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A dying persons tear

Posted

Specializes in Rehab/LTC, Post OH, Med/Surg, Hospice. Has 7 years experience.

Very curious about something. I'm new to inpatient hospice and have only had 4 deaths so far. Two of the patients had a single tear. One of those patients, the niece saw her previously unresponsive aunt open her eyes wide focusing on something in front of her (not looking at her niece) then took her last few breaths. That's when I arrived I saw her tear. The other nonresponsive patient that passed did not have anyone in the room at the time, so I don't know if he opened his eyes or not, but did have the same single tear. Is this common, and do you think they are seeing something so beautiful it causes a tear, or do you think it's caused by fear/pain? Thank you in advance for your responses. 🙂

gorgenurse

Specializes in Currently hospice. Has 14 years experience.

I do home hospice, but I personally have not noticed this. I would think it is more a coincidence. But who knows what they see? We have had patients who see angels, I heard of one who immediately looked up to the sky and raised both of her arms just as she died. I personally would like to think they are seeing their loved ones and Jesus welcoming them home.

Daisy_08, BSN, RN

Has 5 years experience.

I have worked palliative for just over a year. I too have never seen this. Did have one gentleman last month, that was unresponsive for a day or two, very confused and lethargic for weeks prior to that. However one night he he woke up, recognized his wife, kissed her, told her he loved her. Then quickly went back to being unresponsive, and died a few hours later. I have never seen a single tear though.

tewdles, RN

Specializes in PICU, NICU, L&D, Public Health, Hospice. Has 31 years experience.

ws582 said:
Very curious about something. I'm new to inpatient hospice and have only had 4 deaths so far. Two of the patients had a single tear. One of those patients, the niece saw her previously unresponsive aunt open her eyes wide focusing on something in front of her (not looking at her niece) then took her last few breaths. That's when I arrived I saw her tear. The other nonresponsive patient that passed did not have anyone in the room at the time, so I don't know if he opened his eyes or not, but did have the same single tear. Is this common, and do you think they are seeing something so beautiful it causes a tear, or do you think it's caused by fear/pain? Thank you in advance for your responses. 🙂

I don't have any idea why they might have a tear...

If I have done my job well, then I suspect that they are not in pain (spiritual, emotional, or physical) otherwise I would be expecting other evidence of the discomfort. We cannot know with certainty what our patients are experiencing at the end. We only know what our science, our faith, and our experience tells us.

In my opinion, we should hold tight to the perceptions and beliefs that give us hope and strength. My mom opened her eyes as she took her last breaths, and she too had a tear in her eye.

ws582

Specializes in Rehab/LTC, Post OH, Med/Surg, Hospice. Has 7 years experience.

I'm very sorry to hear about your mom. Thank you for all your input. I'm new to hospice and love to hear everyone's opinions/advice. I want to do the best job I possibly can and am learning so much from all of you. Thank you.

Perhaps what we have experienced is not the norm, but we have tear cloths for this very reason. If you google the term you will see that sometimes (not always or often) there is a single tear that we notice near the end of life. We keep small cloths (like beautiful handkerchiefs) in a special area of our comfort care home. When the nursing staff or volunteers are aware that there is a tear we make sure to have a cloth handy & give it to the family. They have all said how much they appreciate it and some have incorporated them into flower bouquets at a wedding or some such thing.

I think it must be the beauty of what we cannot see on this earth that causes such a thing to occur.

Karen

GinaDecorRN

Specializes in Telemetry interested in hospice. Has 5 years experience.

I have never heard of a tear cloth but what a beautiful symbolic token of remembrance. My mother was virtually blind at the time of her death but seemed to be seeing something beautiful the day before she passed. She looked at the blank wall as if she was watching a movie, eyes following ...something, she reached towards what ever it was and amazingly smiled. Mom had advanced Alzheimer's and had not shown facial expression in a year or more. She also spoke of my father (deceased 10 years), although she had long forgotten him. "Your dad is waiting for me to come home, I don't want to keep him waiting."

