We did this for both our parents as they were dying. My Mom was in a coma but would still twitch with pain. We asked her doctor if they couldn't just "overdose her on morphine". He said, he couldn't, but we could. He advised us to ask for a morphine shot every time we wanted and hospice (in the hospital) would administer it. So basically, she drifts off into oblivion and the morphine slows down her respiration until it finally stops. VERY, very peaceful! When my Dad was dying, (hospice in hospital) we did the same thing without asking. The nurses knew what we were doing....

Both my parents had peaceful, controlled passings. No drama or pain filled anguish. My Dad's only fear was pain and we assured him we wouldn't let him suffer (he wasn't at my Mom's death as they were divorced). So the point is no IV's feeding the body with sustenance, and morphine shots to keep you out of pain. When you advance enough to slip into a coma and your organs begin to shut down, more morphine. I've heard it said that cancer patients don't die of cancer, they die of starvation. It is our human will to survive, and some will fight to the end. The morphine makes it a very gentle experience.

I hope this gives you some peace. Much love, Barbe

My dad died while sedated with a morphine drip due to breathing problems, agitation, and severe pain.  This was the first time in almost 1 year that he had no pain.  For him, this was a blessing. 

I'm not sure about the starvation comment.  Usually by the time you are given palliative sedation you are not eating or eating a very limited amount and not drinking much.  The body starts to not want food as it starts to shut down.  Patients are not starved to death.  Eating during the active phase of dying usually causes more harm than good as the body can no longer process and void the food.  Dehydration does occur, however.

Hi Katie,

I didn't realize you are in the Netherlands, so that is good. I would suggest you find out generally how long the coma lasts - I think it would make a difference to your loved ones if it is up to a few weeks, or could go on for a long time (for example, if they were keeping you hydrated intravenously). If you were my mother or sister, I would want the coma to last long enough to be able to say goodbye properly, but not to last too long (for my sake, rather than yours).

Wishing you strength with your decision,

Latte

Alligans, the comment of starvation is just fact. It's true the dying body doesn't need food, but water is with held as well, as there is no IV fluids or sugars at all. It is not a cruel process, it's something we would naturally do if left alone. Just like an animal would go and find a hiding spot in the forest to die. The point is to let the body shut down on it's own with no intervention to delay the process. That's the way I want to be treated as I pass. Don't force anything on me except pain meds. We have that technology, thank God. It is hard to know that you could step in and provide fluid and nutrients to a dying person, but you are only delaying death at that point, not extending life.

I understand now.  I think I misunderstood what you were saying Barbe.  I just didn't want anyone to think that when patients are under palliative sedation that their families and doctors are intentionally starving them to death in the setting of a patient wanting to eat but unable to do so because they are sedated.  My dad had not truly eaten for 2 weeks when he was sedated with morphine.

If you read online there is a lot of controvery surrounding palliative sedation but I truly believe that it is a blessing under certain circumstances and doctors are very good at making sure those circumstances exist before administiring palliative sedation. 

Katie, one thing that I urge you to think about doing is letting your immediate family and caregivers know that you want this and also letting them in on any emotional turmoil that you may be in.  I feel that my dad died a very lonely man because he never let his wishes be known (no will, no advance directives, nothing...which left the decision making up to my mom).  He also never spoke about his fears.  Whenever he discussed the disease, it was only that he was in pain and wanted the doctors to fix the pain.  He never spoke about what was actually going on in his mind.  I can only imagine the emotional pain he was in.  I tried to get him to open up about 5 or 6 weeks before he died but he was closed up very tight.  When he died he was surrounded by us and was getting a lot of love but he was very alone in his mind which I think added to his emotional anguish.  Although I don't think anyone can truly understand what is going through someone's mind who is in this situation, opening up and not being afraid to talk about things that are scary and uncomfortable to talk about can relieve a lot of anxiety, pain, and heartbreak that both the patient and family are going through.  My dad passed a little bit over 2 months ago and I still feel horrible pain that he was very alone in his mind.  I can only imagine how scared he was to be dealing with all of this.  When he was finally placed on hospice care he was already in very bad shape and sedated due to agitation, confusion, and pain issues so he didn't even know what was happening to him.  He previously refused hospice care and didn't want to talk about it when I had brought it up.  His second oncologist tried to start this conversation with him as well but my dad shut him down pretty quickly and the oncologist moved on to fixing his pain.  I wish my dad had had the courage to openly discuss his feelings, goals, and wishes with us because I think that if he did his last months would of been a lot easier on him and on my family.  My advice, talk to your close family.  If you can, let them in.  Let them know what's going on in your mind.  Let them be there with you.  Make sure that you have everything in order.  My dad didn't have anything in order and my mom had to make all of the decision and arrangements.  She did it wonderfully but it was incrediably stressful.   

