Whimpers and Tears of the Actively Dying by Barbara Karnes RN

Whimpers and Tears in the Actively Dying

What happens at the moment of death or in the hours before death, is generally just normal body actions. A tear is natural -- the eyes are partially open and have been for days or even weeks. There is a drying out of the...

Dear Barbara, my mom recently passed away while surrounded by her kids and husband. I cannot stop replaying her last moments over and over again in my head. I know this is normal. However, she had a disease that impacted her speech and for a week before she died, she could not speak at all and slept constantly. Then, minutes before she died, she gave a few whimpers and shed one tear. My brother and I are tormented by this, as we want to know why these things both happened. Why the whimpers? Why the tear? She had an incredibly strong Christian faith, so I am trying to reassure myself that it was not sadness, but perhaps, joy and awe. Or maybe she was just simply sad to leave her kids and husband. I know we will never know. But I am wondering if you could speak on any similar experiences you have witnessed of either or both of these things.

It is interesting to me how much importance we all seem to place on the last few minutes before physical life ends. You are not the first person to ask me about what occurred during a loved one's last moments. We witness the tears, the facial expressions, the sounds, the grimaces. Yet we are so often unaware of those very expressions as life progresses on its routine daily basis. It isn’t until life is ending that we become observant.

What happens at the moment of death or in the hours before death, is generally just normal body actions. A tear is natural -- the eyes are partially open and have been for days or even weeks. There is a drying out of the eyes and the body is trying very hard to produce moisture. Without blinking (and the eyes are not blinking) moisture accumulates and rolls down the cheek producing a tear (generally not a lot of “tears” because the body is dehydrated and not functioning as it normally would).

It seems poetic to believe the tear is sadness or emotionally based. I believe the “tear” is physiologically based. The person at the moment of death is so withdrawn from their body that they are not expressing emotions or even feeling emotions. Their work is that of the little chick working to get out of the shell. They have already withdrawn from what goes on around them days or even weeks before this moment.

The “whimpers” are part of the sounds of dying, no more, no less. Sighs, moans, gurgles, and soundless cries are all part of the normal, natural way a person dies. We, with our fear and deep sadness of the moment, react and hold on to every expression as if it has meaning. It doesn’t.

What does have meaning and is important is that the person who is actively dying can, on some unconscious level, hear. Imagine standing outside watching and experiencing a beautiful piece of nature. You are caught up in the splendor of the moment and from a distance you hear someone speaking to you, calling to you. You hear but softly from a distance. I believe that is how the person actively dying hears us. We, the watchers, need to say what is in our hearts (hopeful we have taken the opportunity to do that long before this moment) and then after we have said our goodbyes just be a presence. Touch, hold, be love as we walk to the end of life with our special person.

Something more about Whimpers and Tears...

When a loved one enters the dying process, it would be so helpful to know what to expect, what to look for. After being at the bedside of hundreds of deaths, I decided to write a hand book for families to help them navigate these waters. Gone From My Sight is the first and most widely used handbook on the signs of approaching death. Churches, families, social workers, nurses, chaplains need this book. Do you have yours?

37 comments

BK Books

Dear Cheryl, it certainly appears to me that your dad was saying goodbye in the only way his body would let him. He gave you a gift. Blessings to you and your family. Barbara

Dear Cheryl, it certainly appears to me that your dad was saying goodbye in the only way his body would let him. He gave you a gift. Blessings to you and your family. Barbara

Susan Crow

My 67 year old Christian sister passed with me holding her hand, died of cancer. A few minutes before she passed, her face became a dark purple/blue/grey with deep winkles, lasted for a few seconds then repeated a few minutes later. She looked to be 100 years old during these few seconds. It looked to be demonic. Then her face went back to normal. It was hard for her to breath, she was on morphine. Have you seen this before or heard of this happening? Thank you, Susan
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BK Books replied:
Hi Susan, no demons present. That final push to leave the body takes more effort for some than for others. Just think of a woman giving birth to a baby, pushing to get the baby out, the facial expressions will vary. So it is with labor to leave this world. Blessings! Barbara

My 67 year old Christian sister passed with me holding her hand, died of cancer. A few minutes before she passed, her face became a dark purple/blue/grey with deep winkles, lasted for a few seconds then repeated a few minutes later. She looked to be 100 years old during these few seconds. It looked to be demonic. Then her face went back to normal. It was hard for her to breath, she was on morphine. Have you seen this before or heard of this happening? Thank you, Susan
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BK Books replied:
Hi Susan, no demons present. That final push to leave the body takes more effort for some than for others. Just think of a woman giving birth to a baby, pushing to get the baby out, the facial expressions will vary. So it is with labor to leave this world. Blessings! Barbara

C

My mother-in-law passed away almost 2 months ago. We had a special relationship. She was like a mother to me, for 30 years.

My wife and I cared for her at home until the end and I helped with things I never thought I’d be doing for her.

Each night, I told her I loved her, and she would always respond, “I know, I love you, too.”

On her last day, she was unresponsive, after being hyper-sensitive and speaking to people who passed away long ago the day before.

On that last day, her breathing was labored and shallow.

I noticed a tear coming from her eye — my wife wiped it off, and, then, another. My wife wiped that one away, and left the room.

As she was away, and a friend was at the foot of the bed looking on, I stroked my mother-in-law’s hair and told her that she would always be with us, in our memories and in our hearts. Speaking in her ear, I told her that I love her. I felt her head move and, when I looked at her, her eyes were open. She looked at me and mouthed, “I know.” I turned away to call my wife, saying, “Mom’s eyes are open!” but, when I looked back, I noticed that she had stopped breathing. My wife did get there and we think my mother-in-law saw her. She left us so peacefully.

I am still so pained by the last moment - I love her knowing I was there, knowing how I felt… but, her last look and her last words, which must have been a struggle, and her immediate passing after them give me so much heartache. I know it was a great gift, but it still hurts because there was so much more to say… there always is.
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BK Books replied:
C. there always is more to say. From what you described you gave your mother-in-law a gift of love and attention. You might write her a letter and put all of your unsaid words on paper, everything you still need to say to her. Burn the letter and scatter the ashes to the wind. Let how well you live your life going forward be the gift you give her. Blessings to you and your family. Barbara

My mother-in-law passed away almost 2 months ago. We had a special relationship. She was like a mother to me, for 30 years.

My wife and I cared for her at home until the end and I helped with things I never thought I’d be doing for her.

Each night, I told her I loved her, and she would always respond, “I know, I love you, too.”

On her last day, she was unresponsive, after being hyper-sensitive and speaking to people who passed away long ago the day before.

On that last day, her breathing was labored and shallow.

I noticed a tear coming from her eye — my wife wiped it off, and, then, another. My wife wiped that one away, and left the room.

As she was away, and a friend was at the foot of the bed looking on, I stroked my mother-in-law’s hair and told her that she would always be with us, in our memories and in our hearts. Speaking in her ear, I told her that I love her. I felt her head move and, when I looked at her, her eyes were open. She looked at me and mouthed, “I know.” I turned away to call my wife, saying, “Mom’s eyes are open!” but, when I looked back, I noticed that she had stopped breathing. My wife did get there and we think my mother-in-law saw her. She left us so peacefully.

