Two years ago, my day had liver and kidney failure suddenly. I was with him for the last 3 days when he came home under hospice and I sat with him for the last 3 hours until his death. At the end I saw his skin mottle and go grey, his breathing speeding up and then he suddenly breathed his last breath. It was a terrible awful 3 days. The last 3 hours were horrible. I can see you all have been through much worse, but it really affected me. After that I felt so detached for a long time. It was like the world was foreign to me...like I wasn't connected to it anymore. It took me a long time to get over this.
Then this past weekend I was visiting my mom (who is 84) who hasn't been doing well. As I was sitting across from her I saw the skin on her left hand suddenly change color in the same way I saw my dad's skin change just before he died. That lasted for awhile and then lightened a bit. I had an immediate panic attack. I had to go into the bathroom and calm myself down. Then when I came home I am experiencing all that detachment and upsetness all over again. I thought I got over this...evidently not.
My aunt is living with me and will probably die here at some point...maybe in front of me.
I am not cut out for all these elderly people dying in front of me thing. I am so stressed out with all this. I am such a wreck since last weekend when I saw that sudden skin mottling in my mom. I know people get old and die but this is too much for me to have them die in front of me over and over.
I can't do this anymore. How do you get over this? Everyday I am waiting for the call from the place where my mom is saying she has died or maybe going downstairs and finding my aunt dead. I feel like my life has turned into death row.
I feel blessed to have had some time with my father before he died, when he was still able to communicate. However, things happened at the hospital, through negligence or callousness on the part of some hospital staff members,which made the loss more painful than it should have been. My father was admitted to the hospital after midnight on Dec.18 for shortness of breath and wheezing. He had CHF, chronic kidney disease and was on Lasix, He seemed to be getting better with oxygen therapy, so I went home after staying ten hours with him. I needed to wait for some deliveries at home. Later that day he suffered a silent heart attack in the hospital, but nobody told me. The nurse only said they were going to put him on the bipap to help with his breathing. Since the bipap had helped him six months earlier when he had his first bout with pneumonia, I didn't think it was necessary to rush back to the hospital that night. I needed to sleep to make up for staying up all night the night before. The following morning the doctor called to tell me my father had to be put on a ventilator, because the bipap hadn't helped him and he was suffering. He was on the ventilator under sedation for three days. Since he was in the ICU, under sedation, I visited him during the day and went home in the evening to sleep, assuming he was under close observation. The hospital is not that far from my home. On the fourth day, I found my dad awake and very distraught -- he wanted the ventilator tubes removed. At first, I thought he wanted to die, but he shook his head -- he didn't want to die, he didn't think he needed the tubes anymore. I explained to him that he had to wait a while longer until the doctor considered it safe to remove the tubes. He calmed down, but he looked so forlorn. I had never seen him so miserable. He was normally quite stoic. However, the fact he was wake and felt well enough to think he could breathe on his own gave me hope. He was able to write notes on paper to tell me what he needed. For example, he wanted a handheld fan from home to cool him off -- even though he had no fever and the room was cold, he felt unusually warm. He wanted me to direct the air flow to his nose, because it helped him breathe. Using an eraser board he told me he loved me, and I told him I loved him, something we did every day at home. I know my presence brought him comfort and that is a great consolation, but the sad images of him still haunt me.
That night I stayed with him all night and I was glad that I was able to advocate for him. When he couldn't sleep I called the nurse who gave him Fentanyl which put him to sleep right away, twice. When he awoke my dad asked me if I had slept, because I tend to suffer from insomnia. I had nodded off in the chair. I told him the nurse said we were both out like a light. My Daddy always worried about me.
On Christmas Eve, he was off the ventilator and it looked like he was recovering. He told me, "You see how much I need you?" I replied, "I need you too! That's what love is all about." He had gotten through other crises before -- he had beaten diabetes and peripheral arterial disease. His surgeon had called his recovery from gangrene on his toes a miracle. The ICU nurse told me to go home and get some rest, that he would look after my father and call me about any changes. I went home, hoping for a Christmas miracle, but I awoke with a feeling of dread. On Christmas morning, I found my father in respiratory distress, the oxygen cannula had fallen out of his nose and he was begging for air, water and God's mercy, over and over. His oxygen saturation had dropped into the low 80's. No one was helping him, and this was in the ICU! When my father saw me he thanked me over and over -- it broke my heart! I got a nurse to put an oxy-vent mask on him and increase his oxygen. He shouldn't have been switched to the cannula, because he was breathing through his mouth. The nasal gastric tube was blocking his airway. After that I knew he could not be left alone. Thank God I had slept the night before, because that helped me stay awake with him for the next 36 hours.
