When relatives ask how long will it take for them to die ?

  1. I have been nursing for 10 years and I still cringe when a family member asks "how much longer will it take for them to die "

    OR " do you know what time they will pass ? so you can call me and I'll come in and sit with them "

    I always tell relatives that we do not know when someone will die .
    We can only tell them if a persons condition is unstable or they are getting worse.

    But they still ask again......can you tell me when ? how much longer ?
    What can you say to these greiving people that will not sound calous ? but also get the message through?

    I somtimes think they believe we have a crystal ball.
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  2. 20 Comments

  3. by   Ted
    I, too, still cringe inside when family members ask that question.

    When death is imminent (within a day or two or three or four. . . .) I basically say the same thing you say. No one really knows. I also talk about the dying process. . . what to expect as their loved one comes closer to their "final moments". In talking about the dying process, I sometimes add, ". . . after so many years of the body's living, it takes a while for the body to figure out how do die." "Prolonged dying" (sorry. . . can't think of another phrase right now) can be very stressful for the family after about three or four days from being told that their loved one is going to die "imminently". (I usually cringe when the doctor says that the patient's death is imminent because many times "imminent" may mean in a day or two or three or four or five or even six or seven . . . . or maybe the patient doesn't die at all - - - right away!! Had the happen a few times too! Had patients go home to hospice after their family was told that death was imminent!!! Go figure!)

    Good topic! Thought provoking. Death is always a sad subject to me, though.

    Regards,

    Ted
  4. by   P_RN
    I sometimes wonder if TV and novels have something to do with the notion that death works on a timetable.

    I've heard MANY people say something like "the doctor told him he only has 3 weeks to live." Incredibly, on occasion they seem to resent if the person lives longer .
  5. by   Beetlejuice
    Here's how I respond to people who ask this question. This is an opportunity to exercise some of those theraputic communication skills. Be prepared to listen. Ask probing open ended questions such as "It sounds like it is important for you to be with them during their last moments." Some helpful theraputic phrases include "No one can pinpoint the date and time someone will die."

    "We don't expect you to stay at the bedside at all times although you are welcome to spend as much time as you like. We will certainly contact you should we notice significant changes."

    "You have no reason to feel guilt if you cannot be at the bedside at the time they pass."

    "We are taking good care of XXX and are keeping them comfortable."
    There are other experts out there that you can tap to assist you such as pastoral care/social work etc. Bottom line: get to know these people. You will usually uncover some underlying issue that caused them to ask such a question. This is the essence of family centered care...and it is not easy.

    cheers,

    Dan
  6. by   Rustyhammer
    Welcome to the boards Dan.
    I too handle it as you have mentioned. I also let them know that it is ok to talk to them and let the pt know "it is ok to go". I have seen comatose pts. hang on til that last son or daughter shows up at the bedside.
    -Russell
  7. by   cargal
    A nurse in my first year shared what she said and I find it very helpful to families. "There's only one person who know that answer to that question, and that is God."
  8. by   Ted
    Good points made on these posts. It's so sad to see families extremely fatigued while they post vigil around their dying loved one. Again, good points expressed. . .

    Ted
  9. by   KarafromPhilly
    One LOL's daughter I came across was upset about her mother's preoccupation. Two years and eleven months earlier, this LOL had asked her doctor how much longer she would live. This goofball said, "Oh, three years." She was trying to wrap up any loose ends because her doctor had basically told her that she was scheduled to die next month, and she believed him. She was in for something relatively minor, and I never found out how it turned out.
  10. by   MikeRN111
    A very appropriate question for this forum.

    As a nurse in a critical care step down unit, we are involved in withdrawl of treatment for all too many of our patients and allow these patients to "let nature run its course" and let them pass with dignity. Invariably, the question will come up, "when is mom going to pass way?"

    I found that many of my coworkers including myself had difficulties early on with this. It was only after addressing our own fears and concerns, was I able to fully help my patient and the family through this extrememly difficult part of their lives. Being able to understand that death is as natural a part of the life cycle as birth is one thing but to discuss and explain that to a grieving family member during an emotional period is another.

    Having had many close family members pass away myself, I have been on both sides of the fence as it were and it has made me a better nurse for it. People feel at this time so completely helpless, feeling so totally out of control in this whole process. I often tell the families that yes, "only two people know what is going to happen and one of them is laying in that bed. The other is up there and he is not telling us right now." I try to quickly dispell any thoughts that some other clinicians may tell family, that we do not know "how long" it will take and speak to any clinicians, telling them that this is not the appropriate response to families questions and concerns.

    It is often at these times that I feel that I am really doing something as a nurse because I know that many of my patients will not "get better" and that it is OK to sit with an elderly woman's side, hold her hand while her husband of 50 some odd years is passing and laugh, cry and say a prayer with her and her family over the many wonderful years they have spent together.

    Thank you for this discussion.

    Mike
  11. by   pebbles
    ... agree with all of the previous responses.

    We always have to consider the family as well when we provide care - they are trying to plan their lives, work, kids, etc... it is hard to wait for something so terrible and not know when. Can't put life on hold forever, but what to do...? Often when I am asked this question, it comes from fatigued family who have posted vigil for a while... or people who legitimately want to know whether they can go to work or travel. They want to be their for their family member, but they have other obligations too. I often say something like "when it will happen is out of our hands now, but I'd suggest you take the time off work... thats just work, this is your family." People always agree with that... I try to help families co-ordinate their schedules so that they take turns or have ways to reach each other. That way they can at least get the rest of life's business out of the way.
  12. by   nursenoelle
    I am so glad to have read this thread. Just two weeks ago a family member of my dying patient stated " there are a lot of people that want to be here when mama goes, can you tell me when it's gonna happen ?" I have never been put on the spot in such a way. Luckily, I was aware of the families' faith and said, " It is not up to any of us down here, the only thing that I can tell you as fact as that she is being made as comfortable as possible, and her vital signs and heart rate are not stable....." etc.

    I also try to remind families that when they are sitting at the bedside that thier loved one may still be able to hear them. This seems to bring some comfort.
  13. by   MK2002
    People ask when a loved one will die because TV and movies have wrongly influenced their minds. The overall population believes that they will be at the bedside at the moment of death, and that this is what they are supposed to do. Being there at the final moment does not occur in the majority of cases. Yet it is what most people have come to believe because of the media. So they ask "When...?" with the hope that they will be there at the last moment and that somehow this will make things better. In actuality it will at least temporarily make them worse for the relatives.

    When my father's condition had become hopeless my mother was told that he would die within 3 days after receiving his last dialysis treatment. This news brought a sense of closure to my mother and myself. It helped us rather than hurt us. We had to face the future and the fact that nothing more could be done. My father had suffered a lot in his final year, and now it would end. I can honestly say that knowing when the end would arrive was better than constantly wondering "What next?"

    With the above in mind you might consider advising relatives of some general time when you know death will arrive, but explain to them that there is no way to know exactly when--or sometimes exactly why. Similarly, explain to them that most relatives are not at their loved one's beside at the last moment, no matter what TV has led them to believe.
  14. by   jemb
    When I was a very new grad in the early '80's, I received a call that my mother was very ill and not expected to survive. She was on the other side of the continent, and I was still scraping by financially recuping from being in school. I called the hospital and asked her nurse if I needed to come right away. (I guess that's a variation on the question of when will it happen.) She very patiently and kindly replied, "It doesn't look good -- probably sooner rather than later -- but the doctor is still working with her. If you haven't seen her recently and want to see her, you should come see her now." Many years later, I still appreciate that reply. Just thought I'd share my experience from the relative's side.

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