Date
June 29 2017
Written By
Barbara Karnes
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Whimpers and Tears in the Actively Dying

Whimpers and Tears in the Actively Dying


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Barbara - August 08 2019

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 - August 08 2019

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 - June 07 2019

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 - June 07 2019

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 - March 31 2019

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 - March 30 2019

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 - March 26 2019

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 - March 26 2019

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 - March 03 2019

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 - March 03 2019

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 - February 06 2019

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 - February 06 2019

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 - November 17 2018

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 - July 12 2018

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 - July 12 2018

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 - December 22 2017

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 - October 01 2017

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 - July 10 2017

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

Melissa Cantu - July 10 2017

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

Barbara Karnes - July 08 2017

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 - July 08 2017

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 - July 07 2017

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 - July 06 2017

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 - July 06 2017

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 - June 30 2017

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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