A couple of days before, I had reassured my father that there was a closed-circuit tv camera watching him in the ICU. He waved his hand in a dismissive gesture as if to say, "They're not watching me." I should have taken that as a warning. Still, I needed to sleep and there was no one else to stay with him through the night, because my relatives live too far away.
I'm so grateful that my half brother, a Critical Care RN, and my niece arrived at the hospital on Christmas Day. The doctor told us my dad's kidneys were no longer responding to diuretics and his creatinine level was rising daily. When I asked about loop diuretic braking and suggested they try a different diuretic, nobody even knew what braking is. I had asked the nephrologist about aquapheresis and he said they didn't offer it and that he needed full dialysis. The hospitalist said my dad was too weak to be moved. She seemed more like a robot than a human being. She said there were only two options, a heart operation or Comfort Care. If he had the operation he would need to be put back on the ventilator and placed on dialysis, which might kill him because the volume fluctuations would stress his heart. The doctor said his heart was not able to perfuse his lungs and kidneys properly, because of mitral valve regurgitation, enlarged left atrium, arrythmia with a blood clot, and blocked vessels. He had been diagnosed with advanced heart disease several years earlier but wasn't considered a good candidate for surgery then, now at 86, after his massive heart attack, his chances were even worse. She said his heart's ejection fraction was 15%, barely enough to sustain life. Mercifully, his heart attack had been silent so he didn't have pain, but respiratory distress is bad enough.
My niece and I tried very hard to convince the doctor to consider other options to no avail. My brother the RN said Comfort Care would save Dad a lot of suffering. My brother and niece started crying. I was still in shock, but broke down over the phone to my best friend in Cincinnati.
The hardest part was when my dad asked me if he was going (dying). I told him that the doctor said his heart wasn't doing too good and he needed an operation. I wanted so much to give him some hope to cling to, but I needed to know his wishes. He didn't want to go back on the ventilator and he didn't want to stay weeks in the hospital recovering from surgery. Two years earlier he had spent six weeks in the hospital just recovering from a botched toe amputation. That took a lot out of him -- he had lost so much weight, he couldn't afford to lose any more. Recovering from open heart surgery would have been much worse. I hated the idea of giving up on him. My purpose in life had been to try to get him well, but I didn't want him to suffer. A respiratory therapist told us that a lot of his patients were living vegetables on respirators because their families wouldn't let them go.
My father said good-bye and thanked everyone present, my half brother and his wife, and my niece. He said to tell his family and friends he loves them, thanks for everything and God bless them. Then he started praying. I told him he had nothing to worry about, that he was such a good, kind man all of his life that God would surely welcome him into Paradise. I reminded him that the priest had already given him the Anointing of the Sick while he was under sedation. His soul was pure and he would go straight to heaven. He thanked me. I had called two priests hoping one of them would comfort my father now that he was conscious, but one never returned my call and the other said he would send a different priest who works at the hospital, but he never showed up. More regret there.
For Comfort Care, my father was moved to a private room and placed on a morphine drip. I missed all the monitors, which I used to fixate upon, looking for the slightest sign of improvement. Thankfully, the morphine and removing the NG tube helped his breathing, and there was a brief time when he seemed his normal, calm self once again, except he was very weak. Again he started praying for God's mercy until a male nurse told him, "God is good, my friend." That seemed to reassure him. I treasure his last peaceful moments, before he lost consciousness. I told him where there is life there is hope and that I couldn't wait to get him home so I could take care of him. He nodded. One of the last things he said to me was that Michael was going to get tired (taking care of him). Michael was the RN who had saved his life during his six-week hospitalization a couple of years ago. That is another story. Unfortunately, Michael was working on a different floor. It really is the luck of the draw -- if you get good hospitalists and dedicated, compassionate nurses, your chances are much better.
As my father lay dying, my half brother and I prayed and read passages from Scripture. I told him I loved him and thanked him for being such a wonderful father all of my life. I had told him these things before. I held his hand. This time was beautiful from a spiritual perspective, but terrible from the physical point of view. People say that hearing is the last thing to go, but I hope to God that his soul was outside his body so he could view his physical suffering with detachment. The nurses told me he was not feeling pain, but how do we really know? At least, he did not appear agitated as some patients do even with morphine, as one nurse told me. My brother had to go home to sleep so I was alone for the last two hours. After 36 hours of keeping vigil with my father, I couldn't help but doze off for a few moments. That was when my father passed away. It was as if he had waited for me to fall asleep before he departed. A nurse said she saw him draw his last breath. One of the nurses was crying. I cried when the doctor confirmed his death. I had already cried several times before my father died, but quietly, so as not to upset him. I'm glad it was the nicer hospitalist who was on duty that early morning, and not the "robot".
