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.


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.....

Thank you for reading - comments are welcome.
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The Dying Process – What To Expect — 2 Comments

  1. The NHS total disregard for your right to life is a disgrace. We all pay for the NHS and as a result we should all have equal access to it. In fact there is an argument that the elderly are more entitled to receive full NHS services than the young, as they have paid more into the system, they should get more out of it and therefore should be of the highest priority.

    Yet the NHS continues to discriminate against anyone 65 years old and over. DNR orders were placed on all coved-19 patients medical records who were 65 and over. This is akin to genocide and the doctors and nurses of today who support and carry out these crimes against humanity are criminals.

    To create equality all doctors and nurses working in the NHS should be required to sign their own DNR notices as a condition of employment. All clinical staff should be required as part of their employment contracts to have DNR notices put on their own medical records. This action would help doctors and nurses to understand how corrupt and dangerous this practise has become, and may help to reduce its use on the general public.

    The abuse during the summer of 2020 was shocking. A 55 year old full time midwife was admitted to a North East hospital with covid-19. She was told that because she was 55 years old she was too old to be resuscitated and a DNR notices was placed on her medical records. This 55 year old full time nurse had no under lying health condition and worked full time for the NHS. She was told she was for palliative care only. This middle aged nurse was terrified being fully trained in palliative care and knew that if full implemented it would most certainly lead to her death. She was particularly concerned about the withdrawal of essential food and water, which is a core part of palliative and end of life care.

    This terrified nurse begged to be allowed to go home. She was discharged from hospital and made a full recovery at home. Had she stayed in hospital she would have likely been percribed a cocktail of drugs including Morphine and Midazolam, which would have rendered her unconscious and suppressed her breathing, likely resulting in her death.

    The continuing abuse of patients in this manner must stop. The level of discrimination against older people, the sick, disabled and those with both mental health and learning difficulties is a disgrace. The Equality Act and The NHS Constitution were created to protect patients from such abuse, yet the NHS is beyond its authority to order doctors and nurses to carry out actions that deny patients the right to life. Euthanasia is currently against the law in this country.

    May I remind doctors and nurses that carry out at these crimes against the UK population, that they are setting the scene for their own demise. Doctors and nurses will do this to your own family and to yourselves should you get sick. Over 680 hospital staff have died this year of coved-19, the majority of which had DNR orders put on their medical records and were told they were for palliative care only. You are killing your own, and if you are unlucky enough to get the covid-19 infection, you are killing yourself.

    I would like you to take a moment to consider how you would feel if your children with disabilities and older relatives were treated in this way. I am aware of reports where doctors have got into physical fights on NHS hospital wards, when one doctor put another doctors father on the ‘Liverpool Care Pathway’, now re-named ‘End Of Life Care’. If this is how hospital staff react when a DNR order is used on their own family, they should think twice about its use on others. Their support of these protocols will one day be carried out not just against their own children and loved ones, but against themselves.

    The number of staff suffering a Moral Injury is huge, staff are unhappy, say there is a culture of mistrust among staff and are leaving the NHS in droves. So many staff find it almost impossible to justify the NHS support for these actions.

    Paula Torrance November 27th 2020

    • Thanks for an interesting message. I’ve just read an article in the Daily Mail today about these notices being applied when not justified. Makes me a little concerned about any future hospital treatment as we are well over 65

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