I gave Mike his last dose of morphine, I invited death to Mike’s bedside.
The date was October 18, 2022. The Hospice Team had come through out the day. The Social Worker, the CNA, a Spiritual Counselor and the Nurse. Each of them explained their roles as they came and went. The Social Worker explained how hospice would help, The Spiritual Counselor explained how he was there in anyway to help, spiritually and/or emotional support. The CNA, Judy, she helped care for Mike. The first bathing he had since I’d arrived. Being clean and fresh seemed to make Mike so much happier. The nurse came last. She assessed Mike’s situation and informed us of where we were and what we might expect. Amy, the nurse in charge of Mike’s care explained the “care” package that would be arriving and what it contained. She explained the use of the morphine and other medications that would be included. Thankfully my sister-in-law, Shari, was writing things down, because it was all spinning around in my head with no direction.
It was after she had went through all the technical aspects of what is going on and what to do that my sister-in-law asked THE QUESTION, “how much time do we have”. That was awakening. Amy’s response wasn’t what I expected. She asked, “Do you really want to know”. Shari and I looked at each other as if we were questioning our own question. I told her it was up to her, but I would like to know. Shari turned to Amy and said, “yes”. Amy then told us Mike had maybe 2 weeks. We both took a deep breath and came back to reality, this was happening and there’s nothing we could do to avoid it.
It was also at this time that Amy mentioned to us that many caregivers have a strong feeling of guilt of giving the last dose of morphine to the dying patient. Having a feeling as though they are responsible for “killing” their loved one. She explained to us to remember “it is the disease that is killing him not the medication.” The medication is to help so that his death is not painful. It was at that moment I decided I would take on that responsibility. I had promised Mike years before that if anything had happened to him, I would take care of Shari for him. This was one thing I could do so that she would not have to take on that burden. I didn’t say anything to anyone, I just knew I would have to act when the time came.
The care package arrived and the use of morphine started. It was in pill form and Mike was more comfortable than the previous days. This began “the surge”. Mike was hungry, more talkative than before, even though his ability to speak was limited due to his stroke.
The next day the morphine dose was increased and soon afterward it became too difficult for Mike to swallow the capsule so it was changed to the liquid form to make it easier for Mike. The goal for the next 8 days to keep Mike comfortable and pain free.
October 26th the CNA had come by. Mike was virtually unresponsive, but Judy spoke with him and us as “normal”. Upon looking at Mike and checking his condition, she contacted Amy, the nurse. Shortly afterward Amy came by. Both of them cleaned Mike up, shaving him, combing his hair and moving him so he could be physically comfortable. It was then that Amy told us to keep an eye on him and if we notice him grimacing that is an indication of pain and we could give him more morphine as needed. He was no longer verbal and we had to look for other indications of pain. She explained that Mike was now in the final stages and she would be making daily visits. She had also mentioned that the timing of the morphine was not of concern. It was to be given “as needed”.
In the late afternoon the following day, we had given Mike his regular dose of morphine, but even after 20 minutes he was still grimacing and moaning. This was a clear indication that he was in pain. I couldn’t stand to see him in pain. I then told Shari I was going to give him more morphine, she agreed. Finally he was comfortable. It was at that time, which was, I believe was 9:00 PM, that we decided to give him his morphine every hour. Throughout the night Shari and I set our alarms and kept Mike comfortable.
3:00 AM, October 28th I went in to give Mike his morphine. He seemed to be sleeping much more comfortable than he had. I was relieved that we were keeping the pain under control. I gave Mike his morphine, kissed his forehead and told him I loved him. I returned to the kitchen to rinse the morphine syringe and put the medication back in the fridge. I returned to the couch and set my alarm for one hour. I laid down on the couch and relaxed a bit. At 3:40 I had this “feeling” to check on Mike. I went into his room, he looked so peaceful. I watched his chest as Amy had previously told us to do. I watched and waited the required 2 minutes, nothing. I knew he had moved forward from this world. I once again kissed his forehead and told him I loved him. I then went and got Shari and told her that Mike was gone.
Yes, I gave Mike his last dose of morphine. Yes, he died shortly after that dose. Do I feel guilty, no. Do I feel responsible for Mike’s death, no. I have pain, I miss him dearly and I wish I had more time with him, but I am also proud that I was strong enough to look beyond my personal desire to keep him with me and give him comfort that allowed him to have a peaceful death. I believe that Mike knew that I would be there for him and Shari, that is why he asked for me to come be with him in his last days.
Those words that Amy told us still resonates with me. It is imperative to remember, it is NOT the morphine that killed Mike, it was a tool that assisted to give him a comfort and peace to allow him to move forward.
Best Wishes
