I am working through different problems/issues with my grief. My Mom died in May - hospice in the hospital - CHF/decompensated cirrhosis from autoimmune hepatitis, cachexia, osteoporosis, stroke, etc. She was on a glucose IV drip since admittance due to hypoglycemia and liver disease.
She was admitted to the hospital on Saturday - the hospice decision was made Wednesday afternoon. I did not ask enough questions about the process. Mom had said her pain was 8/10, she could not take any suffering and was "ready to go". The GI doctor said without a feeding tube, she had a week or so to live. She did not want artificial hydration and nutrition per her advance directives, and the doctor said with ascites, etc., a feeding tube would cause more suffering and the life extension would be minimal.
The nurses started morphine while I went home to get clothes, etc. to stay with Mom. When I got back, she was semi-awake and able to talk, but not as alert as she had been before I left. The nurses said part was due to morphine, part to the dying process ( we ere told her ammonia levels, etc. were rising as her liver was failing, making her sleepy, lethargic, as well.) She stopped eating much a few days before her hospitalization and was having trouble swallowing. Anyway - by Thursday, she was seeing and talking to relatives who had passed, and went through several periods of restlessness - asking me to help her stand, sit, etc. continuously...after a while of this, she was given another medication to ease restlessness.
She passed on Tuesday - death rattle, changed breathing, etc. started early Monday morning. I fought with the hospice nurses because I wanted her to try to eat, drink and take some of her medicines...since she was on "comfort care", they did not want to - but I made such a commotion - they let me try to give her yogurt, ginger ale and her heart medication ... it did not go well...I got the pill down, but she almost choked - she pushed away the yogurt and got 1-2 sips of soda down. I kept the IV drip on the whole time, because that was the thing that had kept her from going into a coma-I felt like removing it was my killing her. The doctor said would not keep her alive, but it was ok as long as her body did not experience fluid overload or she had trouble breathing (she was on low dose oxygen).
Anyway, in hindsight, I am worried, that the morphine which made her sleepy/unresponsive, also prevented her from being able to eat, drink, etc. I worry that my not slowing it down, or demanding that she be more awake those last few days expedited her death by starvation, etc. As far as I can remember, the morphine started out being given about every 6 hours, then every 4, then 2-3 hours the last day or so... Being tiny ( 98 lbs) and having liver failure, I worry that this was excessive, and kept her mostly asleep from Thurs-Tuesday. I did not want her to suffer or be in pain as she was, but I did not want to expedite her death either. I worry that I did not tell them to slow/stop the morphine, or wait until actual death was closer before starting (they started w/o letting me know and said she was in pain and would suffer if the morphine was stopped). The nurses and I monitored her for signs of pain, etc.-if there was none, we skipped the dose, if she seemed in in pain, they administered. Please give me your input as to how "normal" this is, and if in fact, my Mom's death was premature due to her not being able to swallow, eat, drink or take her other medicines. I have a lot of anxiety and pain having been through the dying process with her - she passed peacefully in my arms the Tuesday after hospice started. Any help understanding if this process was normal would be appreciated...I worry I was not "aggressive" enough or allowed bad care, sped up her death, etc. by allowing the morphine.
My mom went on hospice after a fall in her nursing home. It was clear to my brothers and me that mom (CHF, stroke, repaired broken hip) was declining and that the decline caused the fall and not the other way round.
But after the fall (broke her wrist) she never rallyed or made any attempts to get out of bed as she had done in the past. She started making horrible grimaces as though she was in dreadful physical or psychic pain. Due to aphasia from the stroke and the fact that she seemed only marginally lucid, we couldn't tell what was going on. We called in hospice and they started her on morphine which seemed to ease whatever was going on.
Hospice let her down gently. And we were at peace with her being let down gently.
In the end, if she died Friday afternoon or the next Tuesday or even the following month made no difference in the world. What made a difference to us is that mom didn't suffer one needless moment of pain or anxiety at the end of her journey. This was about HER, not about us.
Without all of the interventions - the intravenous fluid, for example - your mother might have died slightly sooner. Without the morphine, she would have died in severe distress.
