For many people, old age or terminal illness means the body literally becomes and feels worn out. Everything is a major effort, and you may even have heard the elderly admit 'I'm worn out, I'm ready to go', such is the overwhelming tiredness that fill every waking moment.

The last stages of life are often spent sleeping, with more hours spent soundly asleep than awake. To an outside observer it just looks like a deep sleep, but these sleeps often border on unconsciousness. As the person awakes again, it is sometimes difficult to realise that slowly but surely they are edging closer to death.

As the body weakens, periods of 'sleep' get longer and longer, until finally the sleeper has awoken for the last time. Breathing may slow, with longer pauses between each breath, until that next breath doesn't come.

Watching someone pass away is sometimes unavoidable.

I have been in the unfortunate situation where I have been present for the last hours of four family members who died in hospital. I'm not in the medical profession, so this is simply my own personal experience which I hope may be of use to others in a similar position.

Two simply slept themselves into death.
The first, with serious lung disease - breathless but not in any great pain - slept more or less for his last 24 hours. He woke briefly for a small drink every hour or so, giving a slight wave of the hand just to acknowledge that he knew we were there. His last hour we noticed his breathing becoming slower, with longer gaps between breaths. Very peacefully he simply slowed and stopped living. No drama or visible distress at all, which spared us much upset.

The second gentleman had suffered a bleed to the brain. Initially his only symptom was vomiting a few times, but this subsided as he became dizzy and woozy. After being sedated so that hospital staff could carry out a CT scan, he was returned to a side ward soundly asleep - unconscious due to a combination of sedation and also his worsening condition. We had already been forewarned that his condition would deteriorate rapidly because of the bleed on his brain, and that nothing could be done to save him.
He 'slept' very soundly for the next six or seven hours, snoring gently, then in the space of probably fifteen minutes his breathing just slowed, sometimes pausing for a minute or so. Then, peacefully, he left us.

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A Video Interview with MacMillan nurses (BBC)

 

 

My third encounter with death was not so pleasant.
This gentleman had been admitted to hospital for treatment for a separate matter, but sadly had an unexpected heart attack on the ward, whereupon his heart actually stopped.
Doctors used CPR and managed to restart his heart and breathing, but brain damage had already been done, and we were told it was unlikely he would survive for much longer.
Although alive again and breathing unassisted, he was in a coma. Eyes were open but, as far as we could tell, unseeing and fixated on the light above his bed.
He remained in this condition for 48 hours, and was sedated as his body seemed to be experiencing some pain. (He was heavily bruised around the chest due to the CPR.) This only changed in the last few minutes of his life, when he became very agitated, as if in pain, and cried out several times before he passed away.

The fourth occasion was an elderly lady, hospitalised with pneumonia.
Antibiotic treatment seemed to be working, and for a few days a full recovery looked possible. Other underlying cardiac problems were discovered, and she soon lost interest in eating. After about a fortnight in hospital she seemed very tired, and although still cheerful with visitors had little interest in anything else.
We had already been asked our views on CPR, and advised that due to simple old age and ailments that we may lose her.
The end came quickly, but not entirely unexpected. One afternoon, just as visiting time was ending, this lady simply coughed (as if to vomit) and passed out. Within the space of 30 minutes we lost her, with just one quiet gasp at the end to signal that she was gone.

R.I.P. and my love to all

As I mentioned earlier, all these people died in hospital. Three different hospitals, in fact.

Ward staff - nurses and carers - in every case were excellent throughout, caring and helpful, and made these difficult times a little easier.
Only one person, a consultant who should have known better, offended me. On an earlier occasion, one of the above patients was admitted to hospital with a urine infection, and there for 12 days. The consultant dumped a DNR notice in the medical notes ON THE DAY OF DISCHARGE without attempting to discuss it with family, who had been visiting at least four hours every day.
When challenged about the DNR, this consultant was incredibly condescending and virtually told us that the decision was none of our business. The DNR disappeared from the medical notes shortly after.
Fortunately the patient survived for more than two years.....


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