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I’ve known situations where those meds were not given, and the natural processes still happened… but were often accompanied by pain and in some cases screaming.

Most of the medications given for this purpose ; I have taken at some point over the course of my life for various ailments or moments in time….. to make me more comfortable…. And in much higher doses than that of a hospice nurse!

I KNOW these medications personally and I know their value when I needed them. I also know that guilt; in my family, my husband’s family, and watching others….

My resolve has had to be- I know the suffering that can happen without it and it’s just not worth that risk; to the patient NOR the families!

Second guessing and doubting is hard not to sink down into—but we do them no honor now… for doing all we knew to do then… to ease their suffering and their flight…. We did our best with what we knew!

Knowing what I know and seeing what I’ve seen- I can’t believe that the low doses I’ve seen given could ever take that which is not coming to an end.

Please troubled heart; don’t keep tormenting yourself! What if SHE had had to make that decision for YOU?!?!

Give yourself the peace that she would want you to have! Give yourself the peace that you would want her to have, had it been reversed! Hugs and more hugs
I hope you find your peace!!!
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KarinBe, one of your original posts says "I knew it was supposed to be 4 hours between doses."

That's not true. I had a morphine drip that I could get a dose every 11 minutes.

Reading your previous posts, you are looking for a reason to be responsible. You need to find a great counselor and deal with that angle. Your parents were dying, they knew they were dying and they were ready to go. Do you begrudge them that peace? Because trying to find a way to live in the past and be responsible for nature, does them no honor.
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AlvaDeer Jun 2022
Yes, Morphine is almost always given as needed. Esp if a person is near death. It is given until the needed relief of respiratory distress and air hunger are not symptomatic and distressing. IV it is given usually 2-4 mg and can be given very often indeed. Our OP has not said if this is a hospice situation, but in Hospice it is typically given until there is relief even IF it hastens death, as I said, by minutes or hours or even days (and one cannot know that).
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Here's another way to look at it: Your mother may have been in terrible pain and suffering. Her nurse and doctors- not you- were responsible for making reasonable medical decisions. It's entirely possible the nurse, seeing your obvious distress and hers, decided that chance of relieving her pain was more important than the risk of not extending her life, especially when those extra hours gained might be hours of excruciating pain.
One of my friends was a hospice nurse. She used to praise families who had the courage to make decisions that ended suffering sooner, and has many medical directives in place for herself and her own family. She's seen suffering first-hand for decades. I know if she was reading this, she would tell you made a wise and loving decision, using the best knowledge available at the time. Your mother loved you, and would not want you to spend years torturing yourself like this. Perhaps you can honor her by forgiving yourself, and spending the years you have left doing things you and your mother once enjoyed? Bake a cake in her memory, walk on the beach in her memory? Whatever you once loved together, do it now. Do it with your kids, if you have any. Isn't that what she would want?
You sound like a great daughter who did her best. Now maybe go live your own best life, with the help of a therapist, if needed?
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There is plenty of information here and on the Internet that tells caretakers about the terminally ill rallying just prior to death, where they mistakenly appear to be coming back and then they abruptly die.

You are not God and you are not responsible for her death. Please learn to meditate and please have a discussion with a grieving specialist. Do you know the 5 Stages of Grieving? https://grief.com/the-five-stages-of-grief/
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You hastened by 2 hours something that was going to happen anyway. In the two hours by which her life was shortened would she have been able to walk in a field of daisies and marvel at their beauty? Would she have been able to watch and smile at her favorite TV show or enjoy cooking her favorite meal? She was dying. No life experience was left to her. Nothing but struggling in pain and waiting to leave the body that had failed her soul and her spirit. It is not your fault that she lost two hours from a life that was miserable. Please understand that you helped her to be free. I hope someone who loves me would do that for me when the time comes. Blessings and peace to you.
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If you, and others here as well, are 9 years into the grief process and STILL unable to 'forgive' yourself for allowing your loved one to pass away, believing that it was YOU who caused their death in the first place when it was really illness and age at play, then intensive therapy is your best bet. Grief counseling and therapy by a professional is the only way you can possibly hope to get past this and realize you had nothing to do with your mother's death. We on a forum can't possibly help you to understand that, especially if we haven't been able to get through to you in 9 years with our own stories and experiences.

