My mother was 90 years old and had congestive heart failure and COPD from asthma. She never smoked. She was able to walk around without a cane, and she had her full mental faculty.
Last summer and this April she had a COPD flareup, which always meant that she retained too much CO2. She also had a leaky valve from her heart, which caused some fluid retention in her chest. So she spent the month of April in the hospital.
She was stable, released from the hospital and sent to the rehab facility. We found it odd that night she seemed confused as she would often get when her CO2 levels were high. Her arms were very swollen and bruised from the IV, too.
She didn’t have an infection but she thought that she saw me and I wasn’t there.
Anyhow I got a phone call the next morning that they were doing rounds and found her not breathing with no heartbeat that morning. She had the BiPAP on and was sleeping at a 45° angle.
They did CPR and got a heartbeat and rushed her to the hospital but she did not make it. This was two weeks ago.
We were shocked. I really thought my mother had at least another year or two. She wasn’t all that oxygen dependent but I guess she was having problems with the gas/blood exchange and had respiratory failure? I don’t know?
So I assume that her heart just gave out. She did have a pacemaker with a defibrillator so I doubt it was afib.
When you ask the doctors they don’t want to comment or speculate. So I’m just trying to wrap my mind around the fact that I thought I’d have her much longer but I’m thinking maybe people with congestive heart failure have a tendency for their heart to just stop?
She died in her sleep in the early morning hours. I haven’t even been able to feel anything because I’m still shocked. I was very close with my mother.
Her death doesn’t match what I thought would happen. I thought she would have a slow decline where she would be bedridden and too weak to get out of bed and then pass at some point but that would be further down the road.
She was getting frailer but as I said, she could still walk around without being so breathless. I think the high CO2 levels made her heart work harder, perhaps. She had CO2 up to 104, which is critical. Then it went down to 70. Then finally to 20s.
Thank you for providing any perspective on this matter.
We still grieve, of course, but it is wrong not to recognize that the end of life is appoaching with this advanced age,no matter WHAT the cause.
Her two combined illness meant she was on borrowed time. The lungs and the heart both pump oxygen thru the body. When neither can do their job anymore CO2 takes over.
I had just had his first grandchild following a collection of pregnancy losses, and he came to my house in the morning, went home to plant his asparagus, and dropped dead in his garden.
His death felt very unexpected to me. He had worked on the nursery in the weeks before he died, and complained about a week before hat he wasn’t feeling as well as he thought he should, and I had experienced a long and difficult delivery.
I blamed myself.
Being who she was at 90 is a wonderful gift. Hoping the pain of her loss is very soon softened by the gift of your memories.
My neighbor got into his car after visiting a friend two streets away, had a heart attack and died in his seat before he could turn the engine on. ‘But he had a check up only two weeks ago’.
Teenagers are killed in car accidents where there genuinely is a drunk speeding driver to blame.
So often there is a ‘what if’ that haunts those left behind. It doesn’t help.
Mourn your mother, grieve for your loss, and live the life for yourself that your dear mother would have wished for you. Love, Margaret
Just to clarify, I wasn’t “hoping” for a slow decline. I just thought that’s how it would go down. I didn’t think her health was at a point where she was going to die yet. Talk about being shocked!!
This is probably a symptom of my anxiety disorder and being too attached to the outcome.
Ive always dreaded this day and thought many times I might have to be sedated and put away. But, I didn’t fall apart. Good to know I’m not that weak.
But, forecasting out to the future isn’t a great coping mechanism, as I’ve just learned. Life can take us by surprise. That’s the scenario I didn’t plan for. Maybe my mother’s death is meant to teach me a lesson in life?
Your mother lived to the ripe old age of 90 years old and you should be thankful that you have had a close bond with her. Do not dwell on her sudden death as this will only cause you grief, but console your thoughts on the happier times you have had with your mother during her lifetime. You were hoping that she would have had “a slow decline and then get bedridden” before she died. The question you should ask yourself is if your mother had become bedridden would you have been able to handle this life-changing situation? Have you thought of the possibility of your mother being bedridden and languishing for many, many years in this state? Be assured that God had a plan for your mother. Because God saw the love and the great bond that you had with your mother, He did not want her to be bedridden as He knew you were not going to be able to handle her life-changing situation.
