Life is futile, dead is dead, the other side

CCU NRS · Nov 25, 2004

I am sorry to hear you are going through this, I understnd how difficult it must be, one thing you said was "whjat if she is alert and screaming for me to keep her alive?" On the other hand what if she is alert and begging you to let her go? I know it is difficult for non-medical people I suffered these same things when my father was dying, I explained to my sisters that he would ot get better, as you said sometimes it is just too uch for the uninitiated.

God Bless you and your Family

pickledpepperRN · Nov 25, 2004

Oh Pam, this is so hard.

Thank you for your post.

There is no one like a mother. As you help your family, they will help you.

Nothing I can say you don/t know.

I am sorry

**canoehead, BSN, RN** · Nov 25, 2004

Traumamama, you know that it is time, probably past time, for her to slip away peacefully. This is the best, most gentle thing you can do for her right now. Let her know she is loved during the time you have left, and go easy on yourself.

Tweety, BSN, RN · Nov 25, 2004

Thanks for sharing, I'm so sorry you're having to go through this. Take care.

I absolutely understand that it's a process for families to let go or not let go. I never judge and allow people their time, even if I get frustrated. People don't have the daily experience and knowledge I do. And everyone has a story, or heard of a story of someone who was given up for dead, removed from life support and lived a happy life for years afterward. It's not easy is it?

Take care and best wishes for you and your family.

chris_at_lucas_RN, RN · Nov 25, 2004

No need to apologize for the length of your post, Traumamama59! Where else will you find the sort of shoulder or ear that you need at a time like this. If we weren't inclined to hear what you needed to say, we'd be somewhere else, right?

Love is so strong when someone we care about is hurting or challenged. It is hard to know what to do; and time and your own faith or sense of how things are, and what everything means on the grand scale will have a lot to do with how you view these last few days and hours.

Know that whatever you do, when it is done with love and sincerity, it is the right thing. I'm glad you shared with us, sorry that you are enduring this trial, and pray for you and your family that you, and your Mom, find peace.

renerian, BSN, RN · Nov 25, 2004

Pam,

I was in that similar boat in 99. My mom was very healthy and suddenly became gravely ill with necrotizing fasciitis. She went into surgery twice to cut off dead tissue. My sister was her DPOA over health care/had her living will. Despite getting 12 units of blood, many FFP, platelets, getting DIC you name it she became septic. She was on a vent/suffering. She was in horrific pain. I asked my family about turning off the vent. My mom did not even want to be on one but my sister gave permission to do that. Everyone told me they could not turn off her vent for the same reason you listed. You are not killing her by turning off the vent. If she dies fast (my mom died in less than 15 minutes) it is not because you turned off the vent. The disease it killing her and the vent is prolonging her death. Try to look at it is you are saving your mother from suffering. A very loving human thing to do to protect her from suffering. Once I looked at it that way I was 100% fine with it. I had to threaten a call to get together the ethics committee from the hospital to do that though. The Dr. there did not want to and refused to do it due to his religious beliefs so he called a resident to do it for our family. I signed the remove vent request right on her patient chart.

I hope this helps you find some peace in your mind while your thoughts are so complicated now.

renerian

rn_nj · Nov 25, 2004

Sorry to hear what your mother, u and your family went through. It is very difficult to be a medical personnel and know what is really happening to our most loved ones who are everything for us. The ache in ones heart is suffocating. I feel you took the right decision out of love and respect for your mother, though it is very painful. Your family took the right decision too from their point of view. Those who luv deeply feel hurt, but also settle differences and let go. With prayers during your, your mother's and your family's tough time.

