I am currently a senior working on my RN degree and then plan to move into my CRNA. My nursing and personal life have come together as my maternal grandmother is in the process of death at this very moment. I am going to see her tomorrow and have learned so much about the fact that some folks feel as if they need "permission" to die...reassurance that their loved ones will be okay and that someone is awating them once they make the transition.
One of my professors spoke about end of life care eloquently and made me realize that if I can help my grandmother let go then it is one of the greatest gifts I could give to her. Her eyes are empty. She is 87, suffered first a TIA and then a stroke about a month and a half ago. We moved her from Florida to Vermont, thinking we could take care of her. She was confused and could not be left alone. A week later she was admitted into a rehabilitation facility. Now she is in the hospital and has pneumonia and they are saying she is suffering from some heart failure. Her appetite is gone, she sleeps during the day and is awake all night, fitting, pulling at her foley...just fidgeting.
My mother said that while she was visiting her yesterday that my grandmother was having a conversation with someone as if she was on the phone only no one was there. Also, several times, she reached towards the ceiling. My mom thinks she was talking to my grandfather. She also mentioned that my grandmother's eyes are empty and that she is completely out of it. My mother is trying to prepare me for the sight I will see when I walk into her room tomorrow. I am starting to realize how different it is to care for someone when you only know them how they are as your patient.
The thing I need help with is that I want to be able to support her and let her know it is okay to let go. To let her know my grandfather is waiting for her and is looking forward to seeing her. I got the sense from her previously that she felt a bit of an obligation because my mother and I did so much to prepare a room for her in what was an office at my mother's house. That we put so much emphasis on holidays and how great it would be to have her in Vermont for a change. I will spend the entire day with her tomorrow, trying to feed her ice cream and rubbing her back. I will bring her rosary beads and a photo of my grandfather.
It is so diffifcult when having to do this for someone I love. My mother is emotionally exhausted and this will fall onto me and I want to do things the best way I can for my grandmother. If I can comfort her and she lets herself go while I am holding her then that will be a great privlege. Even if she lets herself go later that evening, I just want her to know it is okay. She is DNR, DNI, only wants pain measures taken...her body is shutting down, how can I help her?
Specializes in psych, long term care, developmental dis.
I am sorry to hear about your grandmother. When I was a young nurse death and dying was not something that was taught. We kept our dying patients away from others and we frankly, they were left alone alot. What I have learned is such a blessing. How that hearing is the last sense to go, talk with them, hold them and love them.
My grandparents helped raise my sister and I. My grandparents always told us they want to die with dignity and respect. They did not want to be placed on machines, just kept comfortable.
My grandma had alzheimers. She also developed a tumor on the side of her face which the doctor said should be removed as it was causing her pain. At this point she could not remember any of her family, etc.
The tumor was removed but after surgery she had "forgotten" how to swollow. She was unable to eat of drink. We kept her on IV's for another 24 hours and had those removed also. We had a heparin lock for pain medication. My sister and I stayed with her for 10 days day and night. (Side note: while working as a aide, we had a patient die. I was opening up the window in this persons room when the funeral home director came to pick up their body. He asked me why I was opening up the window and told him to get fresh air. He told me that in the "old" days people would open up the windows for the soul to leave and go the heaven) My sis and I would read to my grandma, sing to her (my sister even said "grandma, Deb's singing off key again) talked with her like she was still with us, which she was!, we turned her, combed her hair, gave her oral care, etc.
On the evening that she died it was raining outside. I had just laid down in the bed next to her and my sis was singing to her. She was singing "when you wish upon a star." Grandma quite breathing. My sis called me and we both gave Grandma her last kiss and said "I love you". Then my sis told me "now Deb, open the window so Grandma can go to heaven.
We went home that morning with a rainbow in the sky. What a gift!!
I hope your Grandmother will go to heaven with someone singing and you are given the gift of a rainbow!!
My grandmother is currently under hospice care in my parent's home. I'm staying there too, until my wedding next year.
She was experiencing some dementia prior to becoming a hospice patient, and in the process of dying, it has become acute. The doctor visited yesterday. Her bowel sounds are gone, she hasn't eaten in three days, she has has an bowl impaction, her heartrate is irregular, and her respirations are shallow (her diagnosis is end-stage COPD). He told my Mom he would estimate she had about 3-5 days left.
Last night, my Dad (her son), told her he understood she was in terrible pain, and that it was okay to let go. She answered indignantly, "Let go of what?!?"
