Mechanism of Death

ScottM

ScottM

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iBazinga!
Just got some bad news from my step dad. He saw his doctors today and they have given him a short time left on this earth. His circulation is failing and he is barely getting any blood supply into his feet and legs. They are offering the option of starting to amputate but he feels enough is enough and does not want to take that option. His heart is failing and his kidneys have failed. He is also considering removing himself from taking dialysis and letting nature run its course.

My question is to help me help him what exactly can he expect in the way of 'letting nature take its course' if his feet start to die? What happens if he stops his dialysis? I am looking for the clinical process. It will help me to explain to him what to expect as we work through the decisions he has to make in the next few days.

He tells me he is tired and wants to go to see my mom. He is mentally preparing himself for death. This is the first time I have ever heard him give in. Normally he is a fighter and has been told he may die at any minute for the past 30 years. But he is 84 and eventually in the game of life the house will always win. I know that even now he is on borrowed time. With his heart and kidneys he was given an average of 1 year of survival. He was given that 15 months ago.
 
Scott that is a really crappy situation I'm sorry to hear about your dad's conodition for both your dad an you. I certainly don't have any medical degree and didn't stay in a holiday inn express last night but I can relate annecdotal evidence from two similar situations.

1) My Sister in Law's Aunt made the decision to stop dialysis several years ago. The first beneift of this was that since it was her decision she got to say good by to those she felt necessary. She was apparently very at peace with her decision. As I recall she passed away within a week of her stopping dialysis. She lost conciousness a few days before she died so she was basically asleep.

2) A secretary in my office had a situation that sounded similar to yours. her dad had been on dialysis for years and years and had lord knows how many cardiacs. I used to joke he had nine lives. Then he developed a clot in his leg. The couldn't get rid of it and decieded to amputate. He never recoved from the amuptation and never left the hospital. He did wake up post op but he degraded quickly. The decison was made to take him off dialyisis and the process was similar to my sister in laws Aunt except that he passed away much quicker.

I'd bet his doc would be happy to discuss the matter with you with dads permission and give you good information.

What ever your dad chooses. my thoughts will be with both of you. I hope that the decision what ever it is brings both of you some comfort or at the least relief.
 
smigaldi said:
Just got some bad news from my step dad. He saw his doctors today and they have given him a short time left on this earth. His circulation is failing and he is barely getting any blood supply into his feet and legs. They are offering the option of starting to amputate but he feels enough is enough and does not want to take that option. His heart is failing and his kidneys have failed. He is also considering removing himself from taking dialysis and letting nature run its course.

My question is to help me help him what exactly can he expect in the way of 'letting nature take its course' if his feet start to die? What happens if he stops his dialysis? I am looking for the clinical process. It will help me to explain to him what to expect as we work through the decisions he has to make in the next few days.

He tells me he is tired and wants to go to see my mom. He is mentally preparing himself for death. This is the first time I have ever heard him give in. Normally he is a fighter and has been told he may die at any minute for the past 30 years. But he is 84 and eventually in the game of life the house will always win. I know that even now he is on borrowed time. With his heart and kidneys he was given an average of 1 year of survival. He was given that 15 months ago.
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Is he getting Hospice care? They can do a lot to keep him comfortable and in some cases can arrange support to let him stay at home. When we went through this with my dad, they also provided the "this is what is going to happen" information. Try contacting a local hospice organization - they may be able to supply you with the information.

It can be a slow process and the drugs that they may use to keep him comfortable may mess with his mind - don't expect a lot of rationality every day - but there will be some lucid moments. (The last thing my dad did was watch "one six right" - he seemed to be pretty aware at the time).

If he is prepared, then he likely will go easily. Towards the end he may eat / drink very little and just fade away. But it's tough to see him as a shadow of his former self.