To then see another poster like cinderblock get so upset at the true words from DrBenshir tells me that NONE of us can possibly get through to you who are suffering from such self-imposed guilt. You honestly believe you 'killed' your parent and nothing we tell you will change that. PLEASE seek out professional help before YOUR lives are further destroyed due to something that happens to ALL of us: death. In reality, we have no say in when a parent passes; and whether we hire hospice or administer pain meds to them in an effort to ease their pain, they WILL pass away on God's timetable, no matter what. If those pain meds cause them to pass a day or two sooner, so be it. In the grand scheme of things, I'd rather be on earth a day or two LESS and not in mortal pain, wouldn't you?

We can't always get past irrational emotions on our own; sometimes we need professional help to do so. Now is that time, OP, after 9 years of self torture. It's time you allow yourself to put that memory of your mom's breathing out of your mind so you can move on with YOUR life.

Wishing you the best of luck doing so.
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MeDolly Jun 2022
Yes, I agree, some people like to wallow in grief, it may be Complicated Grief or prolonged Grief Disorder, they are caught up in rumination about the circumstances of the death. The APA now recognizes this as a mental disorder.

Some research has shown that if the grief stricken person was very dependent for practical and emotional needs, or their world revolved around the person who has passed they will be more likely to suffer from one of these disorders.

These people do not find a pathway that leads to restoration of a satisfying life, they are entangled in grief.

One thing this does is keep the attention on them, so it appears that it is a layered mental health disorder.

There is help out there, I hope that these posters reach out and get the help they need.

I wish them the best.
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Oh you poor woman-tortured by a guilt you shouldn’t feel. She was dying and only God decides the hour. You sound as if you put a gun to her head! My sister felt she overdosed my mother at the end but still, it was the end and neither you nor my sister was actively TRYING to kill. What seems to be happening is the pain you feel from losing her has turned into guilt, self punishment. If you could really have had the power to make her live longer, you would have but it was not really in your hands. If you went to bed, you were undoubtedly exhausted. If this continues, you should join a grief group or seek counseling.
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Well, then I killed my FIL.

He was in the hospital with end stage CLL. Slowly drowning in the fluid that was building up his in lungs. He could not cough it up and he was trying, but no strength and no energy to do so.

We get a call that he is actively dying--and we hustle to the hospital. The oncologist met with us (Dh and me, SIL and BIL) and he explained that dad could NOT recover from this, as he had almost no red blood cells and he was actively dying and miserable. Dr asked if he could give dad a shot to 'ease his discomfort'--Dh and SIL just looked like deer in the headlights. I stepped in and said "that would be wonderful"--you guys OK with that?" which was all the dr needed. He stepped up to the head of the bed and the IV hanging there and proceeded to empty a HUGE bolus of morphine. He kept his back to us, but I knew he was essentially ODing dad on morphine. And GOD BLESS HIM for that.

FIL died less than 15 minutes afterwards.

It took YEARS for my Dh to not blame me for 'pushing' the morphine. IDK what he thought was going to be the outcome.

8 months later I was doing the same thing for my sweet dad.

KarenBe--you are wasting YOUR life second guessing your decision. I hope you find a good therapist to help you through this.
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AlvaDeer Jun 2022
Midkid, what a beautiful post.
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KarenBe, you are stuck in a horrible self talk and self blame loop for 9 year. You're saying it's getting worse. Please don't wait. Each day, you are more and more entrenched in this guilt abyss which you can't climb out of. You need professional help, a good therapist who specializes in grief counseling.

Please go search for one asap, like tomorrow.
Call up a local grief support group, call your doctor, hospital social workers, hospice providers, and ask for recommendations for a good therapist. Do it now.
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That breathing was because she was suffocating. That is a horrible way to die. No one would want to suffer for days with that.

Have you considered that your mother was ready to die? That she knew she would not recover and wanted you to be spared watching her pass? She obviously knew you would not be able to deal with this and tried to make it easier for you. She is not in pain or distress, she had a long life, and you are wasting yours.

