Dad died today, was it rushed ?

My dad died today at 8am at home and it was horrible to see him go. I held his hand as he passed. He was diagnosed with lung cancer that had spread to the brain at the start of last month. We assumed his walking difficulty symptoms were due to the heart disease he was waiting for an operation for, not knowing he had cancer going on in his body too. 

About 3 days ago he had been given a syringe driver in his arm for his medication and food/drink. He could still swallow but I guess the nurses felt it would give him what he needs easier perhaps. 

Last night at 9.30pm I suddenly noticed he was breathing oddly, it was like he was loudly gargling water on each breath, I really panicked. I had no idea about the "death rattle" at that point. Thankfully the night carer was due within 20 minutes so when she arrived she said it is normal for a terminal patient to have that sound. She called the district nurse and they gave him an injection of something and boosted some of his meds. 

All through the night he carried on making odd sounds when breathing, so sadly they didn't get rid of the noise. He was asleep all the time and I couldn't wake him. The night carer left at 7am and I sat with him for the next 90 minutes rubbing his hand and talking to him. When he died, within his last hour, he was breathing so fast I knew he wasn't going to last long, as his poor body was never going to be able to keep that pace up for long. 

My reason for writing here is I am so confused if the death rattle he got could have been related to the addition of the arm syringe driver or whether it would have happened then anyway ? Before the arm device was put on he was agitated and plucking at his sheets but he could still talk weakly. Then when on the driver he was just asleep all the time with no interaction, then 3 days later he was dead. He wasn't in any pain from the cancer so I am just concerned he was placed on this device too soon. The nurses say he got it added because he was agitated so it would help with breathing and stopping him moving. I am not sure what was in the medication on the driver but I presume things like morphine and other relaxers. 

I know you can't speak about this exact situation but I did wonder a few things in scenarios like mine. Would there be anything put in a driver that would bring about the death rattle in a patient ? As I hear that happens during being unconcious. He only really stayed asleep all the time since being on that, before that he was at least talking a bit. Could liquid from the driver have collected in this throat and he couldn't breathe properly ? I was so tempted to pull it out of his arm but I didn't. 

I am just so hoping because he was pain free that his passing wasn't bought on sooner than it needed to be. I totally understand why patients in pain might find such a way helpful though. I just wouldn't like to think the driver made him unconscious so then the death rattle could begin, or even blocked up with fluids from it. I keep thinking would he still be alive if it wasn't for that device. It was only a week ago to this very day we even took him up to a local cafe for a small meal and he still had his appetite. This all just seems so fast a downfall.

I wish I knew what the tube was giving him, and what injection the district nurses gave him at 11pm yesterday. I am sure they all did what they thought best I just hope it didn't bring his death on sooner as we went from a few brief chats a day to nothing since the syringe driver was added as he was just asleep all the time. Sure, he was flustered and agitated at times without it, but at least he was talking rather than asleep all the time. We talked about ordering the turkey for Christmas only 4 days ago. 

I know I am rambling, sorry, it is still very raw, I just hope because he was pain free he wasn't rushed to his passing as I always assume it is only those in pain who are given heavy meds. The last 60 minutes of his life will trouble me for a while, the extra fast breathing and loud noise was just horrible, it was so obvious due to the speed of the breathing that he would never last longer than an hour or two. The carer told my mum she felt he was fighting it. I hope he didn't suffer.

If any nurse is able to answer any of my above questions that would be great, if you need to ask me any follow up questions please do. Thanks so much.

  • Hello Johnny, I'm sorry about the loss of your Dad and its extremely hard to cope with especially when you're present, I know because my husband of fifty odd years died January this year of lung cancer, they wouldn't put the driver in even though it was in the house, as he wasn't near death, they said I knew they were wrong and watched my beloved husband, along with my grown up daughters, suffer in the most awful way, right up until the last day of his death they would not give him it.  By 8.30 that night we were all in an awful distressed state so I called the district nurse, Norman was injected and died three minutes later, I was relieved  that he was free from pain and the awful fact that his death was being drawn out longer than nature intended.  Like you my daughter questioned the injection and the quick decline but Norman wanted that and so did I so I explained to my daughter that it didn't matter how quick it was, anything was better than the suffering we were all watching.  So your Dad probably had a better care package and people who understood how ill he was, so think more on how much better he was cared for in his last hours, it's so early for you and your head will be spinning, death is not easy and I fully understand your questions, take care Johnny and I hope you all have the love and support you all need.  Kinds regards, Carol 