Years ago, my dad had earned the nickname "Bongo Baily" after a chimpanzee on a local TV show because of the way my dad could climb all over a sailboat under any conditions. I never saw him show any fear. But a month or so before he died, I was over at the house with my brother and sister and they were helping him get out of his lazy boy and into a wheel chair so he could get to bed. My brother was standing in front of him and had picked him up and was holding him up. All dad had to do was to turn and sit - but he wouldn't - it looked like he was in a lot of pain or something - but he finally said that he was afraid my brother would drop him. That was even sadder than when he finally died...

Hang in there dude.
 
My friend John Chambers suffered through that same situation with diabetes, from being a relatively young Popeye-looking guy to a wheel-chair after multitple amputations. It wasn't fun for him or his circle of family and friends, but he fought the good fight. He said "One day they will just amputate the rest of me and I'll be gone."

There are no good answers, and at this point I can only echo the advice already rendered and wish for the best outcome for him and those who love him. God bless.

smigaldi said:
Just got some bad news from my step dad. He saw his doctors today and they have given him a short time left on this earth. His circulation is failing and he is barely getting any blood supply into his feet and legs. They are offering the option of starting to amputate but he feels enough is enough and does not want to take that option. His heart is failing and his kidneys have failed. He is also considering removing himself from taking dialysis and letting nature run its course.

My question is to help me help him what exactly can he expect in the way of 'letting nature take its course' if his feet start to die? What happens if he stops his dialysis? I am looking for the clinical process. It will help me to explain to him what to expect as we work through the decisions he has to make in the next few days.

He tells me he is tired and wants to go to see my mom. He is mentally preparing himself for death. This is the first time I have ever heard him give in. Normally he is a fighter and has been told he may die at any minute for the past 30 years. But he is 84 and eventually in the game of life the house will always win. I know that even now he is on borrowed time. With his heart and kidneys he was given an average of 1 year of survival. He was given that 15 months ago.
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Sorry to hear the sad news. My neighbor's step dad made the same decision last weekend and no one expects him to make it more than another few days. An otherwise healthy person on dialysis will go downhill slowly, but when you're already in bad shape and going off dialysis you'll go fast. My condolences for the difficult times ahead.
 
It's bad enough dealing with someone you've lost. I've found it's much worse practically sitting by while you know they are dying. I did that with both of my parents. While some might say it gives you a chance to prepare, I don't believe that's anywhere near true.

I'm sorry to see anyone have to be in that position with someone they love.
 
Scott, stop dialysis. You get sleepy, then somnolent, then pass away. Very peaceful. I did that for my father's mom way back in 1977. :(
 
Scott:

If he is lucid now, he knows what he wants and I respect that, now so much more after watching my mom fade away.

We don't necessarily want the torch, but we get it passed nonetheless.

Blessings.
 
Scott,
I'm REALLY sorry to hear that. But it sounds as if the time has come. Listen to Bruce and Geoffrey. Take him off dialysis and put him in a hospice. When my Dad passed of pancreatic cancer a few years back, the hospice really helped both him and us. The other thing that helped was his spiritual adviser (,a pastor in his case). We were all telling him that it was alright to let go, albeit through the tears. Very much like the ones I'm experiencing now, remembering. Nevertheless, I know it was the right decision for us and him. I hope and pray you reach a decision you can believe in too. For it is belief. We can never actually know; at least in this world.
 
Better to not drag a declining situation out, for little to be gained at great cost and pain. Be careful and take care of yourself too.
 
Every one has a time, few get to pick when.

Death with dignity. on his own terms,, It's OK.

Sorry for your loss. we all must go there some day.

And remember, death is the first day of the second portion of your life.

Live right, fear not.
 
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My condolences, Scott. A second vote for contacting Hospice care. They're specially trained in assisting both the patient and the family in exactly these situations. Often they can help patients to stay in their home with family through this.
 
bbchien said:
Scott, stop dialysis. You get sleepy, then somnolent, then pass away. Very peaceful. I did that for my father's mom way back in 1977. :(
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Thanks Bruce.