I feel that for two days that he was sedated, my dad's body and mind were finally at peace.  This peace made his passing easier on all of us, including him.  If he had not been sedated, his death would not of been a pretty site due to the fluid in his lungs, pain, agitation, constipation, and developing confusion.  The pain was non-existent and he was very calm.  I worried about him being sedated when I started reading about hospice months earlier but when that time actually came, there was a peace surrounding him.  I think the decision was an easy one to make for my mom because she watched his disease progress over the months.  My family was sad yet calm.  There was no drama and no pain.  When my mom said that his breathing was gurgly and the nurse was giving him some kind of medication to fix that I got worried about seeing the "death rattle" in person but it was not as bad as I had imagined.  I think it's because of the medication he was given.  The rattle was like a very calm and light snore.  I didn't find it upsetting but rather calming.  I was actually more upset about his breathing prior to the sedation and hospice.  His breathing pattern sounded very bad and upsetting.  For my dad's situation, I think that the sedation was the right choice.  Everyone is different and nobody can tell you if you should or shouldn't do this or what the right choice is.  It has to be the choice that your heart tells you to go with.  All of the issues surrounding palliative sedation are usually thoroughly discussed with the patient and their family before palliative sedation is administered so that everyone is educated about what happens.   

Yep jakaba, I'm pretty sure we're talking about the same thing. No one here has mentioned an injection that ends a life, but the continuation of morphine to keep the patient calm and pain free as the body shuts itself down.

I do believe in euthanasia, though, and wrote a thesis on it once that I was very proud of. In the end it is just the difference of whether any intervention is prolonging life, or prolonging death. In a terminal patient, it's an easy decision to make once they have lost QOL and the will to live. We will all reach that point if we are left to die of a disease rather than accident or crime.

I had terrific talks with my Dad near the end (reached my mother about an hour before she slipped into a permanent coma) and am glad that I did. He knew he was dying. He used to joke that he would die of constipation before he'd die of cancer. So now I know to keep my bowels moving. Another reason to not feed a dying person; the pain of elimination is too much to bear. He told him he was afraid of pain and I was able to assure him that we'd keep him pain free. I asked if he was scared and he said not really, he was interested to see what was next. I told him it was like he was going to another level and I wanted to go with him. He died in his 72nd year.

At one point in Palliative, he was alert enough to tell me he wanted water. Not that fancy water you know, the one that comes from the French alps. The one that when you spell it backwards tells you what you are. I knew he mean EVIAN. Too funny!!! My DD was standing near his bed wrapped up in a blanket as she was chilled. He said Who are you!! I'm Kim, she said. Oh, he said, You look like an Indian. He was a hoot! My DD and I stayed 2 nights with him and then he slipped deeper so I went home until he passed. I didn't need to see him dead. I saw my Mother dead.

Katie, I hope all this chit chat is what you were hoping for when you posted this topic. Most people won't talk about death, but as I've seen both parents pass I am very calm about it.

That's another good one Lisa, but involves 2 meds. I'd rather have the one shot. Like...do you need the Ativan now or the Fentanyl???

(((((Katie))))))

Katie,

May I first say, wow! You are an amazing woman and strong to be discussing your own final destination. I had the honor of being with both of my parents, who died within one week of eachother of met cancer, mom, bc, dad pancreatic. They were just 61 and 63. I was with them both till their last breathes. We used sublingual ativan and morphine. Honestly, my mother knew when she was ready. She always said, a lady knows when to leave the room. She climbed into bed, asked my sister and I to position her bed infront of the picture window. She picked her own bed clothes, and fell asleep. We managed her pain by watching her respirations and listening closely for any moans. We also watched her face for grimacing, but you know. We gave the meds close together to keep her sedated and she passed very peacefully and quite gracefully. Dad, suffered more though, at least I think so. I administered his " Last Dose" I pumped up the amount and gave it early. I must say, it was an honor to end his suffering, For a lifetime, they cared for my every pain, whimper, ache, broken heart. I do feel that you will know when you have reached that final journey home and those that know your soul will know too. I loved that mom spelled it out for me. I had no doubts and proceeded with her plan. I found amazing comfort in that. Dad did not know he was dying though. We found out he had met cancer when he had a stroke and he died a week later just a week before mom. I cant begin to tell you how amazingly peaceful my mom's passing was. just wanted to share. ((HUGS)) to you!

Katie, thanks for starting this discussion. I just began palliative care and have been confused about what I want, mostly because I haven't ever wanted to think about it. Silly, I know. Now I feel focused on my feelings and desires.

Both of my dear in-laws have passed in the last couple of years. Both put under palliative sedation and both passed very peacefully, and quickly (2 - 3 days). They never talked about their end of life wishes but we knew suffering was not acceptable.

I want that for me too, and for you.

Big hugs and lots of love to you Katie.

Becky and Katie,

Thinking of you both.  Hoping Becky is not in pain.  Katie, you are very brave and very smart to make your decisions now.  Sending gentle hugs to both of you and wishing for the best for you.

Judie 

My motto has always been, "hope for the best, prepare for the worst" and so everything else has been made clear to my family, including funeral arrangements, my hopes for my kids' futures and even where I want my ashes scattered

These are my thoughts exactly.

Reading your thoughts and stories that everyone has shared really helps me a lot...It takes the scariness out of the process. We ALL have to go there (cancer or not)...Why not prepare for it?

I just felt the need to offer all of you amazing and loving ladies love, hugs, prayers. peace, comfort, and courage as you travel through this journey! MUWAH!!!!!