Signs of Dying?

simplyklb · Posted: Thu Oct 02, 2008 8:48 pm Post subject: Signs of Dying?

Hi All,
I got Dad transferred over to hospice two days ago. It was a very difficult ting to do. This is a very real question..... What signs do I look for when Dad is actually dying? I think that he has been showing some signs but I need a good idea of what to look for.

Thanks,
Kristi
_________________
Dad - Andy, 70, diagnosed with SCLC in May 2008
2/20/38 - 10/15/08 Fly high, Dad!
Mom - Jackie, 67, diagnosed with NSCLC in May 2008

pbj11 · Site Admin Joined: 12 May 2007 Posts: 1405

Kristi,

I'm so sorry your Dad is declining so quickly. God bless all of you.

Here is a repeat of a prior post I made on this topic with links:

It can go in many different ways. One of our great members, Vee Smith, posted this link not too long ago and it really covered a lot of the different signs and scenarios.

http://www.hospicepatients.org/hospic60.html

Here is another link: http://www.cancer.gov/cancertopics/pdq/supportivecare/lasthours/HealthProfessional/page3

Heart rates can go very high if it is having to work too hard. My husband was in and out of tachycardia and Atrial fibrillation for a few weeks before he passed. He was walking and taking stairs less than 24 hours before he passed. There is no rhyme or reason to what shape the end takes. I'm so sorry sweetie.

Another issue that is isn't spoken about is hemorrhaging and exsanguination from tumor encroachment into a major artery. This is RARE, RARE, RARE. My husband was at risk for this, because of tumor location, but it didn't happen. Typically the doctor will alert you to this possibility or you'll know because of tumor location. If you don't hear about it, don't worry about it. I'm not trying to frighten anyone, this is simply an FYI because I've known a handful that have lost a loved one this way.

This link touches on it a bit.
http://www.fraserhealth.ca/Services/HomeandCommunityCare/HospicePalliativeCare/Documents/10FHSymptomGuidelinesExsanguination.pdf

I do know it's an overwhelming experience that no caregiver is well equipped to handle. Don't feel bad about seeking outside help or calling an ambulance. The key is for them to feel comfortable. That and a lot of love is the best way.

(The first link is directed more at caregivers, while the second and third are more for medical professionals -- but by this point, we ALL have more knowledge than we ever cared to have about cancer.)

Many hugs to you,
PBJ
_________________
Husband diagnosed with NSCLC Stage IV. (Non-Small Cell Lung Cancer) Fought & lived 2 1/2 years with multiple lines of treatment.

Post describing our battle: http://cancerforums.net/viewtopic.php?t=7026&postdays=0&postorder=asc&start=0

simplyklb · Posted: Fri Oct 03, 2008 8:32 am Post subject: Re: Signs of Dying?

Thanks, PBJ!

I got woken up because Dad was having trouble breathing. I gave him .5 mg of a syringe of liquid Oxycodone by mouth. That helped ease his breathing some. I can hear a rattle when Dad breathes. I called hospice to have someone come and look at Dad. I need to leave at 10 AM to go with Mom to chemo and radiation.

I am scared because I don't want to see my dad suffocate to death. I can't believe this is happening. I am not ready.

Kristi
_________________
Dad - Andy, 70, diagnosed with SCLC in May 2008
2/20/38 - 10/15/08 Fly high, Dad!
Mom - Jackie, 67, diagnosed with NSCLC in May 2008

brainman · Posted: Fri Oct 03, 2008 2:28 pm Post subject: Re: Signs of Dying?

Kristi, my heart goes out to you. I am so sorry that your father is having increasing problems breathing. It certainly is not a good sign that now you can hear rattling when he breaths.

You, your father, and your mother are in my thoughts and prayers during these difficult times.
_________________
Jim
Site Administrator and long-term cancer survivor
1992 Astrocytoma grade 2, left motor strip
2005 Recurrence this time said to be an Oligodendroglioma grade 3, same location.
http://cancerforums.net/viewtopic.php?t=2405My Story Part 1: http://cancerforums.net/viewtopic.php?t=2528
My Story Part 2: http://cancerforums.net/viewtopic.php?p=7350
My Story Part 3: http://cancerforums.net/viewtopic.php?t=8029
Blog http://jimhawkinsport.blogspot.com/

hopeful · Regular Joined: 27 May 2008 Posts: 30

Hi Kristi

I've been away from the site for a while. I'm sorry to hear that your father is not doing well. I'll be thinking about you.

pbj11 · Site Admin Joined: 12 May 2007 Posts: 1405

Kristi,

I'm so sorry to hear of this breathing problem. I know your fear and lived it with my husband, as that is how he went. It's good that you have medication to calm him so that he doesn't begin having anxiety attacks over lack of ability to breathe. Hopefully this isn't the end, but if it should be, they usually go unconscious before the end and it's peaceful. My heart goes out to you and I have tears writing this to you.

I'll be keeping you and your family in my thoughts and prayers.

Hugs,
PBJ
_________________
Husband diagnosed with NSCLC Stage IV. (Non-Small Cell Lung Cancer) Fought & lived 2 1/2 years with multiple lines of treatment.

Post describing our battle: http://cancerforums.net/viewtopic.php?t=7026&postdays=0&postorder=asc&start=0

simplyklb · Posted: Sat Oct 04, 2008 3:43 pm Post subject: Re: Signs of Dying?

