First death....

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I work in a dementia unit at an assisted living. We had an 88 year old dementia patient, total care, likes to talk to herself a lot etc. the other morning we noticed she didn't look like she was feeling well, a bit pale and quieter. Staff had taken her bp and got 160/116 hr 76. From previous experience with this resident I know her bp can be off sometimes as she often shakes her arm a lot. I retook it myself within half hour or so of the staff taking it making sure to keep the arm still and got a reading of 117/70 hr of 50 ( her pulse often ran low). Sp02 was good at 97%. At breakfast she picked her food and drink up as she would usually do. Didn't eat as much just seemed tired. We laid her down until lunch. At lunch she still seemed a bit tired but had perked up and was starting to talk more like herself. She still didn't eat great but her color looked better and she seemed more awake. I had called her daughter that morning to let her know she wasn't feeling well and she was going to visit that afternoon. After lunch around 230 I get a call from staff that she was unconcious in her wheelchair and had died. I was in utter shock. Not even thirty mins prior she was talking to us and acting like her regular self... I've seen patients go through the stages of dying but never like this. I feel like there's something I should of done. As she started improving through the day I was less worried. I was going to double check her bp again right before they called me. I just feel terrible.

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Specializes in Gerontology RN-BC and FNP MSN student.

Don't feel terrible. It sounds like it was her time. Losing patients never gets easter. It always a bummer...unless they were suffering and or in pain. Even then it's still sad.

You called the daughter. That was a very good move. Give your self a break it happens.

I've lost patients who were exhibiting the exact normal behavior they always present and turn around and they've passed. Of course know if you need to do CPR or not, otherwise just prepare the body to be presentable to the family when they get there.

Place chairs by the bedside so they can sit by their loved ones before the morgue picks them up. Which you probably already found out. Sorry you had to go thru it...but it's part of our jobs. (((HUGS)))

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Specializes in LTC, assisted living, med-surg, psych.

No, there was nothing you could have done.....it was simply her time, that's all. And how wonderful for her that it wasn't prolonged and painful!

I know that first death is tough. We tend to torment ourselves with "what if I'd done this" or "what if I hadn't done that", when in reality we had no control over the situation. The Lord takes people in His own good time. You did nothing wrong, you didn't neglect her in any way. Rest easy. :yes:

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Specializes in Emergency/ICU.

Maybe it was her time to die? Without knowing her history, it's hard to say, but it sounds like not too bad of a way to go to me.

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At 88, to have a nice nap, a couple of yummy munchies, to have a few laughs, a little chat and for all intents and purposes slip peacefully away seems like a not too bad grand finale.

Beats many of the alternatives, and sometimes when it is one's time, it is one's time. She was sleepy, and she had a little nap, she had a few bites, and by the way you said "she was talking to US" seems to me that she was surrounded by people who took notice in her conversation. That is all very lovely.

May she rest in peace.

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Specializes in CDI Supervisor; Formerly NICU.
At 88, to have a nice nap, a couple of yummy munchies, to have a few laughs, a little chat and for all intents and purposes slip peacefully away seems like a not too bad grand finale.

Beats many of the alternatives, and sometimes when it is one's time, it is one's time. She was sleepy, and she had a little nap, she had a few bites, and by the way you said "she was talking to US" seems to me that she was surrounded by people who took notice in her conversation. That is all very lovely.

May she rest in peace.

Agreed. RIP ma'am.

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Specializes in Complex pedi to LTC/SA & now a manager.

Sounds like it was her time to die and it happened peacefully surrounded by people who care. Would if have made a difference if her family was there? I don't know.

My grandmother passed a week ago. She had just been cleaned up by staff in the facility. She was just shy of her 90th birthday. I was at work. Her eldest daughter was on her way to visit. My mom was home making literally arrangements to transfer her mother to my mom's home when she got the call. My grandmother passed freshly cleaned up, well cared for, her pillows fully fluffed, and a smile on her face.. Very peaceful. Since we couldn't be there holding her hand, it was the best option available.

Don't feel bad. There was nothing you could do.

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Specializes in Surgical, quality,management.

That sounds like a lovely way to go. RIP.

Have you ever heard about people getting better to die? There is no research but anecdotal evidence I seen it last week, a man that had metastatic cancer and unable to sit upright for 5 weeks suddenly was sitting up and out of bed, 3 days later he was dead.

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Specializes in Hospice / Psych / RNAC.
That sounds like a lovely way to go. RIP.

Have you ever heard about people getting better to die? There is no research but anecdotal evidence I seen it last week, a man that had metastatic cancer and unable to sit upright for 5 weeks suddenly was sitting up and out of bed, 3 days later he was dead.

This is common with people who are getting ready to pass. The burst of energy comes in all kinds of forms and all kinds of time frames. My step-dad had Alzheimer's and my mom and I were talking and I asked her what he had been up to. She told me he had got a bunch of tools and was reframing the door to his room. I told her to prepare because he was going to pass. 4 days later he passed in his sleep. It was his time...

I remember a lady who had been in a wheelchair since I knew her and one day I was told she had gotten out of her bed and ran down the hall...I told everyone she was going to pass and she passed 3 days later. It's very unusual not to have the "burst of energy" before passing :).

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Specializes in Medical and general practice now LTC.

Once something similar happened to me, I too work in LTC and client helped us with taking another client to their room and 20 minutes I was called to say first client had passed away, I couldn't believe it but when I saw her she was curled up in bed and had just gone to sleep. Obviously her time to go and she did a good deed before she went

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It sounds like it was just her time, and I also have seen that last spurt of energy right before a patient dies. Was her daughter upset that you did not notify her sooner? I think the patient was blessed to have passed so peacefully with those caring for her. Not much you could have done, she was talking to you earlier, when it seemed like she was talking to herself, she actually could have been having hallucinations. Sometimes whenever my patients said they were seeing angels I would watch them more closely because it gave me the fear that they were trying to pass. Their vitals may have been stable, but sometimes they know way before we do.

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Specializes in kids.

What a relatively peaceful way for her! They should all be that way. I'm glad you called the family. It was clearly her time.

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