The hospitalist who saw my father during his prior admission had urged him to select a DNR status -- is this even ethical? He said to him, "If you're not going to have heart surgery to save your life, then you might as well be consistent." My father was consistent, he had opted not to have chest compressions because it could break his ribs, and he opted not to have surgery, because it would break his breastbone -- he didn't want his bones broken. He did opt for trying the ventilator though, because he thought it would give him time to recover, which it seemed to do, until his kidneys and liver started to fail. I can't help but wonder what if they had tried a different diuretic two weeks ago, or aquapheresis, would my father still be alive?
My dad had been admitted to the hospital two weeks prior for shortness of breath which was diagnosed as pneumonia of unknown etiology. The hospital lab failed to do a sputum culture, even though the sample had been taken The doctor said this error was "disconcerting", but he still discharged my father after two days with just a prescription for 200 mg of Cefpodoxime Pro. I think my father didn't have pneumonia, and that it was his CHF all along. Pneumonia and CHF look very similar on x-rays. I should have gotten a second opinion or tried a hospital that offers aquapheresis. I have heard of aquapheresis helping CHF patients in worse condition than my father was in. However, he had been diagnosed and treated for pneumonia six months earlier, and had recovered, so I had no real reason to doubt he had pneumonia again, except that his sputum had not been tested. Six months ago it had been cultured for staph (non MRSA).
When he was admitted on Dec.18th, for shortness of breath again, the hospital did a sputum culture which turned out to be negative. Even though he wasn't in a high risk category for TB, they also put him in isolation for several days while a tuberculin skin test was performed, which was also negative. They gave him some powerful antibiotics, vancomycin and Levaquin. Nephrotoxicity has been associated with vancomycin since its introduction in the early 1950s. And I found an article called, "Fluoroquinolones: The Deadliest Antibiotics on the Market". Maybe the combo of antibiotics shut down his kidneys or even caused his heart attack. My grandmother died of a heart attack while on vancomycin back in 1984, also at the age of 86. She also had CHF and kidney disease. I understand that vancomycin and Levaquin are sometimes needed, and he had survived their use in previous years, but his kidney function was better then. If my dad's sputum hadn't cultured for bacteria, then why were those heavy duty antibiotics being used? My dad's death certificate states cause of death as "pneumonia of unknown etiology" along with respiratory failure, heart failure, massive myocardial infarction, and acute renal failure.
There's one last thing I want to vent about.... Several days previously, while my father was sedated on the ventilator in the ICU, there was a nurse from hell who always talked down to me and called me a five-year-old in terms of my medical knowledge, compared to the nurses and doctors. I'm not a trained RN, but in 30 years of caregiving for four relatives in succession, I have done a lot of research on their behalf. Still. I didn't want to rattle her ego, so I said, "You certainly know what you're doing." She replied, "Yes, I know my shit!" At one point she told me, "What would you rather have, someone who knows what they're doing or someone who is "touchy-feeling"? I replied I'd rather have both. She answered sharply, "Well, you can't have both!" I asked her if it would be contra-indicated to place an extra blanket on my father. The blankets were thin and the room was cold. Knowing how arrogant this nurse was, I was careful to phrase it as a question, not a demand. Still, she got flustered and said, "If you place too many blankets on him, his temperature will rise and then we'll have to give him more antibiotics." He didn't have a fever and he felt cool to the touch. The nurse lectured me with a sarcastic tone, "You may have taken care of your dad at home, and I'm sure he's a wonderful man and all, but he is in a different world now!" I replied that I was just trying to advocate for my father because he can't speak for himself. She reluctantly brought the blanket and proceeded to wrap it over the top of his head. Since my father wasn't used to sleeping with his head covered, I asked a male nurse permission to move the blanket to cover his body. This nurse misunderstood me and brought more blankets, which further irritated the nurse from hell. I'm not Asian, but she mentioned Chinese families who demand six blankets on their loved ones, even when they have a fever, One thing she told me that disturbed me more than anything else was that she said her religious beliefs didn't approve of keeping people alive artificially! My first impulse was to ask the Intensivist to have her reassigned, but he wasn't available. Then I remembered what my father had told me about not making waves, because he might be the one to pay for it. I was afraid the nurse would pull the plug on my dad, in accordaince with her belief system or as revenge for my complaining about her So I kept quiet and even asked her permission to dim the lights, so she could enjoy her power trip. Later I saw her moaning in the hallway that people don't understand how much work a nurse has to do. An older nurse replied, "Sorry, that's part of the job!"
