"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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Monika von Vultee

My husband died Sept 22. 2020 in hospice I was with him till the nurse woke me up and told me he is in the dying process now.I freaked out because I could not watch my husbands last breath and run home. It haunts me still today. I knew he was dying I used to be an RN but was unable to watch that last breath of my husband
BK Books replied:
Oh Monika, yes, we sometimes do things out of fear that we regret later.
I’m guessing that is what made you “run home”. You might write your husband
a letter. Put on paper all your thoughts, your regret, your tears,
everything you would like him to know about your life together, everything
your heart needs to say to him. When finished burn the letter and scatter
the ashes to the wind. Moving forward let how well you go on living be your
gift to your husband. Blessings! Barbara

Emma Acker

Loved this entry! Thank you Barbara! The chick imagery is so helpful. Also, “sad but not bad”.
Emma (we connect on Insta I’m @endoflifedoulanyc)
BK Books replied:
Hi Emma, having a visual image helps us “picture” what is happening. I love
the chick image too. Blessings! Barbara

I like the reframing as working to leave a problematic body. I dealt with something similar and found this comforting. Thank you for this post.
BK Books replied:
Thank you Lindsay for the alternative wording. Blessings! Barbara

I love the reassurance you provided to this caregiver Barbara and the reference to the chick getting out of their shell. I’m going to use that analogy with future families I care for at end of life.
BK Books replied:
Hi Laura, the chick analogy really seems to describe what the last days to
hours are like as death approaches. Blessings! Barbara

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