I am still so pained by the last moment - I love her knowing I was there, knowing how I felt… but, her last look and her last words, which must have been a struggle, and her immediate passing after them give me so much heartache. I know it was a great gift, but it still hurts because there was so much more to say… there always is.
——-
BK Books replied:
C. there always is more to say. From what you described you gave your mother-in-law a gift of love and attention. You might write her a letter and put all of your unsaid words on paper, everything you still need to say to her. Burn the letter and scatter the ashes to the wind. Let how well you live your life going forward be the gift you give her. Blessings to you and your family. Barbara

barbara

Hi Amanda, in response to your questions about the last minutes before your father’s death; from what you described nothing bad, or pathological was happening. It was sad and I can see why it was confusing to you (having seen your mother die differently) but he died the way so many die. His eyes being open is how most people die—one eye open, one eye partially closed, both eyes wide open, both eyes partially closed, so many different ways but mostly open in some form. I do believe he knew you were there. For him all was like a dream. He could hear but like you would hear and be aware if you were not quite awake from a deep dream, all distant and detached. I also believe he knew and felt your love and support. It was a comfort to have you there as he left this world. You might write him a letter. Put all your love and concerns and tears down on paper. Burn the letter and scatter the ashes to the wind. My blessings are with you. Barbara

Hi Amanda, in response to your questions about the last minutes before your father’s death; from what you described nothing bad, or pathological was happening. It was sad and I can see why it was confusing to you (having seen your mother die differently) but he died the way so many die. His eyes being open is how most people die—one eye open, one eye partially closed, both eyes wide open, both eyes partially closed, so many different ways but mostly open in some form. I do believe he knew you were there. For him all was like a dream. He could hear but like you would hear and be aware if you were not quite awake from a deep dream, all distant and detached. I also believe he knew and felt your love and support. It was a comfort to have you there as he left this world. You might write him a letter. Put all your love and concerns and tears down on paper. Burn the letter and scatter the ashes to the wind. My blessings are with you. Barbara

Amanda

Hi Barbara,
I just came across your blog writeup and read through the comments. It was really helpful, as I’ve been replaying my dad’s last night over and over again, and I’ve been so distressed. When my mom passed away 18 years ago of brain cancer, her eyes had been closed and she was very peaceful as her breathing slowed down. My dad passed away unexpectedly last week – he had overcome lymphoma and he was getting ready for rehabilitation, but ended up in the hospital with a “storm” of complications. I arrived from out of state the day beforehand, when his speech had become very garbled. The few days prior, he had been very confused, asking again and again what was happening, but also fully aware that he was confused and asking if he would be ok. And on his last night, his eyes were fully open and staring, with various moaning sounds all night. He did shed one tear, and Ive been replaying that over and over again with grief, and it helped to read your explanation. I was wondering about two other things- one, he was trying to get words out but my brother and I couldn’t really understand him. I think he said I love you back to us, and I think he said “stop, I don’t want to fight anymore,” and I said, it’s ok dad and just tried to reassure him we were there and hugging him- which is something I did not do the entire 6 months of visiting, due to the pandemic. It is just breaking my heart because he seemed aware of what was happening, but he was also just staring with his eyes wide open. When I would say something, he would open his one eye wider. And when I kissed him, he puckered his lips. Was he hearing me and understanding me? Did he know what was happening, or were they just reflexes? And his other eye was horrible – his pupil bulged and looked like it would be so painful. I have just been so tormented, first because he was supposed to be ok, and secondly, because I’m so worried that he was sad or in pain. Thank you so much for what you do, Amanda

Hi Barbara,
I just came across your blog writeup and read through the comments. It was really helpful, as I’ve been replaying my dad’s last night over and over again, and I’ve been so distressed. When my mom passed away 18 years ago of brain cancer, her eyes had been closed and she was very peaceful as her breathing slowed down. My dad passed away unexpectedly last week – he had overcome lymphoma and he was getting ready for rehabilitation, but ended up in the hospital with a “storm” of complications. I arrived from out of state the day beforehand, when his speech had become very garbled. The few days prior, he had been very confused, asking again and again what was happening, but also fully aware that he was confused and asking if he would be ok. And on his last night, his eyes were fully open and staring, with various moaning sounds all night. He did shed one tear, and Ive been replaying that over and over again with grief, and it helped to read your explanation. I was wondering about two other things- one, he was trying to get words out but my brother and I couldn’t really understand him. I think he said I love you back to us, and I think he said “stop, I don’t want to fight anymore,” and I said, it’s ok dad and just tried to reassure him we were there and hugging him- which is something I did not do the entire 6 months of visiting, due to the pandemic. It is just breaking my heart because he seemed aware of what was happening, but he was also just staring with his eyes wide open. When I would say something, he would open his one eye wider. And when I kissed him, he puckered his lips. Was he hearing me and understanding me? Did he know what was happening, or were they just reflexes? And his other eye was horrible – his pupil bulged and looked like it would be so painful. I have just been so tormented, first because he was supposed to be ok, and secondly, because I’m so worried that he was sad or in pain. Thank you so much for what you do, Amanda

barbara

Hi Elizabeth, in sharing your story of your brother’s dying moments you mentioned that your mom is doubting if your brother was “really ready”. We are never "really ready” no matter what we say before we are on death’s door. Intellectually we can say we are ready to die but that is generally when we don’t really believe it is going to happen. Actually when we are at death’s door we don’t care anymore. We are busy getting out and releasing from our shell of a body. The last “scream” you mentioned is not uncommon. I don’t think there is thought behind the sound. We, the watchers, want to put meaning in those last actions and sounds but the person is so removed from their body and mind those sounds and actions are just part of the chick cracking its shell to be free.
I hope you can share this with your mom so she can let go of her worries. Both of you might write your brother a letter. Put all your thoughts, concerns, tears, and love on paper. Then burn the letter and scatter the ashes to the wind. Know he will receive your love. Blessings to you and your family. Barbara

Hi Elizabeth, in sharing your story of your brother’s dying moments you mentioned that your mom is doubting if your brother was “really ready”. We are never "really ready” no matter what we say before we are on death’s door. Intellectually we can say we are ready to die but that is generally when we don’t really believe it is going to happen. Actually when we are at death’s door we don’t care anymore. We are busy getting out and releasing from our shell of a body. The last “scream” you mentioned is not uncommon. I don’t think there is thought behind the sound. We, the watchers, want to put meaning in those last actions and sounds but the person is so removed from their body and mind those sounds and actions are just part of the chick cracking its shell to be free.
I hope you can share this with your mom so she can let go of her worries. Both of you might write your brother a letter. Put all your thoughts, concerns, tears, and love on paper. Then burn the letter and scatter the ashes to the wind. Know he will receive your love. Blessings to you and your family. Barbara

