Question about dying ....

  1. Hi everyone..I have kind of a strange question to ask...... for those of you who have taken care of a dying person....have you ever noticed the way their eyes appear before anything else gives you a clue that the end is very near????
    I am asking because my uncle is actually in the hospital as we speak and it isn't looking good at all..it's literally a matter of time...He has COPD, emphysema and was diagnosed with lung cancer in May of 2004....he has really gone down hill fast the last few months.
    Today he looked horrible...his VS were Temp 97.0, pulse 98, BP 94/58, RR 36 with alot of abdominal breathing, 02 sat 97% on 15 liters with a rebreather mask and his co2 level is 60...it was 75 the other day. I think my aunt said....
    His cheeks look kinda dusky/purply but the rest of his body..the arms & legs are pale......and when he lifts his arms up they shake like someone who has parkinsons...and one thing that really got my attention was the way his eyes looked...they are really dull looking and almost appear cloudy sort of...not nice & shiny & clear like a normal eye would look and his pupils look big.......... it really made me wonder if the end is alot closer than we realize...I mean they didn't expect him to last more than 24 hours Thursday from what my aunt was saying because he was so bad when he was sent to the hospital from the rehab place he was at, hoping to get better enough to go home,...his 02 level was 62% & lots of dyspnea there, which was why they sent him out.......yes he is a dnr because he doesn't want any life support or anything.......he really has a horrible quality of life at this point..........so am I seeing what I would describe as "death eyes" or can it just be from him not getting enough oxygen perfusion due to his over all condition????? He can only speak a little more than a whisper because his breathing is so hard & takes so much energy & he asked me what day it is today....so unlike him .......I really sadly hope that his suffering ends soon as it is so hard to watch such a thing happening to a person who was so independant doing everything...now he can't even sit up in a chair....and he isn't eating or anything now....but he has an iv & they were starting ppn nutrition tonight because of it......so basically I just wanted to know if the eyes looking the way they are confirm my suspicions......Thanks if anyone has any experience with this ...
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  2. 12 Comments

  3. by   jmgrn65
    I have seen a lot of dying patients have not noticed the eyes.
    As co2 climbs confusion sets in, as well as sometimes agitation.
  4. by   VivaLasViejas
    I'm so sorry your uncle is having such a hard time of things.

    To answer your question: yes, sometimes a person's eyes appear somewhat cloudy or opaque toward the end of life. You may also notice his cheeks are becoming more sunken in, and his body may even appear smaller. This is due to dehydration; in their wisdom, our bodies know when it's time to start shutting down the different systems, and that's why people stop eating and drinking. From what I understand of it, this process provides a sort of natural anesthesia, and is not uncomfortable in the sense that we would think it might be.

    You may also see mottling (where the skin turns a blotchy purple-grey) on the extremities and a waxy yellowish skin tone as death nears. I can't tell you exactly when your uncle's journey will end; no one can predict that with any degree of accuracy because each individual dies in his or her own time. I've seen people with O2 sats in the 60s go on literally for days, and I've seen others who were still conscious and speaking at 11 AM slip away seconds later.

    The best thing you all can do for him is give him "permission" to go; hearing is the last sense to fade, and sometimes people just need to hear that it's OK for them to take their leave.

    My thoughts and prayers are with you and your family. No matter how long you're a nurse, it's never easy to see a loved one go through this. May he be at peace and out of pain soon.
  5. by   leslie :-D
    i'm so sorry to read that he is struggling.
    it 'sounds' as if he has entered the terminal phase of dying, i.e., the s/s that marla suggested.
    i've always noticed the eyes of the dying, in that they appear 'distanced' when their physical body is shutting down.
    i'm sure there are many physiologic factors related to what you are observing.
    but speaking as a very spiritual hospice nurse, i've always perceived this phenomena to be part of the transitioning from 'here' to 'there'.
    not only are the physical parts dying, their souls are beginning their journey and so, the blank, distant look you speak of, is yet another sign they are about to die.
    these transitions can be a matter of minutes, hours or days.

    wishing you both, abundant peace.

    leslie
  6. by   gonzo1
    I am so sorry about your uncles illness. I have never noticed the eyes but I usually "pick up" a sense that I can't describe. I am right more often than I am wrong. That said I have had a couple of cases where I was sure the patient would not last the night and was still with us for several months. Giving permission to let go is a very kind, but very hard thing to do. In the end only God knows for sure.
  7. by   KellieNurse06
    Thanks everyone for the info, I will let you all know what happens...I really appreciate the input..it has helped alot!

    mjlrn.....regarding the not eating or drinking...he hasn't really eaten anything the last few days....and when I was there Friday I kind of got a little upset at my aunt but didn't say anything...she was trying to get him to eat & she got very short with him & actually said " I can't stand this anymore...you have to eat......I feel like smacking you, now knock it off"...I was very taken aback because I couldn't believe she could actually say that to him with everything he has going on right now.....all his energy is going into breathing for pete's sake, and imagine how he feels being like an invalid now pretty much....very very sad.

