How long will someone surrvive after removal of life support? - page 2

by GeminiQueen

117,620 Views | 24 Comments

I'm not sure where to post this question, but I hope this is the correct area. My grandmother was removed from life support two days ago due to not having a DNR. I was certain she would pass within a few hours, but she is still... Read More


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    I hate when they tell people that it will be "less than 24 hours" once life support is removed. I have seen someone live 33 days with no nutrition! Sh had an IV of 0.9 @ KVO (20 at our facility) and that's it. It seems impossible, I know. The docs told the family "24 - 48 hours", but she was a young woman who took great care of herself up until her illness. Her family stayed with her 24/7 (we have no visiting restrictions d/t being oncology/hospice/palliative care). The first time they left her alone, on that 33rd day, she died. They went to the cafeteria to get some lunch (decided to all go together for a change), and she passed within 15 minutes of them leaving. People wait for the right conditions for them - soemtimes they want to see someone, sometimes they want to wait for an event, etc, sometimes they just don't want someone to be there. Everyone is different, and telling families that it will be a certain amount of time only increases their stress level. I can't tell you how many times I have heard people say, "she was supposed to have died 3 days ago", etc.

    I work on the "DNR floor" - if someone is made a DNR, they send them to us as qucik as they can. I think other floors that aren't used to it get flustered and don't know what to do with those pts - like making them a DNR means they will be dead within the hour. It just makes them uncomfortable.

    I'm sorry you're going through such a hard time. Unfortunately, people rarely get the hospice care they need in time - but if that hospital has a palliative care team, or a hospice program, ask them for a consult. They might be able to help your grandma be more comfortable, and they can provide support for your family. I hope everything works out okay for you, and that you can make her comfortable.
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    Quote from Focker
    I don't really understand why you think that would be a good thing to tell someone who is going through the death of a loved one. False hope is not helpful. People can linger on for varying periods of time, but a patient that is truly dependent on a ventilator and pressors at high levels, will die when they are abruptly removed.

    No, actually they don't always. I forgot, where were you in the room of my patient? Oh yeah, you weren't. I struggled all day to keep her MAP up, and had to add the 3rd pressor just to get comfortable. I'm not making this up, and I'm sorry if you don't like or appreciate facts. Talk to some of your fellow nurses. Many patients get discharged from hospice.

    The fact that I've been a nurse for 1 year and have seen it a few times should say something. In fact, I've had a few pts who were on levo and still lingered for days after extubation and dc'ing the levo and replacing it with a MS gtt.
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    I learned when I was a hospice volunteer, that people almost always pass when their loved ones go to sleep or leave the room. The hospice nurse teaching us said that many believe people choose their time.

    Peace to you and your family.
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    Quote from Focker
    I don't really understand why you think that would be a good thing to tell someone who is going through the death of a loved one. False hope is not helpful. People can linger on for varying periods of time, but a patient that is truly dependent on a ventilator and pressors at high levels, will die when they are abruptly removed.
    Just the other day, I had a patient terminally weaned, from levo and dopa, and the vent, and lived with a pressure in the 40-50's and a sat of50-60% for 5 days. This does happen. people die when they are ready. And yes, we've terminally weaned people off pressors and vents, and ended up sending to ltc for months. While these things are not the norm, they do happen.

    Sorry to hear about your grams. Prayers with you.
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    Quote from Focker
    I don't really understand why you think that would be a good thing to tell someone who is going through the death of a loved one. False hope is not helpful. People can linger on for varying periods of time, but a patient that is truly dependent on a ventilator and pressors at high levels, will die when they are abruptly removed.
    I don't see where you are seeing this person is being given "false hope".... I truly believe the old addage of when it's someone's time to go, they are going. If people linger on, it wasn't their time. I was always taught it is perfectly fine to tell someone "there's always hope"...........that may be all someone has.......it's a different story if the loved ones are being told...oh so and so may be ok, or it gets worse before it gets better.............that is what I consider false hope... I as well believe also that people hang on due to unfinished business or because they are waiting for an ok to go or to see a loved one before.......jmpo
    Last edit by KellieNurse06 on May 11, '07
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    Quote from first_lobster
    Just the other day, I had a patient terminally weaned, from levo and dopa, and the vent, and lived with a pressure in the 40-50's and a sat of50-60% for 5 days. This does happen. people die when they are ready. And yes, we've terminally weaned people off pressors and vents, and ended up sending to ltc for months. While these things are not the norm, they do happen.

    Sorry to hear about your grams. Prayers with you.
    Absolutely agree here 100%............My own daughter went through this 3 years ago......she was on dopamine/dobutamine, lasix, and a few others that I can't remember but they were all the heavy duty drugs to try to keep her going......but I remember she looked like someone who had a multi organ transplant from all the pumps hooked up to her.......she was literally on her way out...."it's only a matter of time, nothing more we can do for her" the docs told us.....and her lactic acid was sky high as well.......all from pancreatitis that turned to sepsis causing ards & multi organ failure. sats in 60's on 100% o2 on an oscillating vent, face as purple/red as can be, body swollen like the michelin man.......and she pulled through after 4 days like this and we were waiting for her to pass ( even with us all telling her it was ok to go on)........and we really thought that was the end. Even the icu staff was afraid to turn her for position changes out of fear her heart would arrest....................so I truly believe as well that when one is meant to go they will go when they are ready to...........The body & mind are amazingly strong with willpower. And I have witnessed it with my own eyes......the doctor who treated my daughter literally looked up at the ceiling when she opened her eyes for the 1st time after we saw her pulling through..and said to me " I have without a doubt witnessed a miracle here with my very own eyes. Someone or something of a higher power is most definetly watching over your daughter".............so for a doctor to say that is highly unusual.......I mean I even have pics of her going through this illness because I really though that was it with her......so I have actual proof, not just a story........
    Last edit by KellieNurse06 on May 11, '07
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    I have seen people go to the nurseing homes that were terminally extubated. I have seen some pass within minutes to hours. It is hard to say. I agree that at times that are waiting to see somebody. You may want to whisper in your Grandmothers ear that it is "OK" to go, they may want to hear you or someone else give them permission. Tell her you all are ok with her "passing".
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    I had a 92 year old on a morphine gtt.

    Comfort care only - pt. family refused to move pt. to hospice or nsg.home (Absolutely ridiculous! Tied up a private room on a surgical floor with a patient on comfort care!)

    All we were doing was assessing her pain, oral/foley/peri care. No feeds, fluids or meds. We were waiting for her to die.



    Well, four days later, LOL sits right up and in perfect English asks me for a cup of coffee!

    She was discharged that day and ended up passing away 10 days later (at home!)
    Last edit by Roy Fokker on May 12, '07
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    I'm sorry about your impending loss. I've seen immediate death to days. There is no rhyme or reason or prediction, it's very individualized.

    Roy, what a story!
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    Quote from Focker
    I don't really understand why you think that would be a good thing to tell someone who is going through the death of a loved one. False hope is not helpful. People can linger on for varying periods of time, but a patient that is truly dependent on a ventilator and pressors at high levels, will die when they are abruptly removed.
    I think they were just trying to point out that no one really knows. Yes, most people die shortly after being taken off but it really varies. The thing that needs to be reinforced is that recoverys are rare, so rare that they standout in our minds when we see one so that is why we talk about them.


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