  • Hi Jonny, I am not a nurse but my own Dad died of cancer so I'll just share my thoughts with you. I think it is very easy to get caught up in wondering about the medicine they give and what is happening in the body of person who has cancer and could it be this or could it be that and the what if's. My own Dad had an omlette and beans for his tea and was awake the next morning with a Santa Hat on making jokes, but by that afternoon he was sedated because he was getting agitated and never woke again. I stopped looking to understand the science and biology, it was terrible for us to hear the way he was breathing, but it was us who were suffering not him as he was sedated, and if you have ever had sedation you will know you feel nothing. My Dad's death was coming inevitabley. Free yourself from these troubled thoughts if you can.  

  • I'm so very sorry for your loss. 

    I was in a similar (but not identical) position after my mother died, after having been denied treatment and eventually put on a syringe driver. Our family weren't forewarned that this would result in an abrupt loss of consciousness and death inside 5 days. However, afterwards, there was an insinuation that we should have known. 

    I had many questions for the medical professionals, that I didn't ask, and I have regretted this ever since. 

    I would encourage you to ask for a complete list of the medication given to your dad, to view his notes and get an explanation about the decisions made regarding his care. 

    It seems that there has been an unfortunately lack of communication with your family, and you need clear / unambiguous answers, in order to give you closure.

    Thinking of you all. x 

  • Hello JonnyR thank you for your post.

    I am so sorry to hear that your dad has died. This must be a really difficult time for you and your family and I can appreciate you have questions about how and why it happened.

    While no one here can answer your specific questions about what drugs were used it does seem to me as a nurse that the community team did their best to give your dad a kind and dignified death.  I think when someone develops problems towards the end of their life a decision needs to be made about whether you keep someone alert with troublesome symptoms or make them comfortable. 

    Some treatment can cause the patient to be drowsy and more sleepy but so can advanced cancer itself. Your dad was not necessarily given large doses of medication but this is something you can talk with his team about. 

    The fluid he had in the back of his throat were secretions that we all produce but when your body slows down, as it does when you are dying, they can build up in the back of the throat area. It can cause the sound that you describe and this can distressing. It is likely that he was given medication to help dry up the secretions.  

    Please read our information about when someone dies, it will help, click here  to see it.

    You were with him when he died and from what you describe he went peacefully and did not suffer. You will have an opportunity to talk with the team that cared for him. Please get back to us if you need any more information or support.  You may find it helpful to talk things through with one of the nurses on our helpline.  The number to call is Freephone 0808 800 4040 and the lines are open from 9am till 5pm Monday to Friday.

    Take care,

    Caroline 

  • Dear Johnny, Am so sorry to hear about your loss. Things have happened very quickly since you first posted on here and it is going to take time for you to process everything. Can I first say that I have personally had relatives die much quicker after diagnosis without being put on a syringe driver, so things can happen very quickly.  Secondly, as someone who lives with (non-cancer) respiratory disease it is hard to convey how horrific and terrifying – yet not always painful – it can be when lungs struggle for breath. It is so horrid that I sometimes think I cannot go through this again when a bad period comes and it is only the thought that it will pass that gets me through. Don't get too hung up on the fact your father was not in pain, if he was agitated he was in distress. Since he wasn't going to get back to not having to suffer, was it worth putting him through anymore than he had to go through? Perhaps in time you will come to see how your father was spared suffering and those very experienced nurses caring for him acted with kindness having recognised that he was in the process of dying. Your father strikes me as an incredibly strong and courageous man who did not want his son to know how much he was suffering. While you did not have as much time as you wanted with him, you were there for him, you did all you could. Try to make peace with this as I feel it is what your father would have wanted. It is important now that you find space for yourself to grieve, but I appreciate you also need to be there for your mother.  How is she taking this? If she is desperate for answers, then maybe you could gently find out more. But, if more questions will unsettle her be mindful of that as you proceed. I think you all did your best. You tried really hard. Take care Johnny. It's not an easy time. Grief has to work its way through. My thoughts are with you.