Death
February 9, 2005 3:19 PM   Subscribe

 
Wow. Well that was incredibly depressing. Thanks.
posted by Yellowbeard at 3:26 PM on February 9, 2005


i hope you aren't losing someone semmi.
posted by joelf at 3:35 PM on February 9, 2005


"Sometimes your loved one might feel as if death is near."

My grandmother's last words to the nurse was "I am about to die". The nurse scolded her and said "you're just fine". Five minutes later her heart just stopped.

Thanks for the great link and I'll echo joelf about your situation.
posted by ..ooOOoo....ooOOoo.. at 3:40 PM on February 9, 2005


Four and a half years ago my father's wife (he remarried after my mother died, and I was already long since an adult at that time, so I never thought of her as a step-mother, although she was a much loved member of the family) received great news that her cancer was in remission. It was, alas, a misdiagnosis, and she received hospice care from my father and died a few weeks later.

Ten days later my father was diagnosed with acute untreatable leukemia; he died, three weeks to the day after his wife passed away, having been cared for by my sister, in the same house, the same bed.

A woman came to me after the service (my sisters had asked me to deliver the eulogy) and said, "This is the saddest...and most beautiful...thing I have ever seen.

I had no more words at that point.
posted by 1016 at 3:43 PM on February 9, 2005


Hadn't seen joelf's post before I posted...ditto from me, semmi.
posted by 1016 at 3:45 PM on February 9, 2005


Very interesting post, which provokes much thought.

I don't know if I'm sending my loved one to the Mayo Clinic:

Those symptoms -- doesn't want to get out of bed, doesn't eat, sleeps a lot, withdrawal from activities -- how do we differentiate them from basic depression (and please understand that I'm using medical terms in the common sense, not as precise technical terms)?

An elderly, ill person who doesn't eat or drink exhibits signs of dehydration and lack of energy? They get sicker and might die? Am I missing something?

Let me just say this as devil's advocate, because I'm very interested in hearing the answer: Doesn't this article really say,

Your elderly loved one may become depressed by illness and give up on life. Don't try to stop them, but sympathetically help them. Allow them to dehydrate and malnourish themselves, withdraw from the world, stop caring for themselves, sicken and then pass away.

Imagine treating someone that way who is younger and acutely depressed. Possibly their younger body could take more abuse -- they might not die -- but could you imagine being 'supportive' of their behavior?

Why is it acceptable behavior with the elderly? The instinctive answer is, because they have less to lose, but that's just wrong if you think about it.
posted by guanxi at 3:45 PM on February 9, 2005


(Apologies to those who posted above if my post is insensitive to their experiences. Those posts weren't there when I started writing, or I would have adopted a different tone.)
posted by guanxi at 3:53 PM on February 9, 2005


guanxi, Rage, rage, against the dying of the light?...with you there...for the most part.

Each case is discrete and needs to be treated as such. With my dad's wife and with him, there was no help for it other than to make them comfortable and feel loved.
posted by 1016 at 3:55 PM on February 9, 2005


I posted before guanxi's parenthetical addendum...no apology required at all.
posted by 1016 at 3:57 PM on February 9, 2005


guanxi, the Mayo Clinic pages are meant for people who are caring for a person with a definitive terminal illness diagnosis (like untreatable/inoperable cancer), not people simply who are old.

You're right that what would be acceptable care for a person who is dying would be neglect in a person who is old and suffering from depression.
posted by jesourie at 4:06 PM on February 9, 2005


Mayo?

I put that on my turkey sandwiches.
posted by TwelveTwo at 4:15 PM on February 9, 2005


I like this. It's like I've always said, "Don't ruin a good life with a bad death."
posted by ColdChef at 4:21 PM on February 9, 2005


Sometimes it is just time to go. My mother, in her last few weeks, had the choice between enough morphine to keep her from knowing where she was, or deep pain. The night before she died, she finished correcting the last of her student's papers. We think she may have dislodged an oxygen tube in her sleep, but also, she'd fulfilled her last promise and it was time.
posted by Karmakaze at 4:22 PM on February 9, 2005


I work with terminally ill cancer patients. It's the sort of job you can either find incredibly depressing or incredibly enlightening. It depends on the day.

