We are devastated. Wife found patient(her husband) in driveway with blood coming from ears and nose. He was refusing to go to hospital and was combative. Rescue personnel had to sedate him so he could be airlifted. A breathing tube was put in as a precaution. He suffered a TBI: fractured forehead, fractured eye socket, contusion in front and back of head (hospital said possibly contusions were caused by a whiplash of the brain). Hospital said they could not determine a medical reason why he fell/collapsed in driveway. He was diabetic, hospital stated sugar was a little high but not high enough to cause him to pass out. He was only 56 yr old. He was in the hospital for 10 days on the ventilator. During the 10 days he started wiggling his toes, doing thumbs up on command, shaking/nodding head to respond, would look directly at you when spoken to, repeatedly tried to get out of his bed; he would scoot to the bottom where there were openings below the side railings and put his legs over the side. Nurses had to keep pulling him back to top of bed. He had aspirated and developed pneumonia. He was given antibiotic. He was improving and never regressing. Nurse asked if he needed more pain meds and he shook or nodded his head. Once PT asked, do you feel like doing PT today and he shook his head no. I held his hand and talked to him, he looked directly at me. at the end of the visit I asked him to squeeze my hand and he did. It was a strong squeeze, not faint. Nurse said that he was breathing on his own during the day but that he struggled to sustain it when he was asleep. His wife decided on the 10th day to remove the breathing tube and she did not want a trach put in. His family requested a meeting with his team care doctors to discuss why the breathing tube is being removed at this time. It was stated breathing tube did not need to come out until the 14th day and then there was the option to put in a trach if needed. The team care doctors did not attend the meeting; it was a nurse practitioner and 2 palliative care personnel. My family and I had never heard the word palliative; at the time we did not know what palliative care was. We thought it was a recovery type of care. The NP conducted the meeting; the 2 palliative personnel barely spoke. The NP stated patient had improvement in the last 24 hours and the pneumonia was clearing up, and if a trach were to be put it, it was not known at this time if it would be permanent or not. Did not know if patient would or would not have any disabilities (physical or mental) at this time. If did, could receive therapy. NP repeatedly stated this is the wife's decision; she is his voice since he doesn't have one. Wife stated she and her husband had previously had a conversation and he told her he did not want to be on life support or in a nursing home. But to me, this is saying IF it is permanent, not if it is temporary which was not known at this time. If needed he could have went to rehab facility instead of nursing home. He did not have an advance directive. So this was just his wife saying they had a conversation. He was sedated throughout the 10 days for pain and due to the tube in throat. His wife stated she felt the tube was uncomfortable. I felt a trach would be more comfortable; it would give him more time to recover, allow him more time to get the sedation out of his system, recover from the pneumonia, give him a voice, allow him to drink and eat if possible, and he had been lying on his back for 10 days straight. During the meeting, our sister asked if they could wait the 14 days because her son wanted to see his uncle (he was out of town) and would be back before the 14 days were up. Patient's wife stated, "I'm not waiting for (nephew's name), or for anyone, I want the tube out today, right now." My sister started to cry and my other sister started shaking and had to leave the room. The NP asked the wife if she understood that meant denying him both oxygen and nutrients and she replied yes. Wife said she wanted nature to take its course; God would decide if he breathed or not. After the tube was removed, the patient asked for water and was given it with a sponge; he drank it. He said he wanted to get out of there, and he wanted to go to the bathroom, twice he looked directly at his wife and said her name. He was told he could not get out of bed; he had to use bathroom in bed and he would be cleaned after. He was coughing and trying to get the secretions out due to tube being in for 10 days. He again tried repeatedly to get out of the bed. He was moved to palliative care about 2 hours after tube was removed. Nurse immediately started giving him morphine; even stated had to give him 2 doses instead on 1 because he was squirming all over the bed. More morphine was given. His wife left shortly after the tube was removed. He asked for water and the nurse asked did he want ice and he did. He chewed the ice and swallowed it. He died 7-8 hr later when asleep.