With time, you will come to accept her sudden loss. In the meantime, reminisce each day about the happy times you have had with your mother and you will eventually come to accept and overcome her sudden loss.
Good luck.
This is probably a symptom of my anxiety disorder and being too attached to the outcome.
Ive always dreaded this day and thought many times I might have to be sedated and put away. But, I didn’t fall apart. Good to know I’m not that weak.
But, forecasting out to the future isn’t a great coping mechanism, as I’ve just learned. Life can take us by surprise. That’s the scenario I didn’t plan for.
Thanks for responding.
Both of my parents passed suddenly at different times, late 50s and early 60s. It is different when people go suddenly. However, someone going “suddenly” at 90 is not puzzling, as others have said. And, I don’t think that is really what is troubling you.
It sounds like you feel like you should have been able to “intuit” that she was dying imminently. Don’t do that to yourself. Having had more than the normal experiences with death, the only thing I can say for certain is that it happens when it happens. I don’t say that to be flip. Sometimes we get a hint it might be coming. Just as often, we do not.
I know I have said this before, but our society has a kind of weird expectation of control in these situations.
It might be better to reframe your thinking than to ruminate on “why”. Try to remember a few things… you did nothing wrong, you certainly cannot predict death with any certainty, you were able to see her prior to her passing (which many, many people do not get to experience), and everyone dies alone… it is a solitary journey, even if someone is in bed beside you.
I happen to believe that God is ever present when we make that transition. To my mind and my heart, that is a beautiful thought. You may or may not believe the same. Either way, you made a good choice to return to your life. When the body is done, it is done.
I think much of the advice here is wise and has been trying to steer you to that realization because the people writing it may be seeing something more in your words than simply a request for more medical information.
I am so sorry for your loss. I hope you can find peace in your heart and are comforted in knowing your mother lived a long life and you really were there for her in every way that counts.
I understand your being surprised, especially when so many of our loved ones hang on for years, slowly losing any ability to do anything for themselves.
But others do die in their sleep and I know that is what I would choose.
CHF is serious on its own. My neighbor had to literally be drained of fluids every so often. Was Moms swelling brought to someone's attn? Was Mom given a water pill? When the heart does not pump well, fluids build up in the lungs. You Mom's lungs were compromised with the COPD. I don't think anyone is to blame here. Mom was 90 years old. Her body gave out.
She got frail from being in the hospital last year and this year. But, she could still get around.
Death can come as a surprise and her external looks didn’t match with what was going on inside.
thanks
it must be very tough. big, big hugs from me.
I was wrong. One day, on a Tuesday this past February, she went to bed b/c she was literally exhausted b/c her heart was giving out. She never wound up getting out of her bed again, but dying exactly 7 days later, while remaining in a semi-comatose state the entire time. I was able to spend time with her and sit at her bedside every day for 7 days, so that gave me time to process the fact that she was dying, so it didn't hit me like a brick in the face.
My condolences over the loss of your dear mother. God bless you and help you achieve acceptance as you grieve this tremendous loss.
Did mom have a primary cardiologist? If she did, and you think it might help you to process what mom went through, maybe call the office and ask if you can speak to the doctor and/or one of the primary nurses in the practice, to help you gain some perspective. Make it clear you're not looking to "blame" anyone, you just want to have a better understanding.
My impression from what the hospice nurses told me is that death by CHF can look very different to different patient. My mom had that steady, slow decline, but she had literally no other comorbidities. We were just "waiting", in essence, for her heart to give out. But she was displaying much confusion (like your mom) in the last few weeks of her life, to the point where I was beginning to suspect she was having TIA's.
I know this will likely be small comfort, but my mom lingered for 4 days, bedridden, in a semi-comatose state before her heart finally gave out. I wished every moment of those days that she would just pass peacefully. I had to listen to her labored breathing and watch for signs that she needed more pain medication - thrashing about, moaning. etc. - it would have been more of a blessing to have come into her bedroom one morning to find she had passed in her sleep. As hard as it is to reconcile an unexpected (for you) death, you did not have to watch your mom linger for days as her body was shutting down, just waiting for the heart to "catch up".