Elizabeth

My brother was a heavy drinker and diagnosed with jaundice and hepatitis of the liver. He quit drinking and day 14 his white blood cell count was up so he was admitted to the hospital. Found out his kidneys were failing as well. They drained fluids and were talking dialysis and over night there was a turn for the worse and the said the med weren’t working and that dialysis may prolong his life a little bit the quality wouldn’t be good. We rushed up to say good byes he was 3 hours away and when we get there he is in and out. He hears the can say they are moving him and when the dr came in he told her I don’t want you guys to move me anywhere. Dr says we aren’t. Still in and out of it he was agitated kept messing with wires and pulling at oxygen monitor on his finger the dr says we can take that off and he said is it going to take time away from me and my family and she says no. They move him to a different floor and start the morphine drip and recommend hospice in the hospital. My brother had told my brother on the phone (when we were called to get up there soon if we wanted a decent conversation with him) that he was ok with it that he knew he was dying he thought he had 2 days (more like 12 hours) so she did what she thought he wanted and signed the papers. They come in and explain that the morphine is for pain and they would slowly turn the oxygen off. He was responding by grunting til he went to sleep. When oxygen was all the way off the preacher went in said a prayer. And not long after he passed when walking the preacher out I stopped in waiting room for just a bit and soon after my little brother got me and told me he was gone. The next day my mom said he screamed his last 3 breaths after no responses and I know it is haunting her. He was hanging on for his family and now I know my mom is second guessing if he was really ready to go

My brother was a heavy drinker and diagnosed with jaundice and hepatitis of the liver. He quit drinking and day 14 his white blood cell count was up so he was admitted to the hospital. Found out his kidneys were failing as well. They drained fluids and were talking dialysis and over night there was a turn for the worse and the said the med weren’t working and that dialysis may prolong his life a little bit the quality wouldn’t be good. We rushed up to say good byes he was 3 hours away and when we get there he is in and out. He hears the can say they are moving him and when the dr came in he told her I don’t want you guys to move me anywhere. Dr says we aren’t. Still in and out of it he was agitated kept messing with wires and pulling at oxygen monitor on his finger the dr says we can take that off and he said is it going to take time away from me and my family and she says no. They move him to a different floor and start the morphine drip and recommend hospice in the hospital. My brother had told my brother on the phone (when we were called to get up there soon if we wanted a decent conversation with him) that he was ok with it that he knew he was dying he thought he had 2 days (more like 12 hours) so she did what she thought he wanted and signed the papers. They come in and explain that the morphine is for pain and they would slowly turn the oxygen off. He was responding by grunting til he went to sleep. When oxygen was all the way off the preacher went in said a prayer. And not long after he passed when walking the preacher out I stopped in waiting room for just a bit and soon after my little brother got me and told me he was gone. The next day my mom said he screamed his last 3 breaths after no responses and I know it is haunting her. He was hanging on for his family and now I know my mom is second guessing if he was really ready to go

Sharon

I lost my Mom 2 days ago at the most wonderful age of 100. She has been in an assisted living facility for 4 years due to dementia. She however knew my voice when I walked in the door to visit and would smile. After COVID restrictions started, I hired on as a nurse at the facility so I could be with her. 2 weeks prior to her passing she started being unable to swallow. Hospice was started.
As a RN, I’ve witnessed hundreds of deaths. I have never witnessed a tear at death or maybe I just never noticed. When my Mom passed she was very dehydrated but was kept comfortable on every 2 hour morphine SL. I also put artificial tear gel in her eyes every 4 hours. As she took her last breath, a single tear fell from her right eye (tear of joy is the right side) This was Mom being welcomed by Jesus and my siblings that went ahead of her.

I lost my Mom 2 days ago at the most wonderful age of 100. She has been in an assisted living facility for 4 years due to dementia. She however knew my voice when I walked in the door to visit and would smile. After COVID restrictions started, I hired on as a nurse at the facility so I could be with her. 2 weeks prior to her passing she started being unable to swallow. Hospice was started.
As a RN, I’ve witnessed hundreds of deaths. I have never witnessed a tear at death or maybe I just never noticed. When my Mom passed she was very dehydrated but was kept comfortable on every 2 hour morphine SL. I also put artificial tear gel in her eyes every 4 hours. As she took her last breath, a single tear fell from her right eye (tear of joy is the right side) This was Mom being welcomed by Jesus and my siblings that went ahead of her.

Barbara

Hi Anna, Most people sleep with their eyes partially open beginning in the weeks before death. It is one of the signs I watch for that tells me death is nearing. In the weeks to actual death everything is generally like a dream. A person can hear but it is as if from afar. The tear is probably from having her eyes partially open. Our body sends tears to keep the eyes from drying out. From what you have described your mum died a peaceful, good death. Nothing bad or pathological happened. She was like the little chick working to get out of her shell of a body. That work looks strange to us but from what you described she did a good job. You might want to write her a letter and put your feelings and thoughts on paper. Tell her what is in your heart, say your goodbye, write about the good times and the challenging times. Put all the thoughts and tears on paper then burn the letter and scatter the ashes to the wind. She will know your letter. My blessings are with you. Barbara

Hi Anna, Most people sleep with their eyes partially open beginning in the weeks before death. It is one of the signs I watch for that tells me death is nearing. In the weeks to actual death everything is generally like a dream. A person can hear but it is as if from afar. The tear is probably from having her eyes partially open. Our body sends tears to keep the eyes from drying out. From what you have described your mum died a peaceful, good death. Nothing bad or pathological happened. She was like the little chick working to get out of her shell of a body. That work looks strange to us but from what you described she did a good job. You might want to write her a letter and put your feelings and thoughts on paper. Tell her what is in your heart, say your goodbye, write about the good times and the challenging times. Put all the thoughts and tears on paper then burn the letter and scatter the ashes to the wind. She will know your letter. My blessings are with you. Barbara

Anna Dowling

My mum passed away 2 days ago .she had secondary breast cancer that had spread to her lungs ,spine and lympnode. I watched her slowly slipping away from us for 6 months . She never talked to us about passing away so I’m just thinking was she scared what was she thinking she never said good bye .in the last 10 hours her breathing was a struggle her eyes were open and was blinking but not looking at anything or us but wen we wiped her mouth she would kind of move her head lips I just want to know was she awake or was she sleeping with her eyes half open .wen i told her i loved her and said are u ready to go to dad now a tear was coming out her eye . I’m just hurting so much and keep thinking about the final day mum left us

My mum passed away 2 days ago .she had secondary breast cancer that had spread to her lungs ,spine and lympnode. I watched her slowly slipping away from us for 6 months . She never talked to us about passing away so I’m just thinking was she scared what was she thinking she never said good bye .in the last 10 hours her breathing was a struggle her eyes were open and was blinking but not looking at anything or us but wen we wiped her mouth she would kind of move her head lips I just want to know was she awake or was she sleeping with her eyes half open .wen i told her i loved her and said are u ready to go to dad now a tear was coming out her eye . I’m just hurting so much and keep thinking about the final day mum left us

Barbara

Hi Leigh, from your description of your mother’s last days, yes, she was working to get out of her body. It sounds like she did everything right. She was restless, she was murmuring she wasn’t eating or drinking much, she wasn’t connected to this world. She was the little chick working very hard to get out of her shell. All was as it was supposed to be. She did a good job How fortunate she was to be in your home and have family taking care of her. My blessings are with you. Barbara

Hi Leigh, from your description of your mother’s last days, yes, she was working to get out of her body. It sounds like she did everything right. She was restless, she was murmuring she wasn’t eating or drinking much, she wasn’t connected to this world. She was the little chick working very hard to get out of her shell. All was as it was supposed to be. She did a good job How fortunate she was to be in your home and have family taking care of her. My blessings are with you. Barbara

Leigh Kilsdonk

My nom passed away of end-stage bladder cancer in late October.And a couple weeks before she died her home health aide from Heartland Home Hospice was at our house to give her a bed bath and she and I also changed her bedsheets, and afterward my mom cried out ‘let me out’ in a whining quality as she lay there covered in a quilt. And on her last day she didn’t eat anything, only drank sips of root beer soda and ice water from straws. That evening she rolled out of bed and my sister-in-law came over to help me get her back in bed. She also helped me change her diaper. Shortly afterward a nurse came to check her out. My mom was very restless from that afternoon on until the nurse gave her morphine(2 doses were needed) to calm her down. I between doses she cried out "help me! She passed away in the early hours of the following day. Do these incidences mean that she was trying to let go?