I know this post is too long, but I think it's therapeutic to write about our experiences as caregivers. Now I have to find a new purpose for my life, but right now my life feels pointless and I'm afraid of spending the rest of my life alone. .
As my best friend who also lost both her parents told me this evening.... "Life isn't perfect. But our intentions matter. That we cared and tried, matters. Some things, while maybe altering somewhat the things that happen, may not ultimately change the outcome. Maybe they might have made them worse." God only knows.
My cousin seems pretty stable right now, of course, I've learned to be careful when saying that, but I know she is likely to take a turn downward. I know the time will come. Of course, she may go suddenly without being on Hospice and lingering on. I do want to make sure she's comforted and doesn't feel alone.
If it does come to that, I'll discuss it with the Hospice team and get their input. I'm sure they've seen all kinds of situations.
I will say that I've attended three deaths of elderly people who were more than ready to go and they were not only rewarding experiences but beautiful beyond words.
I learned so much about the cycle of life, which includes death of the body. I will say that my spiritual beliefs influence my reactions, however there isn't a doubt in my mind that while I held my dad I felt his spirit leave his body. I knew then that he'd been released from the cage that had kept him in his dementia world for ten years. Just my view, but I thought I'd share it in case it helps.
Carol
Well he didn't die of a heart attack. Instead he lived longer than his siblings and developed dementia in addition to the heart problems. I took care of him for about 10 years. I felt very privileged to be with him when he died. I held his hand and we exchanged I love you. I miss him terribly, and his being gone is still hard on me. But the death itself was a witnessing and sharing of a final life milestone. I am so glad I was there.
I'm not sure what to do about it. If someone is in Hospice do you have to be present? It terrifies me, though I think I'm a pretty strong person. I don't know how I can do it. My cousin has no one but me. I'm just too scared.
I remember my mom's breathing changing to Cheyne-Stokes (agonal) too and how it slowly and miserably dawned on me that this was "it" rather than just another angina attack she could come back from at least a little while. I can identify with that feeling of it seeming a bit or even a lot unreal...once I really knew and let myself understand....I just stayed and held her hand and told her it was OK, she had done her best. The hospice staff had all ducked out after she calmed down from the chest pain she had before they gave medication for it, and didn't expect it to be right then and there either or they would not have just left me alone. I pushed the call button but they couldn't or didn't come back right away and I did know better than to leave Mom alone to go get them.
I was not there for my Dad - I was driving to try to get there from Little Rock to Pgh PA in a snow storm - I had been at his side in the hospital once and was afraid he might pass then and there but he pulled through. It's hard emotionaly either way!
Your support is extremely valuable to him, Joel, but he will most likely need professional help as well.
That being said, he's lucky to have you by his side.
Carol
The only other thing I can add, is sure, you can expect to be able to function and feel happy again, but not really to "get over it" and be "done" grieving. Grief IS more complicated when the relationship was not as good, too - that seems almost universal. Being there for the last days and last moments of the life of another human being really does change you forever, no getting around it! It starts as being kind of a painful part of you and you need to debrief like you would any other trauma...it gradually becomes just part of you, but the emotions reawaken at predictable and unpredictable times, and you never know when you may discover another layer of it all! Getting help..helps...but it does not make the experience or the impact of it go away! The only way "out" is through. Acceptance, acceptance, acceptance of what happened, of how it feels to be the one left behind, and of whatever else you find in your heart.
If you feel so wrapped up in your own reaction and anxiety getting out and helping others with volunteer work could be the answer. Stepping outside of yourself and making a difference in someone else's life can be a big benefit. Grief comes to all of us and there is no one answer in how to get through it. I do know going through anything alone is always much more difficult. God bless!
Now people want aging and death out of sight. Also, there are so many only children who become overwhelmed with caring for their parents but Americans began having smaller families or no children at all during the twentieth century.
I am a retired oncology RN. I’ve held many people’s hands as they died. We had four deaths on the floor one night. But it will be very different when it’s my mom that’s going. Or my dad. Or even my daughter who’s also an only child. Or my husband! But don’t have fear of death. It’s usually very peaceful, spiritual and amazing. It’s very hard if you love the person because they are leaving you temporarily. I do believe our spirit lives on and that most people go to a happy place with no more suffering. I’ve actually ‘felt ‘ people leave their bodies ( the spirit goes out the head).