(goosebumps). She did not shed tears from what I remember. Only her family.

Hi, I've been searching for someone to talk about this. My Dad died on Easter Sunday of 2014. He had lung cancer. He was diagnosed 6 months before his death. My Loved my sister and I more than anything. The last week before his death he was in and out and sometimes very confused and sometimes not. On the Tues before his death we made a date ( Easter) to get together with him and bring our small children. He got worse as the week went on and stopped speaking. My sister arrived first and as soon as she started speaking a single tear ran down his face. She ask my stepmom if he had been crying prior to her arrival. She said no and looked confused. I arrived 1 hr later and my sister quietly let me know that he had let a single tear fall when she started speaking. I went and sat beside him, talking with him, telling him I loved him and we were all here. He let another tear fall. It broke my heart. He passed away a couple of hours later and it didn't happen again. It haunts me every day. I've cried about it all morning today. I wish he could've spoke to us that day. I feel he was trying to show us he understood and loved us. It was just too weird that it happened when my sister arrived and spoke and then I arrived and spoke.

In my experience, people commonly tear from one or both eyes when actively dying. This was always explain to me as a natural phenomena unconnected with psychological processes. But who knows? I think you can read into it whatever you like, however, I explain to my families that there is most likely not any emotional process behind it.

I've been with home hospice for 9 years now and I remember the single tear happened fairly often the first couple of years. I either haven't noticed or it hasn't happened in recent years. I'm usually not with the patient when they die however.

My mother died the end of May. Two of my 4 siblings had not spoken to her in several months. She had repeatedly tried to reconcile, with no result. I spoke with her on Sunday and she was very depressed. My oldest sibling has MS and had come to visit. However, he "self medicates" and his sleep pattern is off. Mother said that she was sitting alone in front of the TV and he was in the guest bedroom in bed with that TV on. Then she said that she was still wondering why my siblings were still not speaking to her. I was leaving the next day to see her, however she was admitted to the hospital with Pancreatitus that next morning and I was not able to get to her until Tuesday night. I had already been asked to give permission as MPA to place her on a ventilator earlier prior to my arrival late Tuesday evening Multiple organ failure, internal bleeding and a high fever were all present Thursday morning. They were forcing fluids but her kidneys were not responding. I made the decision to take her off of life support Thursday morning. One of my siblings that had not spoken to her arrived as did my brother with MS and three nieces. I allowed them to have private time with her before the nurse came in to turn the respirator off. I was the closest to her and had been able to communicate with her through asking her to squeeze my hand if she loved me, and twice she did! At the end, I had my forhead on hers and just kept talking to her. Everyone else was holding her hands. After the nurse called the TOD, I straightened up and there was one tear coming from her left eye where I was standing. Dealing with how fast things went and wondering if I made the right decision has been bothering me. I wasn't sure if the tear was a non voluntary response or an emotional one. She had been able to hear (hopefully) some apologies from her family. I am not sure if she was aware at that time or not. I have wondered if she was relieved that each of them had said they were sorry or she was sad that she was being taken off of life support. We are not sure if she had any awareness at that time or not. As they were turning off the respirator, the nurse said "she is actively dying on her own". This did and does relieve some of my guilt, but I will never know if that was just something Intensive Care nurses say to help families deal with that kind of situation. I guess "the tear" will always be there for me, I will never know why it appeared...

My father passed away this afternoon. I have been trying to find information on tears and came across this post. I know it is old but I'm hoping that someone can please help me to understand. My father never wanted to be in a hospital or inpatient care. He was diagnosed with stage 4 lung cancer, and I brought him to my house until the medicine that was prescribed was no longer managing his illness. Hospice and I tried everything, even increasing his morphine to a point where typical patients would be sleeping and in complete comfort. My father was a fighter though, and was very afraid of dying. This morning we decided inpatient care was the only place to be as he was struggling to breathe and was conscious while doing so. I was very afraid, seeing him in this condition and I struggled so badly deciding transferring him to inpatient was the best thing to do. I was told he would be hooked to an IV where he would sleep and no longer feel the pain and pass on his own time.