My nom passed away of end-stage bladder cancer in late October.And a couple weeks before she died her home health aide from Heartland Home Hospice was at our house to give her a bed bath and she and I also changed her bedsheets, and afterward my mom cried out ‘let me out’ in a whining quality as she lay there covered in a quilt. And on her last day she didn’t eat anything, only drank sips of root beer soda and ice water from straws. That evening she rolled out of bed and my sister-in-law came over to help me get her back in bed. She also helped me change her diaper. Shortly afterward a nurse came to check her out. My mom was very restless from that afternoon on until the nurse gave her morphine(2 doses were needed) to calm her down. I between doses she cried out "help me! She passed away in the early hours of the following day. Do these incidences mean that she was trying to let go?

Barbara

Hi Margaret, In response to your question about if your father was a “unconscious” in the days before he died. “Unconscious” is the questionable word here. What does that really mean? Does it mean he was aware of his surroundings? I believe he could hear but it is as if from afar but being fully aware of his surrounding I do not think so. His world was much like a dream and he would respond to the dream he was having , not what was happening around him. About the grimace: I don’t know if medically he had a history of pain and was receiving pain medicine. If that was the case then yes the grimace could have indicated pain but more than likely it just indicated discomfort at having his position changed and being disturbed. Blessings! Barbara

Hi Margaret, In response to your question about if your father was a “unconscious” in the days before he died. “Unconscious” is the questionable word here. What does that really mean? Does it mean he was aware of his surroundings? I believe he could hear but it is as if from afar but being fully aware of his surrounding I do not think so. His world was much like a dream and he would respond to the dream he was having , not what was happening around him. About the grimace: I don’t know if medically he had a history of pain and was receiving pain medicine. If that was the case then yes the grimace could have indicated pain but more than likely it just indicated discomfort at having his position changed and being disturbed. Blessings! Barbara

Margaret B

Several days before my stepdad passed his eyes were half open. Would he have been unconscious? When we moved him to change his diaper he seemed to grimace so I was wondering if he was conscious.
Thank you!!

Several days before my stepdad passed his eyes were half open. Would he have been unconscious? When we moved him to change his diaper he seemed to grimace so I was wondering if he was conscious.
Thank you!!

Barbara

Hi Melissa, thank you for reaching out to me about your mother’s last moment. About the tear, it was probably not one of sadness and certainly not unusual. I have seen moisture from the eyes many, many times. When a person has their eyes partially open, (which most people when they are in the last days do) the body sends moisture, tears, to keep the eyes from drying out. An important thing I want you to think about is: we have limited control over the time that we die. You said someone from the family usually arrived around 8 AM and that your mother died shortly before 7AM. I believe she choose to die when you were not there as a way of protecting you. It was her gift to you. Yes, we have that much control. Now about feeling guilty that she was in a nursing home. With her wandering during the night, unless you had nighttime shift help who would simply watch her, you had no other options for keeping her safe. This situation is one that many families are faced with. About your mother sitting up in bed and making a loud sound while she was non responsive: people as they are dying do a lot of strange things that we will never have answers to or reasons for. What I do know is during the dying days and hours the person’s thoughts and activities are not of this world. They can hear us but it as if from afar. We tend to think of peoples minds as being aware just trapped inside a body. Not so. Their work is getting out of their body. Their minds are not tuned to the present. Think of how our dreams are, symbolic, no time frames, disjointed. That is the mind of a dying person so what comes out in the physical relates to what is going on inside of them, not outside. I hope my thoughts have given you something to think about and brought you some comfort. You might write your mom a letter and put your thoughts and concerns on paper. Tell her everything in your heart that you would say if you could. Then burn the letter and scatter the ashes. My blessings are with you. Barbara

Hi Melissa, thank you for reaching out to me about your mother’s last moment. About the tear, it was probably not one of sadness and certainly not unusual. I have seen moisture from the eyes many, many times. When a person has their eyes partially open, (which most people when they are in the last days do) the body sends moisture, tears, to keep the eyes from drying out. An important thing I want you to think about is: we have limited control over the time that we die. You said someone from the family usually arrived around 8 AM and that your mother died shortly before 7AM. I believe she choose to die when you were not there as a way of protecting you. It was her gift to you. Yes, we have that much control. Now about feeling guilty that she was in a nursing home. With her wandering during the night, unless you had nighttime shift help who would simply watch her, you had no other options for keeping her safe. This situation is one that many families are faced with. About your mother sitting up in bed and making a loud sound while she was non responsive: people as they are dying do a lot of strange things that we will never have answers to or reasons for. What I do know is during the dying days and hours the person’s thoughts and activities are not of this world. They can hear us but it as if from afar. We tend to think of peoples minds as being aware just trapped inside a body. Not so. Their work is getting out of their body. Their minds are not tuned to the present. Think of how our dreams are, symbolic, no time frames, disjointed. That is the mind of a dying person so what comes out in the physical relates to what is going on inside of them, not outside. I hope my thoughts have given you something to think about and brought you some comfort. You might write your mom a letter and put your thoughts and concerns on paper. Tell her everything in your heart that you would say if you could. Then burn the letter and scatter the ashes. My blessings are with you. Barbara

Melissa

I lost my Mom in March 2018 and I have regrets we were not at her side when she passed. My Mom suffered from Cx for 5 years. After it moved to her brain, she slowly deteriorated over then next 18 months until she passed. It started out with her forgetting a recipe she had made for years, to falling several times a week. The last fall almost killed her and she never came home – she went to rehab and then a nursing home. My father, 82 at the time, could not take care of her and protect her. She often would get up in the middle of the night and wonder around the house. My dad would tell her to wake him up if she needed something , but she would forget. He would tell her to then turn the light on, but she would forget that, too. Many times my dad would wake up and find her on the floor in another part of the house. Once she fell and hit her head on the foot of the bed and got a nasty cut on her forehead, and another time in the garage. I don’t know why I am justifying our decision to move her to a nursing home, actually I do… I have a lot of guilt over it. She would not have wanted that, but we did not have another choice. There was nothing we could do to prevent her from doing any of this. This brings me to the tear. My Mom was in Hospice and we were well educated on the signs to watch for in the end. First she stopped eating and drinking, then she slept all day with her eyes half open. A few days before she passed the Hospice nurse was there with us and she was sharing how she was going through the process of leaving her body and how difficult it is for the body to go through that process. She shone a small light in my Mom’s eyes and said her pupils were no longer responsive. Right after she left I was on her bed holding her hands and she sat up a little, eyes wide open staring right at me and she tried to talk but all that came out was the sound a deaf person makes when they try and speak. I always think about that – what was she trying to say? was she scared? My dad was at her side every day, and I came by after work and would sit with her and hold her hand and tell her she could go and not to worry because I would take care of Dad. The day before she passed, we left her room around 7P and told her we would be back in the morning. I got a call around 645A the next morning from the nurse who said, “your mother has expired.” Yes, she used those words. When my dad and I got there, her body was still warm. I hugged her and she was so rigid. I could not believe how warm she was – I guess I expected her to feel cool to the touch. I had to leave the room. We sat out in the living area outside her room and the nurse came over and said, “It was the oddest thing. When I checked on your mom this morning and realized she had expired, there was this one lone tear on her check.” Like everyone else, I have thought about the tear daily. Was it joy for meeting her savior? Was she seeing her parents and others who passed before her? Was she sad? Did she know she was alone? I have so much guilt for not being there. None of us were there at that early hour. One of us would usually get there around 8A. No one could explain the tear, no one had ever heard of it. My best friend who is an MD had never heard of it. Thank you for sharing this information and thank you to all of you who have shared your experience. I don’t think my guilt will ever subside, but this gives me something else to think about it.