I believe that I was putting myself through a class so I would be less afraid of death by doing this job. I also know it won’t be the same with my loved ones. But the physical process is nothing to fear. Probably your physical symptoms are your nerves and you’ve got plenty to be upset about. Ask your doctor for a tranquilizer or what he thinks is best for you. Explain your circumstances.
I think two realities make letting go of our declining parent(s) tough. One, it means for many of us that we are taking their place in society. Two, it means becoming more of our own teacher, guide as sometimes we have to learn to almost like parent ourselves, become our own best encourager, and find what nurtures us best that will last us for the rest of our life. Our parents made it and are making it through these final stages of life and so can we!
Let me just say that I am sorry that you are so overwhelmed by the events that are occurring in your life. No one ever deals with the pain of watching loved ones suffer or die and says it is easy. Ten years ago, I was dealt quite a blow when my grandmother was diagnosed with liver cancer. Never a drink, a cigarette, nothing and this strong, vital woman was diagnosed with this terminal disease. As well as that happening, a friend, 28 years old, fell off of his roof and was in a hospital bed as a vegatable until he died. This was all over the course of 6 months. By the way, my grandmother died at 3:30 AM and my friend died exactly 12 hours later.
I was with my grandmother when she died. The last word she spoke was "pain". It was heartbreaking. She was heavily sedated after that and her heart gave out. The suffering that I saw this woman, one of my best friends, go through almost made it bearable that she was gone. I also think it was a gift to me to be there with her. On the flip side, it was a comfort to her not to be alone.
It was not an easy day and I miss both just as much today as I did ten years ago, but if you have done all that you can do and the person that you love so much is ready to go, you just have to keep plugging through your life and let them go. Your life has not ended. You need to enjoy even the smallest of things that bring you happiness. For some it is volunteering or getting a pet. For others it is prayer. I don't know you, but it seems like you have an overwhelming amount of sadness and grief. Maybe you have someone to speak with. Maybe a long walk could do some good. For me, I get in the car, blast the radio and sing my favorite songs at the top of my lungs. By the way, I am a real sucky singer, but I don't care. It is a release. You do what you have to do and try to be strong for your loved one.
I wish you peace and happiness in your life. Don't ever give up and don't ever be afraid to vent or ask someone for help, but you have to do something for your well being. Take care and I really do hope the best for you.
Look into an ALF or NH for your aunt. Limit visits with your Mom until you can get things under control. And please seek counseling and a good doctor who understands how to treat emotional issues. I am not normally a fan of drug therapies but it might be a good "stop gap" measure until you can get your feet under you.
Make just one change today that will improve your life....even if it is a small one.
And come here as often as you need...we're open 24/7 :o)
I was with my mom and dad when they both died and it is a bear.
Personally, because everyone is different, what helped me cope was the fact that it was time for them to go. their poor bodies couldn't take any more and it was time for them to go home.
When my mom died almost a year ago now, I held her hands and looked into her beautiful blue eyes and was telling her to go and find daddy and that he was there waiting for her. It tore my guts out, make no mistake but the reality was that it was time for her to go. She was suffering and then she was free. She actually died with a little smile on her face. I will never forget it.
I agree with you that you can't continue to go through this. Carol has excellent advice in seeking a live support group and are you taking any meds for anxiety? I sure was and still am!! no guilt there! a panic attack is the worst and I was having them left and right and decided that this was no way to live especially since they have a nice med for it and you don't have to take it all the time, just when you need one. xanax works for me and talk to your doctor. If he/she doesn't see it your way, get another doctor. life's too short.
Say what you have to say to your mom, all the things.... you know what I mean, you love her and you wish she would love forever and the 2 of you could go on and on, but that you'll be ok and you will see her again in the blink of an eye.
Now here's a trick that you may be able to use:
EVERY time you have anegative thought and I mean EVERY time, you redirect yourself with a differt positive thought. For me it was a boat. I trained myself to think of a beautiful boat every time I thought of something awful like my daddy's death or mom being so sick, etc.
You can actually create a new habit for yourself in 21 days. It takes 21 days to change a behavior and if all of this insanity, and it is insanity, is getting you bonkers, redirect your thoughts and you will beging to see a difference in how you feel. It's not the easiest thing to do but it sure beats the sox off of not trying something!
Is there a way to find a facility for your aunt? Maybe it's time that you lived your life without this insanity. I know that death is part of life, but I for one am not wired to be a caregiver even though I did it for almost 6 years. I would NEVER do it again and I don't want to be the one sitting bedside holding a hand again either.
I did my job and saw both my parents to their graves and that's enough.
OK, Addie, I hear you and please keep venting here because this website is something that can keep you from going totally bonkers. We Care.
lovbob