If he decides to stay on dialysis but his feet start to die. I know that gangrene and infection will occur. As he becomes septic will he be in pain or will he just get feverish and loose his mind sorta speaking?
 
What everyone says, and do what you can to make certain you have no regrets. In my opinion anything over 80 is past the age of tragedy, so your stepfather has had a good run. Make certain you take care of yourself as well.
 
Don't know much about getting off of dialysis, but Bruce's explanation sounds like a nice one that I'd consider choosing for myself.

Having watched my grandmother suffer through dying a slow death, it's hard but much better for those you love to go on their own terms, with their minds still intact. I gave the eulogy at my grandmother's funeral, and one of my points was that we all had lost my grandmother years prior, the funeral was just when her body finally caught up. Those last few years were hard on everyone.

Regardless, Scott, I'm sorry for your situation. It's not a fun one for anybody.
 
He decided to today to stop all treatment including dialysis and tomorrow will move to hospice. Anyone have an idea what a typical time it will take from the end of dialysis to the end of life?
 
smigaldi said:
He decided to today to stop all treatment including dialysis and tomorrow will move to hospice. Anyone have an idea what a typical time it will take from the end of dialysis to the end of life?
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Scott,

Adam's experiences are pretty typical. When you stop dialysis, toxins slowly build in the system, you become sleepier and then just quit. This usually occurs over the space of a week, maybe a little longer, depending on how dialysis dependent the person is. It really is not a painful experience.

On the other hand, progressive loss of blood flow to the legs is painful. As the tissue becomes ischemic(not receiving enough oxygen) they tend to hurt, just like the pain from a heart attack, which is ischemia of the heart muscle. People get "rest pain" in the leg which is really uncomfortable and hard to cover up with medication.

I am feeling for you, your dad and your family. These are tough decissions to make, and there are no wrong choices.

Barb
 
I'm sorry, Scott, I hope that everything goes peacefully for you and your step dad. :frown3:
 
Capt. Geoffrey Thorpe said:
Is he getting Hospice care? They can do a lot to keep him comfortable and in some cases can arrange support to let him stay at home. When we went through this with my dad, they also provided the "this is what is going to happen" information. Try contacting a local hospice organization - they may be able to supply you with the information.
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All I can say is I feel for him and for you... and I have to absolutely and unequivocally second Capt. Geoff's comments above. One phone call to Hospice and every question we ever had was answered, Mom got the care she needed--especially the medications needed to be comfortable--and I can't imagine having done it without their care. She, too, was at home during the entire process.

EDIT: I have now read the entire thread and see he's made his choice and is going into hospice.

Peace to you and him.
 
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TangoWhiskey said:
Peace to you and him.
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Thanks Troy and everyone else. He seems at peace with this. He is happy he gets to sleep in this morning instead of getting up at 4 am to get ready for his 6am ride to dialysis.

He is telling everyone that this will be quick. His doc tells me he has barely any kidney function. I think we will start to see some effects in a couple of days. I arrive Tuesday night for a week and his other kids will be leaving about that time. So we have it set up so that someone will be with him for a while.

This is my 3rd parent I will be losing. The thing that is different is how he is going out with head held up and on his terms. He has always been like that. He will make a decision and stick with it! I still remember the day 33 years ago when his doctor told to quit smoking or die. He came home threw his cigarettes out and never, EVER smoked again. Not even a last cigarette. My step sister has another story like that shows his other side. She balked at what they had for dinner so he told her she could not have anything. He meant it too. She did not eat ANYTHING nor was allowed to have her next meal until she ate her dinner from the night before. He could be a real stickler once he made up his mind.

He an I had been trying to do a few fun things when I would come down and visit. But all too often there were so many errands to run that we would not get to do all of the stuff we had planned. But he was mostly happy to just go for rides and get to the cemetery to see my mom.
 
Scott,

I'm glad your dad had the ability to make his choice and have it respected. I hope his passing is peaceful and that you and yours move through the grieving process quickly.

Best wishes,
 
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