I lost my Mom in March 2018 and I have regrets we were not at her side when she passed. My Mom suffered from Cx for 5 years. After it moved to her brain, she slowly deteriorated over then next 18 months until she passed. It started out with her forgetting a recipe she had made for years, to falling several times a week. The last fall almost killed her and she never came home – she went to rehab and then a nursing home. My father, 82 at the time, could not take care of her and protect her. She often would get up in the middle of the night and wonder around the house. My dad would tell her to wake him up if she needed something , but she would forget. He would tell her to then turn the light on, but she would forget that, too. Many times my dad would wake up and find her on the floor in another part of the house. Once she fell and hit her head on the foot of the bed and got a nasty cut on her forehead, and another time in the garage. I don’t know why I am justifying our decision to move her to a nursing home, actually I do… I have a lot of guilt over it. She would not have wanted that, but we did not have another choice. There was nothing we could do to prevent her from doing any of this. This brings me to the tear. My Mom was in Hospice and we were well educated on the signs to watch for in the end. First she stopped eating and drinking, then she slept all day with her eyes half open. A few days before she passed the Hospice nurse was there with us and she was sharing how she was going through the process of leaving her body and how difficult it is for the body to go through that process. She shone a small light in my Mom’s eyes and said her pupils were no longer responsive. Right after she left I was on her bed holding her hands and she sat up a little, eyes wide open staring right at me and she tried to talk but all that came out was the sound a deaf person makes when they try and speak. I always think about that – what was she trying to say? was she scared? My dad was at her side every day, and I came by after work and would sit with her and hold her hand and tell her she could go and not to worry because I would take care of Dad. The day before she passed, we left her room around 7P and told her we would be back in the morning. I got a call around 645A the next morning from the nurse who said, “your mother has expired.” Yes, she used those words. When my dad and I got there, her body was still warm. I hugged her and she was so rigid. I could not believe how warm she was – I guess I expected her to feel cool to the touch. I had to leave the room. We sat out in the living area outside her room and the nurse came over and said, “It was the oddest thing. When I checked on your mom this morning and realized she had expired, there was this one lone tear on her check.” Like everyone else, I have thought about the tear daily. Was it joy for meeting her savior? Was she seeing her parents and others who passed before her? Was she sad? Did she know she was alone? I have so much guilt for not being there. None of us were there at that early hour. One of us would usually get there around 8A. No one could explain the tear, no one had ever heard of it. My best friend who is an MD had never heard of it. Thank you for sharing this information and thank you to all of you who have shared your experience. I don’t think my guilt will ever subside, but this gives me something else to think about it.

Kevin B

I am so sorry for the loss of your mother.
I will say that in my experience that tears are are very often a sign of tear ducts closing in the death and dying process. At that stage it is generally the tear duct muscle relaxing.

I am so sorry for the loss of your mother.
I will say that in my experience that tears are are very often a sign of tear ducts closing in the death and dying process. At that stage it is generally the tear duct muscle relaxing.

Ana

I simply disagree with her last tear. My mom past away recently. She has been in a lot of pain but never shed a tear. Prior her last day she ate and was drinking water. She did not urinate for her last two days. She did not speak. Didn’t make any noise. Her breathing was very rapid and slowed down at her last two hours. Her eyes were half way open. She shed many tears in her last breaths. While I sat by her side she blinked three times the moment she passed. I do believe they can hear us and there is no way they can communicate. My mom always wanted us by her side and we all made it clear we were there and we were going to be together with her. And the tears started to roll down her eyes.

I simply disagree with her last tear. My mom past away recently. She has been in a lot of pain but never shed a tear. Prior her last day she ate and was drinking water. She did not urinate for her last two days. She did not speak. Didn’t make any noise. Her breathing was very rapid and slowed down at her last two hours. Her eyes were half way open. She shed many tears in her last breaths. While I sat by her side she blinked three times the moment she passed. I do believe they can hear us and there is no way they can communicate. My mom always wanted us by her side and we all made it clear we were there and we were going to be together with her. And the tears started to roll down her eyes.

Barbara

Hi Millyboo, as a person is preparing to leave this world they start to withdraw their attention from daily activities to parts of themselves that are inside. They often close their eyes or have their eyes partially closed. This is normal and part of how we die. Know your resident can hear you so continue to talk and tell her what you are doing as you care for her, when you are leaving, and when you will return. My blessings are with you and the woman you are caring for. Barbara

Hi Millyboo, as a person is preparing to leave this world they start to withdraw their attention from daily activities to parts of themselves that are inside. They often close their eyes or have their eyes partially closed. This is normal and part of how we die. Know your resident can hear you so continue to talk and tell her what you are doing as you care for her, when you are leaving, and when you will return. My blessings are with you and the woman you are caring for. Barbara

Mellyboo

Barbara! I just read your book Gone From My Sight tonight at the home I work in! I loved it!
A resident of mine is in the stages of the end, she’s stopped eating, drinking. Now she has her eyes closed, when I go talk to her, she starts moving around, whimpers but keeps her eyes closed. It seems as tho she wants to open them but can’t. I wish I knew why this was.
Anyhow. Thank you for your book! 🙏🏽🙏🏽

Barbara! I just read your book Gone From My Sight tonight at the home I work in! I loved it!
A resident of mine is in the stages of the end, she’s stopped eating, drinking. Now she has her eyes closed, when I go talk to her, she starts moving around, whimpers but keeps her eyes closed. It seems as tho she wants to open them but can’t. I wish I knew why this was.
Anyhow. Thank you for your book! 🙏🏽🙏🏽