Guilt has no place in life. If you did something wrong, which you did not, you need to make amends. The only way to do that for someone who has died is to live your life for both of you: do the things your mom would have done; experience the things and the joy she is no longer here to share; live each day as she would have wanted. Be loved and loving, appreciate your family and friends, enjoy the good and the beauty in the world.
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MeDolly Jun 2022
Excellent Post!
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Bedside farewells are almost never the magical thinking farewells we see on stage and screen, and as a nurse lifelong I can assure you of that. Your Mother was dying. You say that she may have lived anothre few days. While it is true that morphine, the best medication for easing breathing and suffering, may hasten death by some minutes, hours, even days, it is the one thing we have to relieve the suffering of those we love.
Those few days you wish for would have been very unlikely to have led to a romantic farewell; instead, as an RN I have seen them come to begging for an end, begging for help. If you want to speak of guilt for allowing that to come, I would understand your reasoning, but for peace and a gentle final exit, and after this number of years, I am afraid you may need help beyond what a forum may be able to give you.
I truly would suggest counseling and therapy, and I am not someone who says this without having HAD the same three times in my life when my own ability and understanding was insufficient to handle a life crisis. While mourning is individual to us all, for you to take on this responsibility of guilt, has a whole pattern that needs to be combed out with help of a professional. Guilt beongs to felons, and they never feel it. What you are experiencing is grief, and it is now, at almost a decade, too long to carry this.
People have many subconscious reasons for remaining in a state of guilt. Guilt implies that thee was an answer, one you chose not to hear. That there was a cure you refused. That something could have been different and you chose not to see it. Guilt implies you could have fixed all this. Am that is a kind of hubris. It suggests you are godlike, or at least a good fairy with a strong wand. Grief, instead, understands that loss comes to us all, and is the price of our giving and receiving love, which enriches our lives.
I am sorry for your loss, but it sadly does not honor to your Mom. Would she not have wanted you to ease her death and celebrate the wonder of her life?
I encourage you to seek help from a good therapist. I have found that often for life transitions work a private practice certified Licensed Social Worker is best. I wish you so much luck and my heart goes out to you.
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KarinBe Jul 2022
AlvaDeer, thank you so much<3
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Dear dear, stop ✋ blaming yourself. You miss her terribly, and I think unconsciously not allowing yourself to go through the proper grief stages because you are blocked by guilt.
I believed that it was her time and God called her. She had many ailments, and if you could talk to her, she would tell you she is free from pain and suffering. Now you should be too. Stop beating up yourself and be kind to yourself. Get to a grief counselor or bereavement group, and work through this.
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KarinBe Jun 2022
Dear Kimbof, thank you for your kind response to my post.
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I hope you can reconcile this. The nurse would not have given a dose if it was too much. Your mom was in distress. I would have done the same thing you did. Your mom needed relief from what was killing her. Thank God , that your mom had this gift.

on Mother’s Day I arrived to find my mom moaning in pain, comatose basically . I called the Hospice on call nurse. Who was with another family and would be awhile. She stated if it had been a half hour since her last dose, have them give another dose. My mom needed it. Your mom needed it. When the nurse arrived she had to give my mother another dose… I am relieved that my moms pain was relieved.

I too, have the I should’ve not left. I should have stayed, they tell you a length of time. I wish I had more knowledge. I was on my way back when I had received the call from Hospice.