    My sister actually told me that she told my aunt she needs to tell him it's ok to go and my aunt was crying & said she can't.
    I really think that is making him hang on...it's so sad.
    I have never had someone close to me slowly dying in front of my eyes like this.
    My grandfather died when I was 18 but he had a heart attack & I wasn't there when it happened. This is the first time I have been through this..except for my daughter 2 years ago, but she ended up making it ...

    Anyway thank you all so much....I hope his suffering is over soon because it's hard seeing this happening......
    I'll post more later ...I am going to see him after lunch so I'll let you all know if anything else is going on & update...... Thanks so much everyone.....:icon_hug:
  8. by   TrudyRN
    Quote from KellieNurse06
    Thanks everyone for the info, I will let you all know what happens...I really appreciate the input..it has helped alot!

    mjlrn.....regarding the not eating or drinking...he hasn't really eaten anything the last few days....and when I was there Friday I kind of got a little upset at my aunt but didn't say anything...she was trying to get him to eat & she got very short with him & actually said " I can't stand this anymore...you have to eat......I feel like smacking you, now knock it off"...I was very taken aback because I couldn't believe she could actually say that to him with everything he has going on right now.....all his energy is going into breathing for pete's sake, and imagine how he feels being like an invalid now pretty much....very very sad.

    My sister actually told me that she told my aunt she needs to tell him it's ok to go and my aunt was crying & said she can't.
    I really think that is making him hang on...it's so sad.
    I have never had someone close to me slowly dying in front of my eyes like this.
    My grandfather died when I was 18 but he had a heart attack & I wasn't there when it happened. This is the first time I have been through this..except for my daughter 2 years ago, but she ended up making it ...

    Anyway thank you all so much....I hope his suffering is over soon because it's hard seeing this happening......
    I'll post more later ...I am going to see him after lunch so I'll let you all know if anything else is going on & update...... Thanks so much everyone.....:icon_hug:
    I'm really sorry for the suffering of your uncle, aunt, and you, and all of your family. It is so hard sometimes to let go. Try not to be too upset with your aunt. She is, after all, losing her (presumably) life mate. She is probably terrified and in at least as much misery as her husband is. As much as we don't want our loved ones to suffer, we also sometimes find it extremely painful ourselves to let them go. Some of us are not heroes and we don't want them to leave us.

