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I witness what appeared to be a very traumatic death on Monday. She had stage 4 lung cancer and had decided to keep her comfortable. She was in a typical hospital room but under Hospice care. I told the doctor that if they didn't do something to remove the fluid in her throat she would end up suffocating on it. He assured me that would be a horrible death and he'd never let that happen. I left at 11:30 PM on Saturday night. On Monday morning at 3:00 AM my sister called me saying that mom can't breathe and I got there right away. Mom appeared to be suffocating. She was conscious and kept looking at me as if to say "Help Me", then her eyes would roll back in her head.. This went on for 6-hours. They tried suctioning her throat but the fluids were too deep. They offered to get respiratory up to use a more flexible tube to remove the fluid that was blocking her airway, but nobody ever came. Finally, I had to request that they increase the Morphine and Ativan to knock her out. This finally worked and she wasn't suffocating anymore. She died within a few hours. This violent suffocating seems to be something much worse than the "Death Rattle" and it has left me with PTSD, which I'm seeking counseling for. I appreciate any related stories or advice that will help me make sense of this and heal from it.

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When step Dad was actively dying last year the nurse told us that his lungs would eventually start to fill with fluid and when his breathing became more laboured to let him know. When the time came, he gave step dad a medication (sorry I do not remember the name) via eye drops and upped his morphine levels. He did not have lung cancer. His death was well managed by the nurse in the hospital to make it as comfortable and pain free as possible.

I am sorry that your mother appeared to suffer at the end. Does your Hospice organization provide counseling? I would start with them.
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rberry Dec 2019
I haven't tried Hospice for counseling but that's a good idea. I think they offer it.
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I looked up dyspnea on several Google sites, and it doesn’t seem as good a match to your post as the ‘death rattle’. It’s not a nice expression, ‘terminal respiratory secretions’ sounds better. The net says ‘those who are dying may lose their ability to swallow and may have increased production of bronchial secretions’ with ‘fluids such as saliva and bronchial secretions accumulating in the throat and upper chest’. This happened with my own mother in the few hours before she died. It’s hard to hear, but very normal (that's why there is a non-medical expression for it). It may also be upsetting for the person who is dying, but there is nothing they can do either. As with your own mother, it stopped when my mother was given extra morphine through a morphine driver.

It’s too late now for you to try this, but I was told (and witnessed) that the last sense to go is hearing. The doctor who came a few hours before the end (my mother died at home) bent down and almost shouted in her ear, and she clearly heard and responded facially. Your mother’s ‘help me’ look could well have been simply about wanting to communicate, to tell you that she loved you, to say that everything was all right. Just holding her hand, which I am sure you did, was what she needed. Give yourself the peace of mind that she now has. Yours, Margaret
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rberry Dec 2019
Yeah, it was surprising how much she could hear, understand and could reply to with expressions after she'd lost the ability to speak.
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An especially traumatic death because this person was your mother. I'm so sorry for your loss, and for what you and your sister had to see.

Please understand that we are only lay people and we can't possibly know the the particular technical details of what was happening inside your mother's body. It would be much the best thing for you to make an appointment to see your mother's hospice team and ask them to explain the process as it happened, step by step.

The only other suggestion I have for you is to ask: was your mother given any medication to reduce the secretions from her airways? - but don't jump to any conclusions about this. If she wasn't, there may have been very good reasons why not; or even if she was they may just not have worked well enough to prevent the symptoms.

I hope you and your sister will be able to come to terms with what happened over time. Wishing you comfort.
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rberry Dec 2019
They did give her Rubinul to reduce the fluids but it didn't seem to help. The trauma is subsiding more and more everyday. Thanks!
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I don't imagine many of us have much experience with dying and judging what is normal and what isn't, if all we've got to go on are Hollywood death scenes then I think that any real death is going to be traumatic and distressing. My mother was given medication to dry secretions and the effect was to completely turn off the production of saliva, since she was mouth breathing this allowed her mouth and tongue to dry up in a way that no amount of swabbing could alleviate - a different kind of trauma but distressing nonetheless. It took me a long time to get over replaying those final days in my mind, especially when I was drifting off to sleep - I think this is just a normal part of the process that we go though as we work through any traumatic event but it just isn't helpful to focus on the coulda shoulda woulda, try to let that go.
And I'm sorry for your loss.
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rberry Dec 2019
They did give her Rubinul that was supposed to dry up her throat and reduce the fluid buildup but it didn't seem to help. Yes, my mother also had an extremely dry mouth as well. However, she didn't want the damp sponge. Thanks!
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I'm glad your dad died peacefully. I think Hospice does have counseling. I'll check it out.
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When my father-in-law was dying (it took 5 days) the gurgling sound was really bad, and they were giving him all the meds to dry up the secretions that they could. It was drops & also a patch(?). I think they actually were giving him extra doses. Hospice kept assuring me it would be much worse on him to suction the liquid out than to just let it be, that it really wasn’t bothering him that bad. It was awful and I wanted to run away, but didn’t. All I could do was pray they were telling me the truth.
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