While in the ambulance for transport I spoke to him and consistently rubbed his head (as this is what he liked). At one point I noticed a tear in his right eye. I'm struggling to understand if this is because he was sad and upset that he was being transported to hospice. He was completely out (with morphine). I wiped his tear and continued to speak to him. Later when we arrived I noticed another tear. I'm so upset about this. I want to think this tear is a good thing, but when I think of tears I think of sadness and I'm so overwhelmed of the thought that he was saddened just before he passed. My father passed away only 10 minutes after we came to the room he was admitted into. I'm experiencing all sorts of emotions. My main emotion is that he struggled for so many weeks and I can't get over how sad he must of been just before he passed. I'm hoping this is not a tear of sadness but just a normal reaction to dying but I'm not finding anything on this. His sadness and struggle is killing me and hurting me the most during this time.

margin261

Specializes in Urology, HH, med/Surg. Has 15 years experience.

tpeach- My heart goes out to you for your loss. I've worked in hospice for a while but can't recall this happening with any of them.

As previous posters noted, it is more than likely a physiological response. But hearing is the last to go, it could be possible he was just happy you were with him at that time. Since he was sedated, he was unable to acknowledge you verbally or even to squeeze your hand. Maybe that was the only way to let you know that he knew you were there and he appreciated it.

Since you may never find out the exact reason/cause of it....maybe you can carry that one in your heart. You were there and he knew it and was comforted by it.

I'm truly sorry for your loss, try to take care of yourself.

I came across this blog as a result of my sister dying a few days of an agonizing and painful battle with bone cancer. A few seconds before she died she had tears in her eyes, starting on side and then the other. Her sudden change for the worst was unexpected and she was unprepared in many areas including family preparations. I know my sister had so many regrets including her treatment. She never caught a break in her life. She died young and suffered all through her life. This really was heartbreaking along with watching her in so much pain and horrific breathing during the day. Her moaning and struggling to breathe was very hard to take. I worry now that I may get PTSD.

I was searching for some answers and this blog popped up first. I have read the comments from "supposed" hospice employees who made comments like "haven't seen this" or "it's a "coincidence". After becoming even more heartbroken and becoming further depressed after reading such comments, I began to seek further information.

I have to say though, please forgive me in advance for being blunt and having a bit of an angry tone. Firstly, in my research, it is VERY COMMON when someone is moments from death who has been ill for a long time to have tears seconds before they pass. This is a natural response by the body. There is no emotional or cognitive association to this. It IS a physiological response.

I can only come to the following conclusions in regard to these comments where posters are writing that they never seen this before. My assumptions are that those who allegedly work in the field either haven't been in the industry very long, are on auto-pilot at work, are oblivious or lack any observation skills when dealing with the dying. If it's the latter, I really have to ask, "what are you really doing here"? Is this simply a job for you or are working here to help others? Are you blindly going on about your job without any care and attention and tuning everything out? That's not the kind of person I want to be assisting a loved one.

Secondly, to write "who really knows"? Well, is this comforting to the loved ones still alive? Science says tearing is a normal part of the dying process and the living should not read anything more into this. Regardless of your faith, if you have a faith, this kind of comment is not helpful whatsoever. The family is already in mourning and if they think in any way their loved one did not die in peace or has regrets, this may be one of the most traumatic events one can endure in their lives.

Thirdly, if someone dies in a hospice or who is receiving palliative care, the person has likely "left on their journey" soon after the heavy, heavy increase in narcotics to help the patient die more peacefully. The deep and struggling breaths is the body shutting down. The body becomes slowly colder and the the breathing between breaths become longer and longer until the both the heart and breathing stops.