    I pray it all ends soon.
  9. by   MrsMommaRN
    My thoughts and prayers are with you. I hope your aunt can see that letting go will be the best for your uncle. NOT the easiest but the best to end his discomfort. Bless you. Hugs.
    Kimberly
  10. by   KellieNurse06
    Hello, I went to see my uncle today but only stayed for about 20 minutes....he didn't want alot of people today because he wasn't feeling great (my aunt told me this morning) so I mentioned maybe I won't go today then..(she said he wouldn't care if I went...it's just my mother who tends to talk very very loudly)...so went....he has the ppn running in one arm and normal saling in the other arm. He actually talked louder today than yesterday..but just using the controls for his bed & answering his phone exhausts him..he said that to me when I was there... he looks pretty much like he did yesterday . The nurse was trying to shave him & only could do 1/2 his face due to him getting a little anxious when the mask is taken off even for a minute....so they are going to try to get the other 1/2 of his face shaved .....he was watching the Pats/Bills game & was doing ok under the circumstances.......he's coughing off & on & has a bit of congestion..probably his lungs getting fluidy...poor thing.....it's awful ...I just make sure I give him a big kiss everytime I leave when I go to see him...He is like my dad and always joked that I am their daughter, they just don't have the papers to prove it...lol...... My aunt stopped over my house this morning with my uncles sister from Florida, who flew out Wednesday & their Sister from Las Vegas did too because they know this is it for him & want to see him before his time is up.......so they are staying at my aunt & uncles house until whatever happens happens........ my aunt was actually in a pretty good mood today.....it's good to see her not upset even though it's a roller coaster with her.....crying, then ok....... I can only imagine.....
    Anyway I will let you know if anything changes either way...I have a big test tomorrow in school which I haven't had any ambition to study for with all of this going on....I am going to try tonight & hope for the best........thanks everyone!
  11. by   KellieNurse06
    Well today they started giving my uncle Morphine but I found out he has to ask for it if he feels he needs it...my aunt called to tell me they were going to start giving him some & I thought this is it today ...then I found out he has to ask for it if he thinks he needs it.......I think when he gets close to the end they will start giving it every couple of hours without him having to ask for it......I went to see him today & when I walked in he was sleeping , mouth wide open and I thought that was close to the end...but he was sleeping...he woke up & seemed same as yesterday. What I thought was really nice was that my aunt mentioned he misses their dog & the dog really misses him too...so the nurse came in to tell me they brought it to the nurse managers ttention & she said since he was in a private room & everything that we can bring the dog in to see him.......so I ran to my uncle & aunts house & got their dog & took her into see him......He was so happy to see her........ He also wanted me to clip his fingernails too , so I did that for him...He didn't even want my aunt to do it..he only wanted me to do it......cute huh?
    One of his friends came to visit him and my aunt tells the guy" This is my niece....the good one" lol......I got a chuckle out of that one.....because my poor sister....is she chopped liver??? lol
    He is back to talking in a whisper pretty much........nothing else has changed.......He gets aggravated though when my aunt keeps asking " are you ok" with every little movement he makes......he closes his eyes & shakes his head in annoyance...lol......I know when I am sick if someone does that to me it bugs the living crap out of me..I feel like saying " just shut up already" ...lol...he still has it even with stuff nearing the end....... I will be surprised if he's still here by Wednesday ......hopefully he will go very peaceful in his sleep or just be so out of it that he isn't aware. He definetly knows his time is close though.......His eyes now look sunken in, they didn't yesterday......and I was looking and his arms still look ok...no funky color changes....yet. Well I'll keep you all posted..... I have clinical tomorrow so hopefully I won't get "the call"...but if so that's the way it goes, right?
    Last edit by KellieNurse06 on Oct 23, '06
  12. by   KellieNurse06
    hello...today my uncle died at 1230pm. I was at my clinical yesterday and got a call that he didn't have long..so I left to go there...... He hung on until today....and my aunt (his wife) was eating her lunch in the room because she was afraid to leave in case..and about 10 minutes after she was done he passed on, and there was really no warning ...he literally just stopped breathing and we waited for another breath that just never came...I went to get the nurse who had him & she came to check him, and he still had a pulse when she checked....so we left the room to let my aunt be alone with him...and when we all went back in, the oxygen mask and everything was taken off so we knew that it was definetly over.......
    He was very comfortable and it was just a very surreal experience .
    I am happy he is no longer suffering because that was 10x worse than what I witnessed today.he was out of it pretty much yeaterday but occasionally he would answer us with a nod or a little sound, and sometimes his eyebrows would raise when we talked to him. He even waved his hand as to say no when the nurse came in to give some morphine last night and said to him she was going to give him some. My sister was there but I had already gone home then.....
    Anyway he is now at peace with no more suffering like he's been doing the last few months...it is sadly a blessing to know he is fine now wherever he may be.........Thanks
  13. by   MS._Jen_RN
    Quote from KellieNurse06
    hello...today my uncle died at 1230pm. I was at my clinical yesterday and got a call that he didn't have long..so I left to go there...... He hung on until today....and my aunt (his wife) was eating her lunch in the room because she was afraid to leave in case..and about 10 minutes after she was done he passed on, and there was really no warning ...he literally just stopped breathing and we waited for another breath that just never came...I went to get the nurse who had him & she came to check him, and he still had a pulse when she checked....so we left the room to let my aunt be alone with him...and when we all went back in, the oxygen mask and everything was taken off so we knew that it was definetly over.......
    He was very comfortable and it was just a very surreal experience .
    I am happy he is no longer suffering because that was 10x worse than what I witnessed today.he was out of it pretty much yeaterday but occasionally he would answer us with a nod or a little sound, and sometimes his eyebrows would raise when we talked to him. He even waved his hand as to say no when the nurse came in to give some morphine last night and said to him she was going to give him some. My sister was there but I had already gone home then.....
    Anyway he is now at peace with no more suffering like he's been doing the last few months...it is sadly a blessing to know he is fine now wherever he may be.........Thanks
    May you and yours find the peace of mind and strength of soul to carry on living as he would have you live.
    ~Jen
  14. by   nicolel1182
    so sorry, glad he is at peace

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