Thanks everyone

My dad struggles to breathe when he awakes from sleep. I thought hospice was suppose to make things easier not harder. I feel that way because now Breathing treatments are done every four hours. I give him ativan every two to four hours. Dad also gets OxyFast every hour as needed. He will let me know when he needs the Oxyfast and a breathing treatment.

Guys, I am scared. It's sad to watch my dad struggle. I told him today that it was OK to let go. I pray that he dies in his sleep.

Kristi
_________________
Dad - Andy, 70, diagnosed with SCLC in May 2008
2/20/38 - 10/15/08 Fly high, Dad!
Mom - Jackie, 67, diagnosed with NSCLC in May 2008

StarryNite · New User Joined: 04 Oct 2008 Posts: 2

My mom has the same trouble, she is stage IV 6 months out from diagnosis. She is on home hospice, I am here primary care giver. I will post a more detailed message here introducing myself, but as far as the breathing problem, we have her on Lorazipam .5 mg at bedtime (for anxiety) also, morphene (Roxinol) every few hours through the night. She also was just prescribed Advair which my sister things is helping a lot but I am not so sure yet, from what I have seen the liquid morphene works the best by FAR for breathing. I also make a small medicine bottle with about an ounce of apple cider and .4 of liquid morphene that she can take on her own if she wakes up and needs it, she says this helps immensly. I basically take the night shift and stay up all night listening for her coughing and breathing problems. We also do a nebulizer with abuterol which I am not sure if it helps or not. Mom also says that very hot tea or coffee helps the "air hunger". There have been some days upon waking (always in the morning, not the middle of the night) where she can't get her breath at all and is terrified. We have also had hospice bring in a hospital bed so she can sleep elevated which helps a lot. she is also on dexamethaxzone given in the morning since it tends to keep you awake, which is a steroid, her oncologist said it is very good for helping with breathing.

Another thing is I sat with her and helped her with breathing exercises, trying to teach her to breath slow and as deep as possible, hold it in, then let it go, otherwise, when she gets anxious because she can't breathe she tries to breathe too fast and begins to panic. This has been helping as well.

I hope that helps in some way, I know how hard it is... you're not alone...

StarryNite · New User Joined: 04 Oct 2008 Posts: 2

Also, Ativan (lorazipam) is a long acting drug. we give it to mom only once at bedtime, .5 of the liquid for anxiety and to help her rest. Ativan works together with the morphene as it relaxes the muscles but is mostly an anti anxiety drug, it won't help the breathing on it's own in my experience. I have found that more than the .5 ml at night or given during the day makes her very disoriented and doesn't help the breathing or anything at all. The morphene every few hours is what has helped mom with the breathing trememdously. She is also on a 75 mg phentanyl patch changed every two days which had all but alleviated any pain she has.

maryaz · Posted: Sun Oct 05, 2008 12:06 am Post subject: Re: Signs of Dying?

Kristi, I am so sorry to hear this about your Dad. I will continue to be thinking of you and your family and have you all in my prayers.

I cannot answer you but I know that most of the time hospice is really good. However, I know someone recently that had some problems. Be sure and inquire as to what your Dad should be getting to make him comfortable. Don't be a afraid to ask someone other than the hospice people that are caring for her.

I know morphine works well when you have problems breathing. I hope something is changed to help him to be more comfortable.
_________________
Mary

Husband is 67 year old Male
NSCLC - Squamous Cell Carcinoma
Chemo and Radiation Treatments together
Allergic reactions to Taxol and Taxotere.
The Story: http://www.cancerforums.net/about9079.html

jb · Regular Joined: 05 Feb 2006 Posts: 18 Location: UK

Hi Kristi!
I'm so sorry you are going through this with your dear dad.My dad passed away last Dec from NSCLC.
His last week was spent in hospital and in his last couple of days he slept most of the time.
He was very restless and would raise his arms and legs up and pull his covers off of him.
He was put on a syringe drive so he was on morphine constantly.
On his last morning with us he just lay very still,occassionally gasping for breathe, until i saw a very obvious sign he was about to pass away and then it was over in seconds.
I will never forget that moment he took his last breath and although it was 'scary' i am so glad i was there with him,holding his hand and saying 'goodbye' to him.
Its the sort of scenario you think you could never cope with but you do get through it and hopefully i helped my dad to go peacefully.
I will keep you in my thoughts and prayers.
Take care
Jackie

simplyklb · Posted: Sun Oct 05, 2008 9:27 am Post subject: Re: Signs of Dying?

Thanks

I am the primary caregiver for not only my dad but my mom as well.

Dad is on a lot of different meds. He does breathing treatments at least every four hours.

Dad's Ativan got upped to 1 mg every 2 to 4 hours during waking hours yesterday. He panics when he can't breathe. The increase in the Ativan dosage has helped Dad rest. He's been using a nebulizer with Albuterol and some other drug (can't think of the name). Of course, Dad gets the OzyFast.

I pray to God every day to take Dad in his sleep. To see him struggle to breathe at times is heartbreaking.

Morphine will not work for Dad as it created a lot of problems for him. Dad was on it for five weeks when he was first diagnosed. Finally, we had to have him switched to the Fentanyl patch.

Kristi
_________________
Dad - Andy, 70, diagnosed with SCLC in May 2008
2/20/38 - 10/15/08 Fly high, Dad!
Mom - Jackie, 67, diagnosed with NSCLC in May 2008

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