I think the advice in this article is spot on, but it's a lot for families of loved ones to accept, especially when the ill person isn't old. We have a very young patient with a new family of his own. His prognosis is very poor and he likely won't leave the hospital. His wife insists on the feeding tube, the full code status, the chemotherapy that can't help him anymore. It's heartbreaking to watch. He needs to go to hospice where they can focus on treating his pain rather than his disease, but that's a hell of a decision for a 20-something year-old soon-to-be widow to make. I can't blame her for her choice.

You know that tired old cliche line in movies that goes something like "he's hanging on because he needs you to tell him it's okay to go"? It's really, truly been like that for a lot of our patients.
posted by makonan at 4:35 PM on February 9, 2005


Signs that your loved one has entered this phase include:
Difficulty getting out of bed.


Oh God, I'm DYING!
posted by spock at 4:52 PM on February 9, 2005


Thanks...now I have something to look forward to opther than the Jerry Springer show.
posted by Postroad at 6:06 PM on February 9, 2005


This is both useful and painful right now. My wife's father is currently going through his last days; I just spent a couple of hours at the hospital, sitting vigil with my wife. I'll be going back in about two hours.
posted by FormlessOne at 6:10 PM on February 9, 2005


I'm pleased to see this information on the Mayo clinic site. I think it's a great service to caregivers who may not be able to get this kind of info otherwise. My wife died of melanoma 3 years ago, and the doctors just wouldn't come out and say that she was dying. We went from "we're about to try another treatment" to death in about three weeks. I finally realized that she was in the process of dying when I asked a question about her water retention on a melanoma mailing list that I was on, and another list member related the experience she had had with her husband, who had also retained water in the final week of his life. I still think of her and how grateful I was to find out what was going on and get some advance warning.
posted by smartyboots at 6:49 PM on February 9, 2005


This reminded me that I need to die young in a blaze of hellfire and glory.
posted by cmonkey at 8:02 PM on February 9, 2005


When my grandfather decided not to take another course of chemo for his non-Hodgkin's lymphoma, he knew he had, at best, two months left. He rented a hospital bed and had it installed in the back bedroom at his house, arranged all the finances with my grandmother (told her where all the insurance policies were, etc.) When he fell in the shower about a month later, he had to be taken to the hospital to be X-rayed for a broken hip. While he was in the hospital he wasn't totally aware of his surroundings, but he was pulling at his IV tubes and trying to get out of bed.

When his father died, he lingered some two or three years in a nursing home, and finally succumbed to sepsis from a bed sore, wasting his entire life's savings and forcing his heirs to sell his home and all his belongings to pay for his care. Even though Grandpa was only semi-coherent, he recognized that he was in a hospital and, I'm sure, thought we'd put him in there, and was panicked thinking he'd go the same way - which to him was the worst way to die.

Thankfully, his hip was not broken, and we were able to take him home where he died surrounded by his family some ten days later, peacefully and with dignity. It was hard on all of us, but we all got to say goodbye when we knew he still recognized us.
posted by mr_crash_davis at 8:13 PM on February 9, 2005


Ditto, FormlessOne. My father, at 59, has about two months left to live due to liver cancer. I visit him at home (we have a hospital bed installed) every other day and have a duffel waiting in my car when it's time to start a vigil. He starts on morphine tomorrow.

guanxi - in my father's case, there is some depression, but his changing diet (he eats only fruit now) has a lot to do with the changes his body is going through. He would love to eat, but just can't. Mostly because the cancer is running crazy through his gut. Anything that goes through his GI tract causes a spike in pain (he's at the point where there is never a break in the pain). His change in diet has less to do with mood and more acceptance in what makes him feel comfortable. Aside from his appetite, it surprises him how much his sense of taste has changed -- he almost gagged on a bit of Coca-Cola the other day (ironic, since he worked for that company most his life.)

Same goes for sleep - he either sits in pain for the day or sleeps most of it away so those few waking hours have more clarity. The hardest thing for me is seeing him in all that pain; I'd rather he sleep through it.

As macabre as it may seem, knowing what will happen is a great source of comfort. Information like this is giving my dad "permission" to finally put his needs (pain management) above our own, for once. And it alleviates a lot of the family's fears about what his final hours will be like. Fear is the big boogeyman to conquer, not death itself.