I know there are a couple of threads regarding end of life and letting the patient go. I'm on the other side of that coin at this time. Tomorrow we are turning off the vent that supports my mom's respirations. She is 75, has Parkinson's and went in the hospital about 4 weeks ago with a perforated ulcer. Long story short, she got peritonitus, sepsis and is now starting that final decline. The surgeon has said all along that she wouldn't make it out of the hospital, and was looking at months of being in the hospital. She has had episodes of spiked temps, low BPs, and then episodes of seemingly starting to begin a slow climb toward getting better. I was down last week because Dad kept telling me that her lungs were congested. I knew from experience what that meant; she was going into CHF. At that time she would open her eyes and try to mouth words. They increased her diuretic and she seem to improve, so I went home. Well, this past week, my dad called me and read me off her lab latest lab values. Knowing too much the way I do, I knew that her condition was rapidly worsening. A call from her surgeon a couple of days later confirmed my worst fears, telling me that it was time to talk about letting her go; so here I am. Seven hundred miles from home. Yesterday when I got here and went to see her, I knew by looking at her that, as my brother put it, the clock was running out. She's jaundiced, swollen, and, to me, has a farway stare. She will react to some stimuli, when the surgeon took the vent off to see if she was breathing on her own, he told her to take a deep breath, she did; and she seems to respond sometimes when dad talks to her. But, we did "the whole nine yards" with her; let the surgeon trach her, put her on the vent and let the surgeon put a NJ tube in her for feeding. As long as she was able to look at me and try and mouth words, I was ok with that, feeling that she wasn't "gone" yet. When I saw her yesterday morning, for the first time I felt like she was already "gone." Dad told me that the kidney doctor wanted to start dialysis on her which would have required placing a shunt. As soon as I saw her I knew that didn't need to happen, it would be too much to put her through, and wouldn't help anyway. So I convinced my dad not to do that, and when her surgeon came in later, he told dad the same thing and explained to him that she was declining and wasn't going to come out of it, so we needed to seriously consider letting her go. If I had not been there, dad wouldn't have been able to make that decision, but I helped him see that it was for the best. We had them dc the IVs, change her meds to pain and anxiety control only and Friday we are going to have them convert the vent to just a trach mask and let her slip away. My brothers can't get here until then. I feel like I killed my mom making that decision. I know it's right, my head knows it's right, but my heart......what if she is still alert in her mind. What if she is in there screaming at me for letting her die? I guess the moral to this story, don't be too harsh on families that won't let go, or take every little good sign as a sign the patient is improving drastically. After my dad had told me about her declining lab values and I called my brothers to tell them that to start preparing for her death, my dad called me the next night and told me that had opened her eyes and looked at him! So of course, he took this as a hopeful sign and called one of my brothers to share the good news. When I called that same brother and told him that the surgeon had called and what he had said and that I was going down, he was devastated. He couldn't believe that she wasn't getting better since she "responded" to dad. So, sometimes when families don't undertstand medical things, even if the nurses and doctors are telling them that things are grim, sometimes they take the smallest good sign and make it into a hope for recovery. Don't be too hard on them. Sometimes it is lack of knowlege that keeps them from thinking that their family member won't experience a medical miracle. In my case, knowlege felt like a bad thing. Dad could tell me that mom was responding all he wanted, but I knew from the labs, xrays and reports from her nurse (God bless them all) that, in her surgeons word, the dominoes were falling. I hated knowing what test results meant. I hated not being able to share my dad and brother's enthusiam for her chances at recovering. Well now there will be no more lab tests, no more sticking her. She still has a gaping wound in her abdomen and there will be no more painful dressing changes. My head said that it's the right thing to do; my heart is breaking over it. I need my boyfriend here to hold me close but he is taking care of my son 700 miles away. I took off this weekend to be down here, so consequently I am going to be in the hole on my next check because I have no PTO time. I am on weekend option and have already used the few hours I have accured a couple of weeks ago when I was sick. I don't even know when I will get to go home, depends on when she does pass away, and what arrangements are made after that. I am so sorry this is so long. If you recognize my mom as someone on your floor or as your patient, I just want to say thank you for taking such good care of her. Thank you for being patient with me for asking a million questions that most families never ask, and thank you for answering my millions off questions. I feel a kinship with you for sharing information with me, that probably according to HIPPA you might not should have, but it did help me help dad make the right decision. My mom isn't in an ICU, but in an advanced care hospital which is actually just around the corner from ICU in this hospital, so thank you to the nurses, RTs, aides, techs, and anyone else that took care of her from both units. I really feel comforted knowing my mom was taken care of by such wonderful, caring people. I'm sure it was comforting to my mom hearing those soothing southern accents coming from the people that were taking care of her. Again, sorry this is so long.
Pam

Salty1 · Nov 25, 2004

I, too, am sorry you are going through this ordeal. Based upon the information you have provided, it is obvious you have made the right decision. You raised a question as to what if her mind is lucid and screaming, etc., etc. In answer to that question, I note that a Nephrologist was suggesting placement of a shunt for dialysis. Because of this, I would suspect that the BUN & Creatnine were elevated resulting in mental clouding and obtundation. Your judgment appears correct. God bless you.

Salty

mattsmom81 · Nov 25, 2004

I'm so sorry you are going through this, and I have been there. God Bless you and your family as you make these difficult decisions.

akcarmean, LPN · Nov 25, 2004

May God be with you and your family in your time of need. I know this had to be a hard decision have faith in yourself and your knowledge and know that you chose the right thing. I will keep you and your family in my prayers.

Angelia

Blackcat99 · Nov 25, 2004

Sorry to hear about your mother. It sounds like you are making the right decision. My prayers are with you.