Dear Barbara, I would like to know why the breathing pattern is different at
end of life. My Mother had fast and labored respirations. She did have
COPD, but my Dad had the same breathing pattern and he did not die from
COPD. This was very disturbing to me. Are they suffering when breathing
like that?
The irregular, difficult breathing that occurs at end of life frightens most
people. As we watch we feel something bad is happening. Our loved one is
hurting, struggling, suffering, and of course this is disturbing to us.
In the hours to minutes, sometimes even days, before death, a person’s
breathing changes. First it becomes fast, often with congestion, and then
gradually the breaths becomes slower and slower. As breathing slows (ten
times, or even six times, a minute) the person actually breaths like a fish,
with their mouth opening and closing. This can be frightening if you don’t
know that it’s normal.
The congestion that occurs before death will depend upon how hydrated or
dehydrated a person is. The more fluids in their body, the more congestion.
Sometimes changing their position (laying them on their side) will help to
redistribute the fluid, and the breathing will sound quieter. Suctioning the
fluid generally does not eliminate it. The bottom line is that congestion and
difficult breathing are a part of the normal dying process.
Is the person suffering? I think not, although it appears that they are. By the
time they are hours from death their awareness of what is going on around
them and of their body has diminished. What I envision is the little chick
working hard to get out of its shell. In the hours before death from disease
our body is shutting down. It is laboring to release itself from this planet. It
is a struggle, just as the chick is struggling, but I don’t think either the
person or the chick are suffering.
Something more about Laboring to Leave:
Difficult breathing during the natural dying process is only one of the many changes that we will witness when a person is dying. It's comforting to know what to expect during that process. Gone From My Sight (The Little Blue Book) is a "road map" of what will occur during the dying process. The Eleventh Hour is the companion book and is more specific about the changes in the last days, hours, minutes, seconds and just after death. These two books, along with your nursing staff, will provide knowledge so that you can better support the one who is laboring to leave.
27 comments
Hi Karin, In response to your blog comment about your mother’s breathing in the hours before she died——her breathing fast without pausing was not out of the ordinary. It indicates the body is shutting down, nothing works right. A little oxygen sometimes eases the intensity, often times not. Giving the morphine often slows down the breathing but other times not. Giving the extra morphine and your mother dying 2 hours later is not the result of the morphine. The morphine did not hasten her death. With her body shutting down, her circulation slowed which means the morphine didn’t get to do its work in the usual amount of time. I’m thinking neither the 30 minutes dose or the one 2 hours before your mother’s death had any effect on her body. You didn’t say how the morphine was given, liquid in the side of her mouth, suppository in her rectum, on her skin, under her tongue, by needle in the muscle or in her vein. In a healthy body each way has a different time to take effect. In the vein being the fastest. In a body that is dying none, including in the vein, takes effect in what is considered a normal time frame. The sooner the person dies after the drug was administered the less effect the drug had on pain or time of death.
I hope this information has eased your mind. Know we always do the best we can with the information we have at the time. Let go of the doubts and savor the good times.
Blessings! Barbara
I also wonder about the fast and laboured breathing, you answer that it becomes irregular, but what about the fast and regular breathing with NO pauses? My mother was breathing like that when dying for about 7 hours before passing.This was so disturbing and stressful to me, that I rang for the nurse 30 min after she got morphine, and asked if she could have some more, the nurse gave her some more and my mother passed two hours later. I blame myself:(
I wanted to help her but didn’t understand that the morphine made it so much more difficult for her..
I wonder how much longer she could have lived if this had not happened, no one knows..BUT I would really like to know about this fast breathing, everyone is talking about the pauses, like Cheyne-Stokes, but what if there are none??
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