Barbara

Dear Constance, it is so hard being at the bedside when our loved one is dying. We just don’t understand all that is happening. From what you have described of your mother’s last moments nothing pathological was happening. Actually it sounds like she did a very good job of dying easily. In the days and hours before death we are like the little chick working to get out of its shell. It works very hard to release itself from the confines of its shell. When we are dying we are working to get out of the confines of our body. Dying is not painful. Disease causes pain. From what you described your mother was not in pain. In fact the work to release from her body was not the struggle that many have. I don’t know why her eyes had tears. I do know that inside of her body, during that time, was not like she was acutely aware of thoughts and feelings. Her hearing and thoughts were as if hearing from a distant, as if being in that space between being awake and asleep—no feelings, no thoughts.
Constance, you might write your mother a letter. Put all of your concerns, thoughts, love and tears on paper. Write about the positive and about the challenges. Mom will understand. When you are finished burn the letter and scatter the ashes to the wind. You might also find my booklet My Friend, I Care helpful. My blessings are with you. Barbara

Dear Constance, it is so hard being at the bedside when our loved one is dying. We just don’t understand all that is happening. From what you have described of your mother’s last moments nothing pathological was happening. Actually it sounds like she did a very good job of dying easily. In the days and hours before death we are like the little chick working to get out of its shell. It works very hard to release itself from the confines of its shell. When we are dying we are working to get out of the confines of our body. Dying is not painful. Disease causes pain. From what you described your mother was not in pain. In fact the work to release from her body was not the struggle that many have. I don’t know why her eyes had tears. I do know that inside of her body, during that time, was not like she was acutely aware of thoughts and feelings. Her hearing and thoughts were as if hearing from a distant, as if being in that space between being awake and asleep—no feelings, no thoughts.
Constance, you might write your mother a letter. Put all of your concerns, thoughts, love and tears on paper. Write about the positive and about the challenges. Mom will understand. When you are finished burn the letter and scatter the ashes to the wind. You might also find my booklet My Friend, I Care helpful. My blessings are with you. Barbara

ConstAnce

My mom passed last week. I was at her bedside. She had been unresponsive for 5 days after a stroke. Eyes completely closed, yet when she took her last breath both of her eyelids were filled with tears. She made no sounds ever just stopped breathing and then the tears. It breaks my heart to think she was in pain or sad .. I don’t understand it, I’m tormented with the images. I wish they were tears of joy greeting her savior …. does everyone who dies typicall have tears even if their eyes have not been open at all and not watering because unable to blink?

My mom passed last week. I was at her bedside. She had been unresponsive for 5 days after a stroke. Eyes completely closed, yet when she took her last breath both of her eyelids were filled with tears. She made no sounds ever just stopped breathing and then the tears. It breaks my heart to think she was in pain or sad .. I don’t understand it, I’m tormented with the images. I wish they were tears of joy greeting her savior …. does everyone who dies typicall have tears even if their eyes have not been open at all and not watering because unable to blink?

Barbara

Hi Connie, from what you have described about your father’s death it sounds to me that nothing pathological was happening. He was dying the way most people die. It is so hard for us the watchers to understand how people die. We are used to how people die in the movies, most of us have never been at the beside in “real life” to know what is normal and what is not. The mucus was the result of fluid in his lungs. His body was shutting down and not able to process the fluid so it just stayed in his lungs. That is a normal part of dying. The crying and speaking out is also very normal. Our eyes are generally half open and fluid comes to the eyes. I don’t believe they are tears of sadness, just moistening of the eyes. About the speaking: in the hours to minutes before death a person is very removed from their physical body. Their world is like a dream world. They can hear as if from afar but they are very dream like. Their speech reflects what is happening in their “dream”. During the days and hours before death the person who is dying is like the little chick that works to get out of it’s shell. It appears to us they are just laying there, agitated, often murmuring when in fact they are working to get out of their body. I hope this has helped you see that your dad did a good job of dying. It is terribly sad that your father died but I don’t think anything that happened was pathological You might write your dad a letter. Put everything you want to say to him, the good and the challenging parts of your relationship in your letter. Let the tears flow, say what is in your heart then take the letter, burn it, and scatter the ashes to the wind. I hope this has offered you some guidance. My thoughts and blessings are with you. Barbara

Hi Connie, from what you have described about your father’s death it sounds to me that nothing pathological was happening. He was dying the way most people die. It is so hard for us the watchers to understand how people die. We are used to how people die in the movies, most of us have never been at the beside in “real life” to know what is normal and what is not. The mucus was the result of fluid in his lungs. His body was shutting down and not able to process the fluid so it just stayed in his lungs. That is a normal part of dying. The crying and speaking out is also very normal. Our eyes are generally half open and fluid comes to the eyes. I don’t believe they are tears of sadness, just moistening of the eyes. About the speaking: in the hours to minutes before death a person is very removed from their physical body. Their world is like a dream world. They can hear as if from afar but they are very dream like. Their speech reflects what is happening in their “dream”. During the days and hours before death the person who is dying is like the little chick that works to get out of it’s shell. It appears to us they are just laying there, agitated, often murmuring when in fact they are working to get out of their body. I hope this has helped you see that your dad did a good job of dying. It is terribly sad that your father died but I don’t think anything that happened was pathological You might write your dad a letter. Put everything you want to say to him, the good and the challenging parts of your relationship in your letter. Let the tears flow, say what is in your heart then take the letter, burn it, and scatter the ashes to the wind. I hope this has offered you some guidance. My thoughts and blessings are with you. Barbara

Connie

Feb,3 a little after 2 my Dad went to Heaven being there and seeing him die has left a horrible Mark on me I can’t get it out of my mind he sound like he was drowning 5 hours before he was gone he was crying out help me he even said Connie help me he had found out in December he had colon cancer that has spread to his stomach it spreaded very fast I was with him everyday from the day he found out taking care of him giving him all kinds of stuff to fight cancer ,blue barries walnuts ect,,,, my Daddy was a Godly man who loves Jesus I know where he is ,but can’t seem to understand the cry for help ,I even feel we let hem die we should have done something to clear the mucus up he was drowning just looking for help please I am in need of some kid of answer, connie

Feb,3 a little after 2 my Dad went to Heaven being there and seeing him die has left a horrible Mark on me I can’t get it out of my mind he sound like he was drowning 5 hours before he was gone he was crying out help me he even said Connie help me he had found out in December he had colon cancer that has spread to his stomach it spreaded very fast I was with him everyday from the day he found out taking care of him giving him all kinds of stuff to fight cancer ,blue barries walnuts ect,,,, my Daddy was a Godly man who loves Jesus I know where he is ,but can’t seem to understand the cry for help ,I even feel we let hem die we should have done something to clear the mucus up he was drowning just looking for help please I am in need of some kid of answer, connie

Sandy

Tonight I watched my mom take her last breath before she did her eyes had tears. I started to cry because I didn’t want her to cry I walked away crying . Later I came back to her and begged her to go to heaven see and be with her mom , dad sister and son. I played a song for her and then she closed her mouth and a big tear came down she took a few short breaths and then I told her to let go go home then she stopped breathing. To me and I will believe she had seen her family and it was tears of joy to finally see them . That was so peaceful to watch and I thank you sweet Jesus for taking her home.

Tonight I watched my mom take her last breath before she did her eyes had tears. I started to cry because I didn’t want her to cry I walked away crying . Later I came back to her and begged her to go to heaven see and be with her mom , dad sister and son. I played a song for her and then she closed her mouth and a big tear came down she took a few short breaths and then I told her to let go go home then she stopped breathing. To me and I will believe she had seen her family and it was tears of joy to finally see them . That was so peaceful to watch and I thank you sweet Jesus for taking her home.

