"I Wanted Dad To Have a Gentle Death, But..."

Dear Barbara, My dad had severe labored breathing, 40 to 50 breaths a minute. I contacted the hospice RN who recommended 5 mg of morphine every hour. I gave it, as she prescribed.  Five hours after his doses of morphine his respiratory rate became 8 breaths a minute, 3 breaths a minute, and then his last breath. I feel guilty that giving him the morphine killed him. I worry that I shouldn't have followed the hospice RN's recommendation. I worry that 5 mg x 4 was way more than a lethal dose. I worry I hastened his death.  And then I wonder if he didn’t want to leave - which is what I’ve heard about those that do this type of breathing. I wanted him to have a gentle death and it did not appear gentle.

I'm glad you reached out. Here are a couple of things to think about so you can feel more assured that your dad indeed had a gentle death.

40/50 breaths per minute is way too many to be comfortable (even though rapid breathing can be a very normal part of dying). 

Rapid breathing like your dad was doing is exactly where a small bit of morphine (5 mg is small) helps slow down those 40/50 breaths a minute to a more comfortable range. 

Eventually, with or without morphine, his breathing would have gotten slower and slower until it stopped BUT before that happened you made your dad more comfortable. 

I have not heard that rapid breathing is a sign that the person does not want to leave. At the point in the dying process (hours to minutes or even days before death) the person is working to release from their body (think of the little chick working to get out of its shell) their job is to get out of their body and it is hard work. We, the watchers, are seeing the struggle and thinking something abnormal is happening. It is not. What we are seeing is work to become free of this cumbersome body. 

Nothing bad is happening, sad, but not bad.

Something more about...  "I Wanted Dad To Have a Gentle Death, But..."

There are two resources that I encourage you to have when helping families understand pain management for their dying loved one.  Pain at End of Life and New Rules For End of Life Care, DVD Kit. The film and the booklet will provide understanding and reduce the fear that comes with what the dying process looks like.

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I lost my mom over four years ago, but still continue looking to BK for comfort. Reading other’s experiences reminds me we are not alone, and how similar our fears and expectations are. After all this time, the education is still a constant, it has truly helped me to better understand what was happening. I sometimes have to look back and mentally implement what I’ve learned, to better accept the ending stages I saw. It does feel weird at times, like, “she’s been gone, why bother now?” Knowing now what I didn’t know then is sometimes what gets me through the day. In hindsight, most of us are not empowered with this knowledge when coping with end of life.
My mom’s hospice nurse said to give the rx as needed. I did not see that as harmful, there’s nothing else you can do. I recently lost an aunt, with the same direction from the nurse. Family members were making accusations that too much morphine was given, and that’s what killed her. The body doesn’t develop addiction or experience overdose, it’s so that they can be comfortable while trying to leave.

BK Books replied:
Hi Emily, knowledge is like a jigsaw puzzle, we keep adding pieces and
finally can see the picture. Thank you for your sharing. Barbara

Charles Elliott

I work with a hospice group in Ohio and we use your books and love the help they give.
I am a Bereavement Chaplain and do support groups. The group I’m in offers groups in all 50 states and some other countries.
It is Grief Share. You may want to share this with those needing a support group.
To find a local support group:
Go to Grief Share.org
Scroll down to “Find a group” click there.
Enter your city or zip code and it will tell the closest groups to your location.
Hope this helps.

BK Books replied:
Thank you Charles. I have put this info on the blog site. Blessings in the
work you are doing. Barbara


This addresses something I just went through today, February 8 with the passing of my mother. She had developed pneumonia and was struggling with coughing and breathing. I was told to give 1 ml of morphine every two hours and the effect was frightening. She had a death like expression several hours before she stopped breathing completely. I feel like it was too much and hastened her death. It is a heavy burden right now.
BK Books replied:
Hi Gloria, I would have wanted to give my mom the same dosage of morphine
if she was having labored breathing. I hope reading the blog confirmed you
did the right thing to bring her comfort. The expressions were just part of
her working to get out of her body. My blessings are with you. Barbara

Donna Stawicki

I’ve been an email subscriber for sometime and I have several of Barbara’s books on grief. I lost my stepdaughter 9/5/21 and her father, my husband, 1/24/22 both to Covid. Barbara’s insight into death has been a comfort to me during this time of loss.
BK Books replied:
Donna, so much loss! I hope you can find a grief support group through a
local hospice or church. This will be a challenging time and you don’t
want to walk it alone. Blessings! Barbara


Thank you Barbara. What a beautiful way to process our grief. I will share with my siblings and the grandchildren. The focus now should be in our good memories and love in our heart for him.

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