For your sake , change the narrative. You helped give your mom the gift of dying pain free.
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KarinBe Jun 2022
Dear Babsjvd, thank you so much for responding to my post. I´m sorry your mom had so much pain.
The thing is I don´t think my mother had pain, neither was she struggling to get air. She had very fast breathing and I was afraid that would make her heart stop. But the morphine made her heart stop. I was not prepared for this.
The thing is I noticed that my mom did not want that second shot (she was totally awake), but I was so dedicated in helping her breathing that I didn´t take it as seriously as I should have.
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I killed my father, too, I totally understand. Everyone says it wasn't my fault, but they don't get it. I was the one actually administering the meds. Yes, the Dr approved it all, and yes, he was dying anyways, and yes, the meds made him more comfortable. But he was my Daddy, and I gave him the meds that hastened his death. I'm still working on how to carry on living. I think one thing that helps is that I'm still taking care of Mom, which I promised him I would do, even though she is difficult and I really don't want to. I couldn't sleep for days after his passing without hearing that awful breathing... Because it was covid, it was impossible to get nurses in to help at the end, so I was the nurse, and I didn't know to put a pillow under him and prop him to one side to help the breathing. So much guilt. I'm so sorry that I couldn't make him more comfortable. I tried to ease his mind by promising to take care of Mom, and his beloved grandson, and my brother. I hope it helped a bit.
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DrBenshir Jun 2022
You didn't kill your father. Repeat this daily until you start to believe it. Unless you came into his room with active covid knowing he would catch it and die you did NOT kill your father. It is arrogant to believe you did. If your father could have told you, he would have asked you to help him and you did, with a doctor's direction. You and KarinBe need to understand that this is the greatest kindness you can do for a dying parent - ease their suffering and show them love and respect to the end and beyond. Now you have the more difficult task of living as they would want you to. You have failed in that. Get help, both of you.
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i am so sorry you have been suffering with this for 9 years. i know you've heard this a lot but you absolutely need regular and sustained therapy because clearly the therapy you've gotten in the past was too brief or not sufficient for whatever reason. often someone will see a therapist and think it's not helpful but really it's just that one therapist wasn't a good fit. shopping around is important. you deserve to live a life free of self-torture and it will require work to get there. you thought you were doing the best thing for your mother and you were trying to help--only if you had intentionally tried to kill her would you deserve to feel this badly. you are innocent and you need to learn to stop punishing yourself, and only regular therapy and possibly medication can help with that. and i mean like, lifelong weekly therapy. otherwise you will continue punishing yourself for the rest of your life.
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KarinBe Jun 2022
Thank you, cignal, you are absolutely right, finding the right therapy and the right therapist is very important. Thank you.
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Friend. I'm so sorry for the years of anguish you have gone through. My mom declined slowly at first from copd but began a quicker decline as the disease progressed. She has begun having episodes where she could not get a good breath and it panicked her to think of what her end would be like. I promised her I'd not let her suffer. The hospice nurse told me how to do the dosing of morphine drops. Mom had a similar pattern of breathing that you described for a time. It then changed to something more difficult to watch for me as she began to really struggle to breath. No details; you don't need those in your head. I kept mom dosed as instructed. I made sure she never FELT air hungry even though that was what her body seemed to experience. She passed after multiple doses of morphine in relatively short succession. For years I felt responsible for ending that life too soon - what if I had given too much, too fast? I later came to understand that there is a huge difference between EXTENDING someone's life and PROLONGING their death. Your mom's body was shutting down and no one has control over that. My mom's physical process of leaving this earth was not peaceful or quiet but I was able to take away her fear and discomfort. She was lucky to have you to do the same. The hospice nurse would not have given her another shot of she felt it was unwarranted. Witnessing a loved one die is beyond difficult; I'm wondering if you are having difficulty accepting what you saw as part of a normal (horrible, terrifying) process. When a baby is born that process is intense and can be scary to watch. Think of her physical death as her soul's birth process. Not being there to witness her last breath was a blessing to you and I'm betting what your mom preferred. That flood of chemicals your own body was releasing in response to your own distress can physically change your brain's neuropathways. The riverbed now carved keeps those same thoughts flowing through the same channel. You feel what you feel but that feeling doesn't reflect the truth. You must find some kind of counseling to help you sort feelings from facts and allow you to enjoy the good memories of years with your mom and not the stress of her last few hours. Peace to you...
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notgoodenough Jun 2022
"I later came to understand that there is a huge difference between EXTENDING someone's life and PROLONGING their death."

That is extremely well put. Thank you.
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Morphine or no Morphine your mother was transitioning. Giving her the morphine might have made it a little quicker, but that is it, she had no quality of life remaining on this earth, why would you want her to remain longer and suffer more?

To say with 100% accuracy that the last shot of morphine was the reason she went a little quicker, is something you are devising in your own brain and are continuing to promote to yourself, the question is why?

I would strongly urge you to go to therapy, get some help, this self-imposed guilt is something that you have been manifesting way to long. It appears that this thought process has all consumed you.

Keep in mind, we are all destined to die, you or no one else here on God's Green Earth is powerful enough to stop the process.

I for one would prefer dying quicker, suffering in pain is not my thing.