Certainly you should not worry that you were not aggressive enough. I am glad for both of you that your mother died peacefully in your arms.
She was in pain, was terminal and had no hope of recovery. She wished to pass peacefully.
In your shoes, I'd be asking myself why I was trying to play God. And why you tried to cause your mother additional suffering by attempting to feed her, give her medications that were not for her comfort and generally cause a commotion when the poor woman WANTED to die peacefully.
Maybe that IS actually what you are seeking forgiveness for.
I hope you avail yourself of Hospice's specialized grief counseling.
You've asked this question at least 3 times now. I am sorry for your loss and understand that 5 months is not at all a long time to be grieving.
But instead of berating yourself for something you had no control over, tell us something wonderful about your mom.
I know I responded to one of your previous posts and once again, I'm so sorry you are struggling so much with the grief thinking that somehow you would have been able to prevent it. It took me many years to get through my dad's death but, I faced it head on, sought all the help I could get by going to the hospice support groups, one-on-one counseling, went to the cemetery a lot and by reading books. I have a book about grieving the loss of a parent. If you want the information let me know and I will look for it (it's been packed due to moving).
I mean no disrespect when I say that we are not God. Everything is in His hands and in His timing. Nothing takes Him by surprise and He knew long ago how things would play out. Your hung up on the aspect of thinking you caused her to die - you didn't. What better way to have her pass away than to pass peacefully in your arms as hard as it was for you BUT, would have been a comfort for your mom. I know so many, many people who did not even get to be with their loved one when they passed away (especially during the COVID pandemic )my husband included. He feels awful about it but, he was extremely ill at the time. So there are many of us who feel terrible for one reason or another.
You did the best you could, you were with her during the whole process and it could be, you really didn't have a clear understanding of what happens to a person who is actively in the dying process. When you have a cold or the flu, you don't feel like eating but, have to force yourself and your body is still fully functional. How much more difficult would it be for someone to be "forced" to eat when their body cannot take food or drink in. You clearly loved your mother - many parents don't even get that from their grown children. Many die alone without someone advocating on their behalf. I truly feel bad that you are tormenting yourself. Even if you are going through counseling, until you reach the point of accepting that it was her time to leave this earth and that she let you know "she was ready to go," you will stay stuck indefinitely. Please don't do that to yourself.
There will always be some of us who think we didn't "do enough" or "wasn't aggressive enough" especially if it was the first death we've experienced and I don't know if that's your situation. Our bodies wear out, cars wear out, appliances wear out - everything wears out eventually that's the only point of using those as examples. Nothing or no one lasts forever.
I hope you will start giving yourself some mercy and grace just as God does.
You've been in my prayers and will continue to be - please take care of yourself now.
"To everything there is a season and a time for every purpose under heaven, a time to be born and a time to die; a time to plant and a time to uproot..."
Ecclesiastes 3:1
https://www.agingcare.com/questions/does-anyone-have-advice-on-how-i-can-learn-to-forgive-myself-and-find-mental-peace-462003.htm
https://www.agingcare.com/questions/i-feel-responsible-for-moms-stroke-heart-attack-please-give-me-some-advice-on-how-to-forgive-myself-459676.htm
https://www.agingcare.com/questions/how-do-i-cope-with-regret-for-denying-that-my-mom-was-dying-459665.htm
My mom is in hospice care for end stage CHF. I just had to start her on morphine today. She was so agitated and in distress with her labored breathing. She really hasn't eaten since Thursday. Hasn't drank anything much more than a sip or 2 of water. I strongly suspect we are near the end of her Earthly journey.
You did nothing wrong. You made all the right decisions. You gave your mom a peaceful, pain free passing. It's the last gift we can give to the people we love. Be at peace. You love your mom, and she loves you. She knows you love her and did what was best for her, rather than keep her longer, in pain, to delay your having to say farewell.
Hugs and prayers, my friend.
I'm sorry to hear that you are encountering what may be your mom's final moments of her earthly journey. You will be in my thoughts and prayers as well. May God give you strength to face what lies ahead.
I'm glad your mom has you during this time in her life - take care and hugs to you.
When the human body is shutting down, hunger vanishes. There is no desire to eat or drink; that does not come about due to 'morphine' but due to the body shutting down and preparing to die.
