Hi,

I’m sorry to read about your loss and in particular that his end of life experience wasn’t quite as he and your family would have hoped. I can only relate my own experience as the son and grandson of people who died of cancer at home and as a patient who came close. These are my thoughts, for what they’re worth.

He would probably have been scared, in pain and frustrated towards the end. However much Oramorph or Diamorphine he was given, he probably needed more but the doctor felt unable to oblige. This is frequent cause of friction between patients/family and clinicians who are obliged to stick to prescribing guidance. My normally deferential Dad shouted at the doctor “what’s the worst that could happen? It’s not as if she has time to become addicted to the heroin is it? FFS!” All opioids have side effects which can trigger behavioural changes. Someone close to me had horrendously vivid terrifying nightmares which she couldn’t distinguish from reality for several hours. Without the drugs she was in severe pain - achieving a balance is difficult. 

Older generations were brought up to be deferential and respectful towards doctors and nurses. That inhibition runs deep, building up frustration within a dying patient who might feel the need to let off steam. Family members are the only other available target, so we often feel the brunt of this frustration. Social inhibitions start to break down and someone who has never sworn in front of their children or grandchildren may start to swear like a trooper all the time. This isn’t personal, the family have done nothing wrong, it couldn’t have been prevented - it just happens … a lot! 

Finally one of the stages of grieving involves guilt. However rationally we try to think, we find it hard to accept that death was inevitable and we blame ourselves. “If only I’d made him/her visit the GP sooner”, “if only I’d insisted he was seen sooner by the consultant”, “if only I’d insisted he stayed on chemo for another month”, “if only I’d etc. etc.”. 

Like the rest of us, you and your Mum are only human and I’m sure you both did everything you could to make his end of life journey as smooth as possible. It’s over now, you need to give yourselves time to recover. He wanted to die at home and you gave him that. Imagine how guilty you’d both have felt if he’d died alone and scared on a busy hospital ward because he couldn’t go home and all the hospices were full. 

I hope you and your Mum are able to come to terms with your loss and eventually accept that you did all you possibly could have done.

Best wishes
Dave

Hi,

I’m sorry to read about your loss and in particular that his end of life experience wasn’t quite as he and your family would have hoped. I can only relate my own experience as the son and grandson of people who died of cancer at home and as a patient who came close. These are my thoughts, for what they’re worth.

He would probably have been scared, in pain and frustrated towards the end. However much Oramorph or Diamorphine he was given, he probably needed more but the doctor felt unable to oblige. This is frequent cause of friction between patients/family and clinicians who are obliged to stick to prescribing guidance. My normally deferential Dad shouted at the doctor “what’s the worst that could happen? It’s not as if she has time to become addicted to the heroin is it? FFS!” All opioids have side effects which can trigger behavioural changes. Someone close to me had horrendously vivid terrifying nightmares which she couldn’t distinguish from reality for several hours. Without the drugs she was in severe pain - achieving a balance is difficult. 

Older generations were brought up to be deferential and respectful towards doctors and nurses. That inhibition runs deep, building up frustration within a dying patient who might feel the need to let off steam. Family members are the only other available target, so we often feel the brunt of this frustration. Social inhibitions start to break down and someone who has never sworn in front of their children or grandchildren may start to swear like a trooper all the time. This isn’t personal, the family have done nothing wrong, it couldn’t have been prevented - it just happens … a lot! 

Finally one of the stages of grieving involves guilt. However rationally we try to think, we find it hard to accept that death was inevitable and we blame ourselves. “If only I’d made him/her visit the GP sooner”, “if only I’d insisted he was seen sooner by the consultant”, “if only I’d insisted he stayed on chemo for another month”, “if only I’d etc. etc.”. 

Like the rest of us, you and your Mum are only human and I’m sure you both did everything you could to make his end of life journey as smooth as possible. It’s over now, you need to give yourselves time to recover. He wanted to die at home and you gave him that. Imagine how guilty you’d both have felt if he’d died alone and scared on a busy hospital ward because he couldn’t go home and all the hospices were full. 

I hope you and your Mum are able to come to terms with your loss and eventually accept that you did all you possibly could have done.

Best wishes
Dave