swallow food is stopped and the mouth should be kept moist with mouth sponges. If dying ppl were on medication that could cause withdrawal or distress when suddenly stopped the appropriate action would be to replace them with subcutaneous alternatives for comfort measures.
Sometimes as death approaches the dying become terminally agitated and this is a response to a sudden surge in Adrenalin from the body's flight or fight response. This can manifest in plucking at bedclothes thrashing around or even trying to climb out of bed. If someone moans or groans this should be taken as a sign of discomfort and diamorphine should be given by subcutaneous injection. Some ppl have syringe drivers to keep them settled but not everyone. Breathing changes towards the very end and patients can appear to be labouring heavily in order to breathe. They can develop terminal secretions that pool in the back of their throat that sound like a chest infection. These ordinarily can sound alarming to the onlooker but rarely trouble the person.
Your presence with your grandmother would have given her much comfort as she would have been aware of your presence and hearing is the last sense to go.
Sometimes the dying process can take longer than we would like and when this happens we can become unsure of our decisions and it can be distressing or uncomfortable for the family. But it is a natural dying process we go through at the end of life.
Seeing someone we love die is very hard. I have attended many dying patients but when it came to my own mother I was traumatised. You are grieving but you afforded her all the comfort in her last days.

I've been in this exact same situation with my great grandma. I take comfort in the fact we were there for her and comforting her, just in case she could hear.

So sorry OP. It's an awful time. I recall my dad dying st home and he had a 24 hour carer who was wonderful. She gave him yoghurt unfortunately when he could no longer swallow and he took some into a lung and was in masses of distress, luckily my brother was there, he's a consultant doctor in ITU so was able to deal with it - nothing helps how we, as onlookers feel, it's very distressing and sad. However the drugs they're taking help to ensure they don't suffer

Sorry for your loss OP. I was present at the death of my grandmother in February and it was similar to how you describe. She was and end stage of dementia and had received end of life care the same as you describe also. In her final hour she was given a dose of a sedative which really helped to settle her, and her breathing went from a horrible moaning and rasping to becoming much quieter, shallower and less frequent before eventually stopping altogether. It's distressing to see, but as a previous poster has mentioned it is the natural process of a body shutting down. I am sure that your being their brought much comfort in her final moments. Look after yourself Op.

OP I've just had this with my dad

Fortunately I had read up on it quite a lot while he was ill so had a better idea of what to expect. It was incredibly traumatic though and I asked for doctors to give him a sedative and morphine - I think they would have done it a couple of hours later maybe, if I'd not been there to ask them.

It is an appalling thing to say. I can only tell you that I know how you feel, there wasn't any other way and I'm sure we both did our best with it. All good wishes to you

*appalling thing to see

sorry, what a time to get my words in a muddle - dad died a month ago and I still don't make much sense!!

I went through exactly the same with mum last year, she died from pancreatic cancer five months after diagnosis. She was on a syringe driver and unconscious for 11 days before dying. I was with her and experienced the same as the OP. A year on and I am still utterly traumatised, I have dreams about her all the time and am struggling to cope with how much she suffered.

Op, I witnessed this with two of my grandparents, and my husbands mother, all with cancer, and all I can say is that you do learn to adjust to it and live with the memory.

It's shocking and traumatising when you see it. But you will move past it as time goes on, and start to remember her and the good things about her.💐

Im so sorry for your loss OP. My mum died 14 years ago next month very suddenly during surgery and we had to leave her on the ventilator because she was an organ donor. I torture myself thinking I wasn't with her when she was finally gone even though I know she wouldn't have known anything about it - she was already gone before I said my goodbyes. I am glad that she didn't suffer and that I didn't have to go through what you did though, I can't imagine

My dm died in the last year and was a littled distressed. I insisted with nurses that she be totally sedated as no way could l sit there and watch her suffer. She has been on meds for a long term illness and suddenly could not take them any more due to swallowing difficulties. She had huge withdrawal symtoms which caused agitation. Getting the sedation calmed her and 24 hours later she passed peacefully. Her illness had caused her great distress so it was a relief to see her at peace.
Its a very traumatic time.
Try to dwell on the good memories. Also l found it helpful to be able to talk over the situation with family members who were there. We went over it again and again until that memory faded.

As I was reading this I couldn't quite believe it, a very similar thing happened to me at the beginning of the week, my Grandmother had been taken in by ambulance and they suspected that she had a heart attack - they did a procedure on her heart identifying 2 blockages and manage it slightly unblock one - but unfortunately there wasn't enough oxygen and blood getting around her body. Palliative care was to be discussed the next morning. I sat with her all night and we spoke we she was slightly agitated as that comes with active dying and she was given morphine. That helped a lot. I went home for some sleep the next morning she awoke and asked for weetabix - they called me explaining they could not feed her as they worried she would choke - I said I was making my way up to see her anyhow

On my journey there 40 minutes she passed away - having been with her the entire day before I can't help but think she didn't want me to be there at the point of her passing

Back to her old saying of as long as your okay don't worry about me ......

I can only Imagine the pain you are going through seeing something like that. Did the hospital relatives depart offering any counselling or have the funeral directors offered any?

Op I'm sorry for your loss.My own Df died last year from cancer that had gone everywhere including his brain.I found the death rattle the worst bit.He struggled for a few days after six weeks in hospital.He was agitated and thrashing about one night and he developed secretions that dm thought was.part of the cancer from his lungs coming out of his nose and mouth...A brownish gunk!!His death was.awful but his life was a.full one.I would not wish him back with cancer in his spine too.I focus on his life not his death.

I used to work on the elderly ward at a hospital so death was a regular occurrence, it's really not nice to see but you did the right thing by not prolonging her life, if she had morphine she wouldn't of been in pain.. so sorry for your loss

How are you OP?

Thanks for sharing your experiences and advice on the matter. I'm fairly young and so have not experienced many deaths in the family. I am lucky for that and lucky that I had such a good relationship with my grandmother and that I had her for as long as I did. Similarly, although witnessing a death is traumatic and leaves memories that will probably never go away, I feel like it is in a way a privilege to share someone's final moments and to have gotten to say goodbye.