Finally, based on some of the responses here, I am further disturbed by the lack of training given to palliative/hospice care employees in regards to the death process and what the loved ones may see. When we are told "hearing is the last to go". The real question I have is, "when is that"? Before the last breath? After a period of heavy sedation?

I truly hope my post helps others not feel guilty or sad about their loved one should they see them teary eyed moments before death.

Edited by Mothermarie

tyvin, BSN, RN

Specializes in Hospice / Psych / RNAC.

I've worked many years in Hospice and the patients are at rest; willing and wanting to pass (except for one and he wasn't crying)... I've never seen this tear. The family members cry and the patient might cry during goodbyes and family group. Have never seen this tear at passing.

It is usually the matriarch or patriarch of the family who is passing so tears on their part is unusual as this is a defining moment for them in front of people who they've raised and influenced their whole lives. They are experienced in life and have told me they want to be remembered as accepting and content to pass. There's that "I don't want to stress any of them, so I'll leave when they do" phenomenon, which is witnessed quite often.

Beautiful tear...

tyvin, BSN, RN

Specializes in Hospice / Psych / RNAC.

Mothermarie...I am so truly sorry for your loss. It made me very mad to read your post and at how unprepared the whole deal seemed to be. I've always worked for hospice agencies that are professional and don't allow the people to suffer if it can be helped. It all comes down to the doctor and the hospice team and their understanding and actions to ensure the patient's passing goes as well as can be.

I've never worked alone and for the most part have free reign as case manager and anything else I deem fit to help the person's journey. The fact that many of us do not witness the tears at death is a testament to the preparation that is done to ensure the patient's passing with dignity. In my experience if the patients is crying due to pain than that needs to be evaluated stat.

I won't work with families who limit medications toward the end for whatever reason and perhaps that is one reason I've never had to sit with someone suffering so intensely whenever I've worked actual hospice.

I've witnessed it, and yea, there are tears, and it's bad. I see how they let them pass with no help from hospice in LTC or SNFs, and that too makes me mad. I've held the trembling hands of COPD patients trying desperately to take a breath and eventually die from no oxygen...no morphine; looking straight into my eyes for some kind of help, some kind of relief...the docs too busy and the patients don't need it; I've heard it all...I've tasted the salt on my face. People drowning in their own mucous without any sign of a suction machine in sight...yea; I've seen those tears; I see them right now. This is probably the reason I will always have a suction machine delivered anywhere I'm working if I can. Also, the reason I am so bold with the docs now. They know when I call I won't back down until I get what I want.

I finally said I won't do this anymore...these people shouldn't have to suffer...this is no way to die. I needed control, and home hospice was the way for me to achieve that.

If the case is that bad, they usually don't opt to go home and pass like all my patients do. An in home hospice should be a manageable death; one that can be celebrated with family and friends, and if not, that's OK too, but still pain management is key. Yea, for the most part, I've had cushy areas where the worst it got was a death rattle, or bed sores. People pass and they are manageable deaths...suits me just fine. I got a lot of friends waiting for me on the other side. It took a long time for me to get here, and I'm going to keep assisting people to the other side. I've paid my dues.

I also think it's an absolute injustice for anyone like your sister to have had to go through with what she did. Do you have the answers you seek from her chart, or talking with her doctor about how something more could have been done to ease her pain? That's where I would start if you want closure about the events. There are some very bad hospices out there as well; people need to be careful and aware of their rights concerning all of this.

I understand you anger; you have a right to it. I think your sister would want you to grieve, but eventually heal and think of her with fond memories. Don't forget the pain, as that was part of her life as well.

My mom had the tears in both her eyes before she died. Her eyes were closed as she was comatose. I knew exactly what it meant. She didn't want to die. It's as simple as that. They were tears of pain.

I have worked hospice for several years and have noticed a tear on many of the patients. Usually just in the corner of the eye, not actually running down the face. I have always wondered about this, I know it's not a coincidence because it happens frequently, . Sometimes i am with them at the time of death holding their hand while they pass I know they went peacefully.

Edited by hiddenheart