Here is a link to 'demystifying' the death process:
https://www.aurorahealthcare.org/patients-visitors/blog/what-happens-as-we-die-we-demystify-the-process
And here is another link which is a guide to understanding the end of life signs and symptoms:
https://www.crossroadshospice.com/hospice-resources/end-of-life-signs/
Hospice goes through the death process with their patients again and again. They don't do anything to hasten the process, nor do they rely on the family members of the patient to do anything............they allow nature to take it's course, and only intervene with pain meds as needed for comfort care.
THAT is what you need to understand so you can allow yourself to heal. Read the articles I linked, and anything else you can get your hands on, in an effort to let go of the situation which you had NO control over in the first place. You're going to HAVE to, if you want to get past this scenario that's going to ruin YOUR life, which is not what your mother wants. Think of how upset SHE is now, knowing that she was ready to go, but you weren't ready to say goodbye. And that you're allowing your life to be wrecked now as a result. In honor of HER, allow yourself to heal.
Well said and you gave "Laurabelle01" things in which to reflect upon as well as good resources.
I'm not criticizing you; my mind has been stuck in neutral as well, and I know the frustration of repeatedly questioning yourself w/o being able to accept the conclusions. It isn't easy to find a path out of this mental wilderness.
What has worked for me is to focus on the fact that suffering is no longer an issue, I did what I could at the time and made decisions I could. I'm not sure that in these situations any one of us makes decisions we don't at some time question or regret.
And I also wonder how much of that arises from lack of self confidence in a situation that's rare and fortunately isn't repeated on a regular basis. It's a unique situation. And I don't think it's unreasonable to question our actions. But at some point we have to make a decision and move forward, as there's nothing that can be changed now.
So, focus on your other talents and assets, gradually move back into the living world and make plans for the next steps, and the rest of your life. This isn't easy, and the guilt will still plague you, but doing something that builds confidence is I think part of the healing process, as you need to come to terms with yourself.
Becoming involved in charitable work and activities is also a big help, I think. It can produce positive thoughts and make you feel better about yourself. Sometimes I wonder if our own self perception is at the base of questioning whether we acted properly or not.
Think about it, and please tell us what your plans are now for the rest of your life. Please?
I really liked what you said - "What has worked for me is to focus on the fact that suffering is no longer an issue, I did what I could at the time and made decisions I could. I'm not sure that in these situations any one of us makes decisions we don't at some time question or regret."
I'm glad for you and that is something I want to remember when I go through this with my mom in probably the near future. Very good perspective!
I'm sorry for your loss, and more sorry for your obvious angst over how your mom's last days went.
People in hospice care (end stage, which mom was in) do not generally eat anything, nor do they want to. The swallowing reflex is poor and often they'll choke on even the smallest and smoothest of foods.
It sounds like you fought so hard to keep her here---kind of against her will. But in the end, she did die, and you are beating yourself up over it.
Being totally honest (and I do not mean to hurt your feelings) for what purpose were you trying so mightily to keep mom alive? I get it. Both my daddy and my FIL were in hospice at the end, and the natural desire is to keep them with us as long as possible--but if their choice is to exit this life with dignity and as quickly as possible--who are we to override those God-given rights?
Daddy was on whatever fluids he could swallow the last week of his life. That consisted of red popsicles. Anything else caused him to choke. The morphine eased his horrible pain and made sitting by his side calm and spiritual, instead of anxious and dreadful. We never once second guessed HIS decision to have hospice.
I'm not judging you. it sounds as if you made these decisions all alone.
BUT--don't dwell on it. Seems that you do believe in an afterlife (mom seeing departed relatives)..think about that and the glorious reunion with those people.
Take time to mourn, but don't beat yourself up over the 'coulda, shoulda, woulda's' that come with a death.
Your mom was going to pass, no matter what you did. If it gave her a couple more days and that makes you feel better, then take that and hold it close to your heart.
I hope you have some close friends, and family who will help you through this grieving period. I am sorry for your sadness..but this too, will pass.
Beautifully said and yes, this too shall pass as nothing lasts forever.
See All Answers