When does death occur?

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Specializes in LTC.

I have a question that is a kind of scenerio. If you have a patient that the bone marrow has stopped producing ANY blood cells/platelets and they are not recieving any more blood transfussions, how long can they be expected to live once they recieve the last transfussion. Pt has SEVERE CHF, leaking skin from the fluid retention, and mentally confused, her weight is up to 365 pounds at 5'4" and yes a LOT of this is fluid. Dr thinks 100+ pounds (I dont know how that is possible). She has had 30+ transfusions over two years.

I say that it is a kind of scenerio b/c this is my grandmother. I am a student nurse and I dont want to ask instructors b/c I am afraid they will turn it into a lesson and I cant handle that. I asked her doctor and he would give me no real answer and almost made it sound like I should look it up. I tried to research it but I am unable to find answers to my main question. I know that RBC's are replaced every 120 days and platelets last 7 days but she was up to once weekly transfusions. Am I to expect slow gradual decline for the next week? Or will it be immediate?

I hope this doesnt sound like I am looking at this clinically, Im not. I want to know so I can use that knowledge so I can understand in my heart what is going on and maybe make it easier for someone when it is my turn to explain to another family.

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Specializes in LTC.

BTW, she has requested that all meds be stopped and only pain control be given. She started hospice today.

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Specializes in SICU.

I am sorry that you are going through this with your grandma. I know you are looking for some type of control in this situation, however, there is no set timeline. Your gandma has multiple co-morbidities and no one can tell you it will be the stopping of blood transfusions that she will die from.

Enjoy the time you have left with her and please support her decision for hospice. Please talk to the hospice nurses about what to expect as they will be able to give you a better understanding of your grandmothers condition. Hospice nurses are wonderful and should be used more often.

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Specializes in LTC.
I am sorry that you are going through this with your grandma. I know you are looking for some type of control in this situation, however, there is no set timeline. Your gandma has multiple co-morbidities and no one can tell you it will be the stopping of blood transfusions that she will die from.

Enjoy the time you have left with her and please support her decision for hospice. Please talk to the hospice nurses about what to expect as they will be able to give you a better understanding of your grandmothers condition. Hospice nurses are wonderful and should be used more often.

I would love to be able to do that... the problem is I live 12 hours away from her. I am 32 and my mother and uncle are still trying to sheild me from realities. I cant get answers from anyone and the hospice people cant/wont talk to me. We made the trip two weeks ago, this weekend, and going back this coming weekend. I am worn out to say the least. I didnt know if there were answers and I know nothing in medicine is for sure. I support her every decision in this matter. She has lived in pain for way too long. I smile through the tears. I am still trying to learn everything that I can though and having to do it the hard way and I figured some of the best answers I have gotten from here anyway, good place to start for me :)

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Specializes in Cardiac step-down, PICC/Midline insertion.

My guess is that it could happen quickly just because of the fluid overload in itself. When it's not where it's supposed to be it goes in the lungs and things go south quickly w/o IV lasix. I've seen this with several CHF patients from working at Oklahoma Heart. Combined with the fact that her hgb is probably very very low, she already is going to be hypoxic. It is not a glamorous death....very difficult to watch. The hypoxia gets so bad that the heart finally dies and just flatlines. Many people think death involves passing quietly and peacefully in bed....but it is a process. At least the ones I've seen so far and it's hard on the family to see it progress. Once the fluid gets in the lungs, their breath sounds turn into a raspy rattling sound, they mouth breath irregularly and their mouth gets very pale and dry, they weep fluid out their skin, and the O2 sat gets lower and lower until everything just stops.

I'm not trying to be gruesome or cold, just trying to sorta paint a picture of what death from this condition looks like because I've actually seen it and have dealt with the family while it is happening. I am sorry that you are having to go through this and prayers are with you and your family. I hope this helped?!?

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Specializes in LTC.

It helped VERY much HeartRN. It was what I was wanting. Everyone is scared to tell me b/c I am dealing with it first hand and I knew someone would have answers for me that were to the point on this site. Thank you.

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