IMO you were wanting her to live longer for you, not her, maybe she was ready and that is what happened she made the decision to move onto a better place, this you will never know!
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Kimbof Jun 2022
This was great advice.
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I am sorry you have been suffering so long over this. I am sure others have told you not to be guilty. I hear your mom was so important to you. Her death under any circumstances was going to affect you strongly. I have a counselor to whom I retell every step of my mother's decline. I think it helps. Also my brother and I literally reprocess everything including childhood and adulthood stories of my mother. It has been a year of intense family therapy without the therapist. Like almost every day. You may need this.
I see 3 points in your story that are a focus. The nurse had said it would take time; you called and they gave shot; and you didn't get to say goodbye.
Firstly, the nurse tried to prepare you but she doesn't know. Every time they give us a prediction, it's wrong. I think mom's breathing change is an indication of a change in status. She probably had only hours to go. In hindsight, you really needed that nurse to update you that night, giving you a better indication. She wasn't perfect.
The shot sedated her yes. But the nurse knew what she was doing. She wanted to relieve your pain as much as mom's. In reality mom may have been hanging on cuz you were there. She was looking at an agonizing wasting. Instead she was asleep.
It seems you wanted an idyllic death while you were there. But most often they wait til you leave the room briefly to die. They stick around because you are there. Your mom already know how much you love her. She knew you were there for her. It was easier for her to go like she did. How do you know? Maybe this was the way it was supposed to be.
I hope I didn't cause you more guilt or sound too simplistic or trite. Every step of this is traumatic and you question everything. But your mom had a good death too. Just not the one you wanted.
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PS- you may have sought help from therapists before- you must find one that will work for you.
FOR you.
You are reading things about death that may not be correct. Fast breathing is distress.
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My Dear Friend,
I have been in the black hole of guilt- depression, replaying my father’s death over and over. … please keep reading my note to you even after I say this next part.
you must get counseling and possibly ( even fir the short term) medication. You must do this b/c you know that your beloved mother would not want her daughter to suffer. Am I right? Re-read that last sentence. She would not want you in this anguish.
i think what would also be extremely helpful to you, which I did , is to talk to Dr about the process of death and how morphine affects the body. Your mom was in DISTRESS. You and the PROFESSIONALS did the correct thing. If the microphone would have hastened her death, the staff would have said “no”. What the Morophine did was to slow her heart rate so her panic at not being able to get enough air ( I’m sorry if this is bringing back memories) was lessened. It calmed her panic.
there are people who believe there might be a miracle~ even though they are watching the death process. I can respect that. Miracles happen, but, dear friend, they are rare. As much as you want to think you were controlling the situation ( her death), you were not. Call it God, call it biology. You , the nurse, dr, etc we’re not in control then. You ARE in control now. Seize this control.
One more thing. Often loved ones pass away when the people they hold dearest to them are not watching. Again, call it God, natural instinct…. I don’t know why, but perhaps it was a last kindness to you. You must be gentle with yourself.
I beg you to seek counseling bc the days you wished for your mom are being given to YOU. Life is exquisite… please live it.
With Love.
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Thank you Sadinroanokeva, for responding.<3
I know that morphine is often used for the dying, what is bothering me is that my mother was given another dose of morphine so soon after the first one, and this caused her to stop breathing.
The nurse said nothing of the risk of doing this before giving the shot.
My mom would have lived more days if this had not happened, she was totally awake.
I have taken help from different therapists over the years, it keeps coming back and I see it as a film playing in my head as if it happened yesterday.
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kjb1025 Jun 2022
Oh Sweetie,
There are so many things that you do not know for sure. Trying to use facts and numbers to statistically calculate how much longer your mother would have lived is impossible.
Maybe, just maybe, she waited until your brother was gone and you had gone to bed to pass. Maybe that is why she was in distress, she knew she was at the end but she did not want you to witness it.
Take comfort in the fact that she loved you and you loved her.
Please, please look for comfort in all the love coming your way.
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Based on my experience I can understand why so many people believe that the medications given at the end of life have hastened death, my mom changed noticeably after her last dose of dilaudid and passed away shortly after. But the thing is she had already been dying for days before that and had many doses prior to the final one, so in my opinion even if it had helped push her toward the inevitable conclusion that was a good thing. You dear mother was panting and in physical distress for 9 HOURS and you gave her something to ease her suffering, that was a GOOD THING.
You have ruminated too long about this, please do as Sadinroanokeva has suggested and seek counselling about this 🤗
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KarinBe Jun 2022
Thank you, Cwillie, for responding <3. It was maybe a good thing with one dose of morphine and sedatives, not two..that pushed her over the edge. If you die shortly after one dose of morphine (I´ve heard this many times) then you are about to die any minute or hour.
But to be given two doses with not so much time between is pushing the person to die! I did not, at that time, understand thing, I was dedicated to help my mother in what I thought was distress.
I later read that fast breathing in the dying is not necessarily a sign of distress, BUT very distressing to caregivers.
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I am so sorry you are still struggling with this. Morphine slows the heart rate. It gives pain relief to the dying. It was common where I worked to help patients get through the dying process. You need mental health counseling, a good doctor to help you with your depression. Replaying this mentally for 9 years is non productive. PLEASE get help.
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