A Dying Persons Tear

What Members Are Saying (AI-Generated Summary)

Members are discussing the presence of tears in the eyes of loved ones moments before death, particularly in the context of hospice care. Some users believe it is a physiological response and not related to emotions, while others express concern about the lack of training and awareness among hospice workers. There are also personal stories shared about witnessing tears before death and the impact it had on loved ones.

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. ?

Specializes in PICU, NICU, L&D, Public Health, Hospice.
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.

Specializes in Rehab/LTC, Post OH, Med/Surg, Hospice.

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.

Specializes in Urology, HH, med/Surg.

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.

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...

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.

Specializes in Rehab/LTC, Post OH, Med/Surg, Hospice.

Mothermarie,

I am the one who started this thread 4 years ago. It's been a long time since I've logged on, and I just happened to see my thread pop up, so I started reading the comments and came across yours. I am truly sorry for your loss and for what your sister went through. My heart goes out to you and your family.

I had only been a hospice nurse for 2 months when I posted this thread. I've been at the same inpatient hospice unit now for 4 years. The small single tear I spoke of I have seen many times since. It's never a tear that runs down the cheek, and is usually in one eye for some reason. It never appears to be from pain, or shortness of breath, and the person always has a relaxed facial expression. Several nurses I work with have seen this as well. Since we work at an inpatient unit, we witness this much more often than the home nurses would, because it seems to occur minutes or sometimes a couple hours before a person passes. All these years later, and I'm still not sure what causes the tear. I understand it could be physiological, but I personally believe there's an emotional reason behind it. I have 2 theories.

First, people who have had near death experiences always talk about how beautiful and peaceful it is. It would be very interesting to know if these people had this tear during their experience. My second theory is this: Many of my patients (when they were alert and could speak) knew they would be passing soon. People usually become very lethargic or unresponsive when they are close to passing and are no longer able to speak. I believe they are still aware though, and that tear may be caused by them being sad because they know it's time to leave. Yes, I am sorry they feel sadness, but on the other hand, it is the intense love they have for you that makes them sad to leave. This is something I explain to my family members who are afraid to say good-bye to their loved one because they feel they will cry too much and make the patient feel bad. You cry so hard for them because you love them so much. It's an absolute blessing to have someone you love so much that you don't want to leave them. Tears are proof of that intense love.

Like I said earlier, it could possibly be physiological, but most of my patients are dehydrated and their eyes are very dry. Some people even keep their eyes open, so they are excessively dry. I've seen single tears in these people as well. Something I'm sure of though, is that the single tears I've seen were definitely not due to discomfort or physical pain.

You also spoke about hearing being the last sense to go and for how long. I am a firm believer in people being able to hear until the end. The reason why I believe this so strongly is I've had several people who were completely unresponsive and waited until their family left before they passed. Family would be at the bedside 24/7, and they step into the bathroom for 5 minutes, and the person passes. I've also had people hold on when it looked absolutely impossible, and less than 5 minutes after the family arrives the person passes. We have all seen it too many times to be coincidental. If I'm alone with someone when they pass, I always assume they can hear me and wish them a peaceful journey.

Specializes in Palliative.

Oh my goodness I love this idea! I work on an inpatient palliative unit and I've had a couple with a single tear. It's very moving.

On 12/24/2015 at 8:15 PM, tpeach03 said:

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.

Recently I lost an uncle. His death was unexpected but in his last few minutes of life he said he wasn't going to make it to the hospital but that he didn't want to die.  He shed tears. He died in a cousin's arms ? I am sad and more now because he died crying.  Could it mean he was sad that he left his mom behind? He was my grandma's sole caretaker.

tpeach03 said:

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.

Your father will have been happy you were there with him, my mum (she had dementia and cancer) passed away and had a tear in her eye a few moments before she passed away, there was just my younger brother and I there with her at the end. We were closest out of us 4 siblings, everyone in the family had been to visit, she did not seem sad even with the tear so it wasn't upsetting, I could feel it was because she loved us and knew we were holding her hand 🥰 hope this helps x

Specializes in BNAT instructor, ICU, Hospice,triage.

I am an old RN and have experienced 30 plus years of ICU and then hospice so LOTS of deaths!  And many many many patients do tear up in the end.  My own mother was 44 years old when she died when I was 16 years old from colon cancer and she was on hospice.  She did cry when she passed, we were all at the bedside, she had been unresponsive for a few days, but when she stopped breathing my grandpa just broke down and my mom also cried.  It was a sadness to leave us but also a happiness and joy to meet her new life of graduation.  

I have gone through the responses because, it was a question I had as well. 

I have come to the conclusion, until it can be explained better,  that this is a phenomenon associated with dying. I would go further to say, that, this is a sign post of active dying. 

I was prompted to research the last time, I saw my mother who was unresponsive at the time, a tear fell from her left eye. I wiped it and said to her, I will come to give you a bath in the morning.  The neighbouring patients told me that within 5 minutes of my departure, my mother died. 

When that tear fell, I was telling her all who send their love and that I was going to be there for her and expressed my love for her.

She knew I wasn't co.ing back to see her alive. I just wished she told me that she was leaving.  

Having read these posts, in future. I will look at the tear as a signpost. 

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