What do you say to a patient who wants to die?

[francine79]

This evening I took care of a lady who is suffering from severe anemia. I went to her room to encourage her to get in the chair for dinner. She adamately refused. I said to her, "It's important that we get you out of bed so that you don't get any sicker than what you are." She said I have to get sicker. I asked why. and she replied, "So I can die."

I was stunned, of course. I held her hand and said, "I understand that you want to die, but you don't need to get sick in order to die." She replied, "I have to get sick so I can die."

It was pretty hard hearing someone who sees no other way out. I understand she wants to die, but it's hard to accept this lady is choosing to die suffering from pneumonia or something else, when she could die peacefully, although maybe not as soon as she would like.

I guess I can understand a little now that I think about what I'm reading. She just wants to die as soon as she can. But I hate to think that it's going to take longer than she thinks. She still continues to eat and drink so it could take alot longer than she may think.

[iliel]

that's such a hard issue. No one can really understand the pain of someone who is sick.

We all should respect the choice of someone who wants to die. We don't need to condone it, we just need to be there and let ppl live their life as they see fit.

I think you did the right thing by letting her know you understand what she's saying.

My Dad has been very very sick, for as long as I can remember (TTP, Hep C, Heart disease, diabetes and now leukemia) I understand why he dosn't want to go through anymore treatments, it's not fair to have to live your life that way.

[wonderbee, BSN, RN]

That is such a good question. I don't think there is a solid answer. It leads to deeper questions such as how far one either helps or hinders one to die. It is a question we will all be faced with whether we like it or not.

My mom is quite frail and suffers from dimentia. I hear her saying she wants to die but in other words. She say's she can't go on or can't take it anymore or that there's no reason to go on. I just acknowledge her feelings with a touch or a look of understanding. She says she wants to go. That is her feeling. The goal of her treatment is to keep her comfortable, not to cure. Under those circumstances, I think it's just best to help them pass by supporting them through the process without trivializing their experiences.

If the goal of treatment is cure, then acknowledgement of the current situation and gentle re-direction to the business of living would probably be in order.

Just my opinion. Not a professional one but one from the heart.

Kathy

[Carolanne]

I heard that statement a lot when I did my nursing home rotation and it is an awkward situation, to say the least. I think there just comes a point when a person feels so ill and so drained and depleted that they have come to accept death as a process which will relieve them of all of their sickness and pain and they are actually looking toward it. I ran into the same situation quite a bit, trying to encourage a pt to eat their meal, and they said they just wanted to go back to bed and die. I try things like "I understand how you must feel, but perhaps a little dinner will make you feel a little better right now. The food certainly looks delicious tonight." Sometimes it works, sometimes it doesn't. Just do/ say whatever seems appropriate at the moment.

[Jennerizer, ASN, RN]

I've run into similar situations also & have found that one day they may be willing to give up their life, but the next day--they are much more alert & oriented & have a different attitude. Sometimes it's the disease that is wearing them down, other times it may be the medications or a combination of both. It sounded like at the time, she wanted to talk to someone about how she was feeling. It was good that you were there. I've seen often times how the care giver doesn't even acknowledge what the person is saying, they simply want to sit them up to eat & get out of the room as quickly as possible. It's great that you took the time to hold her hand & speak to her. You're probably one of the few (if any) that took her concerns to heart & that means something.

[NurseWeasel]

Unfortunately I've been in that situation too (as a friend, family member, and nursing student / assistant). About all you can do is hold their hand, acknowledge their frustration, pain, fatigue, or whatever, and listen to them. Just being with them and truly listening while they vent will often times help, even if they don't show evidence that you've made a difference. You just gotta know how frustrating it would be to be hurting, and sick, and old... you know? Yet we can't push them over the edge, either. So a little TLC, therapeutic communication, and touch therapy is pretty much the extent of what you can do... ((hugs)) to you and your caring heart.

[nurse2be in ny]

I worked as a psych tech for four years, and in the course of that time I talked with quite a few patients who were suicidal, either actively or passively. Lending a caring ear does help much of the time, not trying to offer solutions or advice, but simply being there and hearing what they have to say. And I know from personal experience that sometimes problems and pain (mental or physical) can be so overwhelming that you feel totally alone, and simple human connection sometimes works wonders.

[renerian, BSN, RN]

After a long battle with cancer, my dad said this to me. I told him I understood and I would be there to support him while he was so ill. I listened alot. Maybe a social worker or counselor can get her to let some of her frustration out.

renerian

[Lorus]

Its good to think about the big picture in these situations. Ill examine that patient's circumstance and then ask myself (and the patient) -what would make them say that to me right now? What do they need? Are they having pain? How can i help? Sometimes statements like this are mentioned as an attempt to reach out in some way. For what? Like Nurse2b in ny said, lots of times people in this situation feel very alone and all they want right then is for someone to listen, or just to be physically present. Sometimes people actually need permission to let go- to be told that its ok to die. Empathy, communication, and patience are key in situations like this. -Lorus