There are some outside members of the family who feel this sort of info is "giving up". But, my dad *is* dying and nothing is going to change that, so we might as well learn about it and be prepared. This isn't stopping me from visiting him as much as I can and I'm thankful that all family affairs, both financial and emotional, have been taken care of.

Treating death like a process doesn't make my father's life any less valuable. Knowing what you're up against lets you sort through a lot of the pain and concentrate on the time you have left.
posted by Sangre Azul at 8:31 PM on February 9, 2005


Such similar experiences we all have. Grandmother died at home, in her bed this summer and it was a very difficult experience. She had become frail, depressed, blind and stopped eating. We discontinued nutrition and fluids and she lived another 5 days. She was properly medicated (I hope) and, on the last day, told me that she was "shriveling up" and scared. I will always wonder, hers being the only death to which i've been exposed, if we handled it properly. She told me that she wanted to die for weeks before she did, but when the end came, It wasn't as peaceful as we'd hoped. Life is messy I suppose. Thank you, semmi, for giving me the chance to speak candidly about Grandmother's death. It was difficult then and I still think about it and wonder if I could have made her more comfortable.
posted by nanu at 8:46 PM on February 9, 2005


I just want to go like my grandfather, peacefully and sleeping.

Not all panicky and screaming, like his passengers.

/inevitable
//preemptive apologies for any offense

posted by yhbc at 8:49 PM on February 9, 2005


You know, I'm nineteen and have never had a death in the family. This article and its comments seem so distant from my experiences, but frighten me beyond belief.
posted by sian at 8:55 PM on February 9, 2005


yhbc: That was funny
posted by nanu at 9:14 PM on February 9, 2005


"Eating or not eating won't slow down or speed up the dying process."

That's ridiculous beyond belief.
posted by parrot_person at 9:20 PM on February 9, 2005


I think it's a clumsy way of broaching this sentiment -- My father has told me that "what has happened could not have happened any other way." That goes for his life and his impending death. I'm not going to waste my time wondering if a few scraps of apple will have bought or lost him a few days.
posted by Sangre Azul at 9:45 PM on February 9, 2005


Sangre Azul

My neighbor was diagnosed with liver cancer in November. We just found out about it a few weeks ago. 40ish father of two girls. We weren't close or anything, our conversations consisted mostly of "hey how's it going" as we both took out the trash on Sunday nights.

Last Thursday night, he went to bed and didn't wake up.

Thanks for giving me some insight into what was going on across the street, and condolences for your father when he decides it's time to go.
posted by Windopaene at 10:10 PM on February 9, 2005


I hope I don't die comfortable. Worst death imaginable. Ima keep clawing my way out of the grave like a zombie with his hair on fire.

Pain is the proof that you aren't dead yet...
posted by Osmanthus at 2:19 AM on February 10, 2005


yhbc: a much needed laugh in a thought provoking but very depressing thread. Thanks.
posted by chrid at 2:34 AM on February 10, 2005


Nothing kills a message board faster than folks showing up for news and discussion and finding therapy sessions in progress. You should really save it all up for your real life friends and health-care professionals.
posted by milovoo at 8:36 AM on February 10, 2005


sian's comment is the best evidence of how necessary this kind of information is. I was in my forties before I experienced a death (my father's) in any kind of real way-- holding his hand, giving him morphine, watching his eyes glaze, sitting by the bed when he became unconscious. Painful as it was, it was also a privilege to attend to him as his life ended.

My grandmother, by the time she was my age, had attended a number of deaths, starting when she was a teenager, and she had a whole store of knowledge about the processes of dying. I remember her saying once, "People get very restless just before they die, you have to put them back into bed", which is something borne out in this article. We often are, these days, ignorant of the stages of dying, as we are so well shielded from it. Thanks for posting, semmi.
posted by jokeefe at 1:35 PM on February 10, 2005


For those who are interested, he passed away at about 2:30 AM today. He went well.
posted by FormlessOne at 5:05 PM on February 10, 2005


My condolences, FormlessOne.
posted by damn yankee at 10:23 PM on February 10, 2005


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