Does anyone have any advice on how to help her let go? Her body is clearly done. But with the dementia, I don't think she has the ability to understand and process that she is dying. If anyone has any advice, I would be so deeply appreciative.
the_PPK: is your grandmother on pain medication such as Morphine sublingual? Is she on oxygen?
It took about 8 days for one of my residents in LTC to pass away. She hadn't eaten for those 8 days, was finally on bed-rest with an air mattress (had to tell the day shift not to get her up), was positioned frequently, given oral care, eventually morphine...
But it did take 7 days for her body to completely shut down. For 2-3 days I would think "I don't think she'll be here when I come in at 11pm," and boy did she really stick it out. She was a strong woman!
I would keep on with pain management. Oxygen may also keep her comfortable. I would also suggest, like the above posters did, to share any happy stories or memories with her. She might not realize what is happening to her at this point. Keep her comfortable and share some pleasant moments with her...
Yes, she is on Morphine sublingual and ativan, along with a fentnyl patch. She is also on oxygen 24/7.
She is still with us. Her extremities are turning blue, and urination has ceased. She has not eaten in 8 days, and had no fluids for 2. Just mouth care.
Last night, we all sat around her bed, told happy stories/memories, sang to her, told her it was okay to let go, etc. She is what I would describe as semi-comatose. She is mostly non-responsive, but occasionally she will say something that is very difficult to understand. She no longer looks at faces, or will focus her eyes on us.
She is 5'8", and 98 lbs. No one can say she isn't a fighter. I think she's just going to have to let go on her terms. She's always been extremely stubborn, and I suppose this is no different.
It sounds like your grandmother is somewhat comfortable. When I know one of my residents is dying, I usually like to sit for a few moments and brush their hair a little bit, hold their hand, tell them "I love you,"
It really is wonderful that your family is so close to her. I've seen so many people die alone, and not even have family come in before the funeral home does. It's a bit sad sometimes, but you never know what the family is going through...
Bless you for being so caring of her and her needs!
Thank you so much. It's good to hear someone say that. It has no been easy, but as a family we have felt extremely convinced it is the right thing to do. I am extremely proud of us for doing this for her.
My Mom (a nurse now retired from patient care) sent away our 24-hour CNA's this morning, and is caring for my grandmother herself, seeing as how it appears we are in the last day or so.
When I told my Grandma last night all the stories, and how much I love her, I also thanked her for being my first patient. As she did in life, her death is teaching me so much.
There are no right or wrong answers here, You sound like you are doing as well as anyone can expect
As you already know, the situation requires a lot of love and patience- from everyone. This is probably one of the most difficult things you will experience in your lifetime.
The bond between grandmother and granddaughter is especially strong and will continue for a very long time after she passes on.
It is difficult to see her this way and any affection, understanding and love you can give her will benefit all of you.
As her granddaughter, you can not be her nurse,
Get professional advice - be it from her doctor or nurse or SW on what to do.
My prayers are with you, may you have the strength you need to deal with this emotional time.
Your parents will need you as well, be there for them.
hippylady7211
40 Posts
I am sorry to hear about your grandmother. When I was a young nurse death and dying was not something that was taught. We kept our dying patients away from others and we frankly, they were left alone alot. What I have learned is such a blessing. How that hearing is the last sense to go, talk with them, hold them and love them.
My grandparents helped raise my sister and I. My grandparents always told us they want to die with dignity and respect. They did not want to be placed on machines, just kept comfortable.
My grandma had alzheimers. She also developed a tumor on the side of her face which the doctor said should be removed as it was causing her pain. At this point she could not remember any of her family, etc.
The tumor was removed but after surgery she had "forgotten" how to swollow. She was unable to eat of drink. We kept her on IV's for another 24 hours and had those removed also. We had a heparin lock for pain medication. My sister and I stayed with her for 10 days day and night. (Side note: while working as a aide, we had a patient die. I was opening up the window in this persons room when the funeral home director came to pick up their body. He asked me why I was opening up the window and told him to get fresh air. He told me that in the "old" days people would open up the windows for the soul to leave and go the heaven) My sis and I would read to my grandma, sing to her (my sister even said "grandma, Deb's singing off key again) talked with her like she was still with us, which she was!, we turned her, combed her hair, gave her oral care, etc.
On the evening that she died it was raining outside. I had just laid down in the bed next to her and my sis was singing to her. She was singing "when you wish upon a star." Grandma quite breathing. My sis called me and we both gave Grandma her last kiss and said "I love you". Then my sis told me "now Deb, open the window so Grandma can go to heaven.
We went home that morning with a rainbow in the sky. What a gift!!
I hope your Grandmother will go to heaven with someone singing and you are given the gift of a rainbow!!