Barbara

Hi Tracey, in response to your questions about your brother-in-law’s health; I am wondering when he last saw his physician? A doctor needs to evaluate him for the source of his pain. Until anyone knows why he is in pain, two Tylenol isn’t going to do anything. I am sorry the visiting nurse has not addressed this but you can by taking him to a doctor and have him evaluated. It also sounds like there are some mental health issues (Vietnam, depression, anxiety are possibilities). Have him evaluated for that while you are at the doctors.
It doesn’t sound to me that Jerry is actively dying but that he has some physical and mental challenges that need to be addressed.
My blessings are with you, Jerry, and your extended family. Barbara

Hi Tracey, in response to your questions about your brother-in-law’s health; I am wondering when he last saw his physician? A doctor needs to evaluate him for the source of his pain. Until anyone knows why he is in pain, two Tylenol isn’t going to do anything. I am sorry the visiting nurse has not addressed this but you can by taking him to a doctor and have him evaluated. It also sounds like there are some mental health issues (Vietnam, depression, anxiety are possibilities). Have him evaluated for that while you are at the doctors.
It doesn’t sound to me that Jerry is actively dying but that he has some physical and mental challenges that need to be addressed.
My blessings are with you, Jerry, and your extended family. Barbara

Tracey Taylor

Hi Barbara – I was referred to your page by a friend who lost her husband, and received so much help & insight from your book “gone from my sight.” I was looking through your posts to see if I could find help, but did not, so I am reaching out to see if you can help.

My husband & I, my two adult boys (28 & 26) live in an extended family house with my husband’s older brother, Jerry (70 this year). While living here, we’ve all lost brother Mike, Dad, and Mom – 2006, 2008 and 2015, in order; we all live(d) together. Since Mom’s death, Jerry has deteriorated – vision, health (diabetes), personal hygiene & outlook on life; he expresses he’s in ALOT of pain. He has a visiting nurse and meals on wheels. Even before all this death, Jerry, a Vietnam Vet, was recluse – he went off in preparation for Y2K. Although his vision is deteriorating, he refuses glases.

Now, he is sleepless at night, but sleeps MOST of the day; moaning/crying out in agony (nurse says take Tylenol for pain).
I don’t know what to do, Barbara.

Any advice you can offer is greatly appreciated.
Sincerely,
Tracey-the-sister-in-law

Hi Barbara – I was referred to your page by a friend who lost her husband, and received so much help & insight from your book “gone from my sight.” I was looking through your posts to see if I could find help, but did not, so I am reaching out to see if you can help.

My husband & I, my two adult boys (28 & 26) live in an extended family house with my husband’s older brother, Jerry (70 this year). While living here, we’ve all lost brother Mike, Dad, and Mom – 2006, 2008 and 2015, in order; we all live(d) together. Since Mom’s death, Jerry has deteriorated – vision, health (diabetes), personal hygiene & outlook on life; he expresses he’s in ALOT of pain. He has a visiting nurse and meals on wheels. Even before all this death, Jerry, a Vietnam Vet, was recluse – he went off in preparation for Y2K. Although his vision is deteriorating, he refuses glases.

Now, he is sleepless at night, but sleeps MOST of the day; moaning/crying out in agony (nurse says take Tylenol for pain).
I don’t know what to do, Barbara.

Any advice you can offer is greatly appreciated.
Sincerely,
Tracey-the-sister-in-law

Pam Johnson

I have witnessed “the final tear” twice. The first time was with my 1st husband. While his daughter was at his bedside, he seemed to wait until his son arrived to pass away. His daughter told him that both she and his son were at his bedside and loved him and a single tear trickled down his cheek and he took his last breath.
Then recently, my Mother was unresponsive for 24 hours. Just before she died, she opened her eyes, seemed to look at me, my son and daughter as we were telling her how much she was loved. She then closed her eyes and a single tear appeared as she took her last several breaths. It was a comfort for us. I found this site as I was exploring if there was a physiological reason for this experience… I will continue to believe it is a sign from God. It is a reassurance that it was time for the suffering to end. Blessings to all who have experienced loss.

I have witnessed “the final tear” twice. The first time was with my 1st husband. While his daughter was at his bedside, he seemed to wait until his son arrived to pass away. His daughter told him that both she and his son were at his bedside and loved him and a single tear trickled down his cheek and he took his last breath.
Then recently, my Mother was unresponsive for 24 hours. Just before she died, she opened her eyes, seemed to look at me, my son and daughter as we were telling her how much she was loved. She then closed her eyes and a single tear appeared as she took her last several breaths. It was a comfort for us. I found this site as I was exploring if there was a physiological reason for this experience… I will continue to believe it is a sign from God. It is a reassurance that it was time for the suffering to end. Blessings to all who have experienced loss.

Cassandra

Thank you for all the information you have on this subject. They dying process is so fascinating and beautifully natural. Hospice has helped make my journey with my cousin easier. Being educatined with accurate well written information is so important. Thank you Barbara!!
Cassandra & Reba

Thank you for all the information you have on this subject. They dying process is so fascinating and beautifully natural. Hospice has helped make my journey with my cousin easier. Being educatined with accurate well written information is so important. Thank you Barbara!!
Cassandra & Reba

Melissa Cantu

I see now where you have the books in other languages so disregard my question earlier. Thank You

I see now where you have the books in other languages so disregard my question earlier. Thank You

Melissa Cantu

I just wanted to ask if these books come in Spanish?

I just wanted to ask if these books come in Spanish?

Barbara Karnes

Hi Carol, your question do I see a “difference in the dying process and emotions, actions, of Christians and those professing no faith in Christ?” is one others have asked also. My answer is really, no, I don’t see a difference. People die the way they have lived. Their dying is reflected in their personality traits, their fears, their beliefs. We don’t suddenly go from being a challenging personality to being a submissive one. Our personality actually intensifies so from this example we become more challenging, not less as we approach death.

Sometimes as death approaches, or in the case of suicide in the days to moments before the action is taken, people explore their beliefs, previous and current and come to “terms” with what they have chosen to believe. Some pray when they have not prayed in a long time. Some do not. This relationship we have with our God (or not have) is such a personal one that these thoughts are generally not shared but kept deep, deep, within ourselves.

Nicole’s death is heart wrenching. There will never be answers for why she found life so difficult. What I have learned is that sometimes life is just too hard. It is just too hard to be alive. I hope you find a bit of comfort in the knowledge that she is at rest now from this challenging life that she had.

Hi Carol, your question do I see a “difference in the dying process and emotions, actions, of Christians and those professing no faith in Christ?” is one others have asked also. My answer is really, no, I don’t see a difference. People die the way they have lived. Their dying is reflected in their personality traits, their fears, their beliefs. We don’t suddenly go from being a challenging personality to being a submissive one. Our personality actually intensifies so from this example we become more challenging, not less as we approach death.

Sometimes as death approaches, or in the case of suicide in the days to moments before the action is taken, people explore their beliefs, previous and current and come to “terms” with what they have chosen to believe. Some pray when they have not prayed in a long time. Some do not. This relationship we have with our God (or not have) is such a personal one that these thoughts are generally not shared but kept deep, deep, within ourselves.

Nicole’s death is heart wrenching. There will never be answers for why she found life so difficult. What I have learned is that sometimes life is just too hard. It is just too hard to be alive. I hope you find a bit of comfort in the knowledge that she is at rest now from this challenging life that she had.

Barbara Karnes

Hi Mary, I read your comment on this Blog Whimpers and Tears post about families being concerned about “gasping for air and short of breath”. Yes, it seems no matter how much teaching and prep work we do with families about the normal dying process and what all happens it never truly prepares them for the actual experience.

Ninety percent of our work in end of life is teaching. Repetition is part of that teaching. Repeat, repeat, repeat. “ Mom is doing a good job. Mom is doing what she is suppose to be doing. This is how a person dies. Nothing bad is happening, nothing pathological. This is how people die. See how she is breathing with her mouth open, those fish like movements. She is suppose to do that. The sounds—those are normal. Those are the sounds people make as they are dying.” All these things we say, over and over again as we guide a family through this final life experience of their special person.

Get the family involved in the moment. Get them individually to say goodbye. Talk about the positive as well as the negative. Encourage touching and holding. Get the family beyond their fears to what they are seeing and interpreting as “bad” into an interactive, giving love and encouragement space.

Mary, thanks for asking. Think I’ll take these comments and do another Blog with them.

Hi Mary, I read your comment on this Blog Whimpers and Tears post about families being concerned about “gasping for air and short of breath”. Yes, it seems no matter how much teaching and prep work we do with families about the normal dying process and what all happens it never truly prepares them for the actual experience.

Ninety percent of our work in end of life is teaching. Repetition is part of that teaching. Repeat, repeat, repeat. “ Mom is doing a good job. Mom is doing what she is suppose to be doing. This is how a person dies. Nothing bad is happening, nothing pathological. This is how people die. See how she is breathing with her mouth open, those fish like movements. She is suppose to do that. The sounds—those are normal. Those are the sounds people make as they are dying.” All these things we say, over and over again as we guide a family through this final life experience of their special person.

Get the family involved in the moment. Get them individually to say goodbye. Talk about the positive as well as the negative. Encourage touching and holding. Get the family beyond their fears to what they are seeing and interpreting as “bad” into an interactive, giving love and encouragement space.

Mary, thanks for asking. Think I’ll take these comments and do another Blog with them.

Deborah Peters, RN

Dear Barbara,
As a nurse for the past thirty four years, I have had the opportunity to fulfill many different nursing roles. The majority of my experience has been with Geriatrics. I have been a bedside nurse, as well as a DNS in SNFs and Hospice Director/Primary Nurse. As a very hands on Nurse Manager, I always made certain that my facility staff had direct access to your publications. I have probably used the “Gone From My Sight” booklet several hundreds of times. It was the perfect educational/supportive tool for the families and loved ones of my patients/residents. It was a very beneficial segway into those difficult discussions that needed to take place. Since I retired as of my last position of DNS, I can only hope that the new Director has continued to use it as well as having incorporated your other publications as needed. I just wanted to let you know how helpful and meaningful your work has been to me throughout my years in our profession. I very much enjoy following your email communications. Keep sharing your expertise and knowledge as you currently do. You are contributing a great deal to the Nursing Profession.
Sincerely,
Deb Peters, RN

Dear Barbara,
As a nurse for the past thirty four years, I have had the opportunity to fulfill many different nursing roles. The majority of my experience has been with Geriatrics. I have been a bedside nurse, as well as a DNS in SNFs and Hospice Director/Primary Nurse. As a very hands on Nurse Manager, I always made certain that my facility staff had direct access to your publications. I have probably used the “Gone From My Sight” booklet several hundreds of times. It was the perfect educational/supportive tool for the families and loved ones of my patients/residents. It was a very beneficial segway into those difficult discussions that needed to take place. Since I retired as of my last position of DNS, I can only hope that the new Director has continued to use it as well as having incorporated your other publications as needed. I just wanted to let you know how helpful and meaningful your work has been to me throughout my years in our profession. I very much enjoy following your email communications. Keep sharing your expertise and knowledge as you currently do. You are contributing a great deal to the Nursing Profession.
Sincerely,
Deb Peters, RN

Mary Kautza

Barbara

Recently we had two hospice patient families express dissapointment that it appeared to them that their loved ones were “gasping for air and short of breath” while in the end stages of dying. Families were very upset, one of the individuals was even a RN! The patients were receiving medication for symptom control so it was not r/t a lack of medication. We do give all families your “little blue book” and explain the process, indicating that all family members should read the book as it will help them understand what will occur during the dying process. Do you have any further tips or hints we can use to help distressed families as their loved ones die?

Barbara

Recently we had two hospice patient families express dissapointment that it appeared to them that their loved ones were “gasping for air and short of breath” while in the end stages of dying. Families were very upset, one of the individuals was even a RN! The patients were receiving medication for symptom control so it was not r/t a lack of medication. We do give all families your “little blue book” and explain the process, indicating that all family members should read the book as it will help them understand what will occur during the dying process. Do you have any further tips or hints we can use to help distressed families as their loved ones die?

Carol Alix

In your experiences do you see a difference in the dying process and emotions, actions, of Christians and those professing no faith in Christ?
Do people in those end weeks/days tend to reach for God.

I ask because my daughter died by suicide (gunshot) 11-20-16. She was 47. Her 23 year marriage to a narcissistic man that does not believe and then a 5 year marriage to whom she thought was her soulmate -- (a narcissistic women) that likewise has no faith. The last 4 years were very hard on Nicole.

Nicole was saved at a young age and grew away from the church as an adult.

I fear she turned away from God in the end and wondered with all your experience if there was a pattern…..

In your experiences do you see a difference in the dying process and emotions, actions, of Christians and those professing no faith in Christ?
Do people in those end weeks/days tend to reach for God.

I ask because my daughter died by suicide (gunshot) 11-20-16. She was 47. Her 23 year marriage to a narcissistic man that does not believe and then a 5 year marriage to whom she thought was her soulmate -- (a narcissistic women) that likewise has no faith. The last 4 years were very hard on Nicole.

Nicole was saved at a young age and grew away from the church as an adult.

I fear she turned away from God in the end and wondered with all your experience if there was a pattern…..

Dee

I agree with your description of how our dying ones might hear things. I have accompanied many dying persons over the past 50 years and am quite sure many – perhaps all- DO hear. Sometimes they will respond to my voice when they do not respond to others – I feel like I am really addressing them and when they respond it is often as if they are coming from a long, long way down. And, I believe they are. It is important just to reassure them that they are doing well. If it seems hard, acknowledge that it can be hard work, but rest is assured. Let them know great peace awaits them and, if you share a faith, acknowledge that. Otherwise, just try to honor them and be very humble in trying to discern their wishes.

I agree with your description of how our dying ones might hear things. I have accompanied many dying persons over the past 50 years and am quite sure many – perhaps all- DO hear. Sometimes they will respond to my voice when they do not respond to others – I feel like I am really addressing them and when they respond it is often as if they are coming from a long, long way down. And, I believe they are. It is important just to reassure them that they are doing well. If it seems hard, acknowledge that it can be hard work, but rest is assured. Let them know great peace awaits them and, if you share a faith, acknowledge that. Otherwise, just try to honor them and be very humble in trying to discern their wishes.

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