(((hugs)))
My mom’s hospital in town stopped taking her insurance. But, her insurance treated her stay as in network since she went there as an emergency.
but, that meant that her cardiologist wasn’t affiliated with the hospital. He was new to her also. So, I didn’t get much out of him.
I am very surprised, given your somewhat unrealistic ideas of all of this, and a bit of what is seeming like denial, that your mother's doctors were not so frank as to explain all of this to you. They should have been more honest with you, and they should have spent more time with you.
I am very sorry for your loss. If your Mom was still a full code blue and there were not DNR orders it does look as though family, decision makers, were intent on keeping her with you as long as you could. I think you did that for her.
I would like to suggest to you that you revisit whichever doctor involved in your Mom's care, an actual appointment, to tell him that you are having trouble processing this loss, and that you would like his or her complete honesty to help you process. You may also want to see a counselor and I really suggest a Certified Licensed Social Worker who works with life transitions.
I know you are realistic enough to know that your Mom lived a good full and long life. There would likely not be an age at which you would say you are willing or ready for this loss.
I hope you will go on celebrating this long life and all your Mom saw and experienced. I wish you the very best and healing going forward.
Her echo came out fine the month prior and she had a pacemaker with a defibrillator. She also passed with her bipap on and sitting at an angle.
The only thing was her arms were very, very swollen and red from the IV in the hospital. The hospital cleared her for discharge and she spent one night in the rehab and passed that morning.
Even the nurse at the rehab who spoke to her the night before was shocked.
But, my mother had two difficult weeks of high CO2, gaspy breathing, etc.
My mom’s hospital in town stopped taking her insurance. But, her insurance treated her stay as in network since she went there as an emergency.
But, that meant her cardiologist wasn’t affiliated with the hospital. He was new to her also. So, I didn’t get much out of him.
So, I’m wondering if the swollen ref arms made her have a deep vein thrombosis? They took the IV out a few days prior and she was taking a blood thinner, Eloquis and a diuretic.
But, was the edema in her arm a symptom of her heart not pumping well? I don’t recall her having that the year before?
I live in Denver. My mother lived in NY so I had to coordinate her doc visits with others, which was t the best for me. Moving to a high altitude was not a good option for her nor could I go live in NY. So, I don’t have any doctors that really cared enough to explain this to me.
I had the same thought though, that that should have been up front with me if they detected anything. She went through this worse the year before due to a chest cold and came out fine. A champion at the rehab center because she was up and walking in no time.
She wasn’t eating and getting glucose and being hydrated from the IV.
sSi many others just lie there bedridden and my mother, being a type A personality, always seem to be a fighter, and real hardy.
I say this not to be mean or dismissive of her passing… but at 90, her death wasn’t unexpected. Somewhere in the back of your mind you probably knew her time was limited. You may not have allowed yourself to truly see it, and that’s normal.
CPR on an elderly person is rough. Very easy way to break a rib, severe bruising. It’s very hard on the body… it’s a trauma. It’s no wonder she didn’t fully bounce back. Her body just gave out, as a body tends to do in old age.
It sounds like she was a spirited, sharp, and energetic person. Would you have preferred her to have the slow death you mentioned? Would she have? Watching her deteriorate mentally and getting extremely weak can be devastating. It’s like they already died and only their living body is there. You mourn twice, first for her inner self, and then mourn again when the body dies. Seems that would be much harder on both of you.
Expected or no, death is a hard thing to face and accept. Take the time to grieve.
So, I thought my mother would pass in a year or two, but not when the hospital discharged her and I got on a plane back to Denver, never understanding that it would be the last time I’d ever see her again.
That’s the problem. She was upset that I had to fly back for work and I was so flip about it because she was worse off the year prior and came out of that fine.
And, it’s frustrating because I was used to talking to my mother and using an Echo Display at the house 3x per day to see her, but while in the hospital, the phone was behind her and tough to reach or hear.
Cutting me off like that was difficult. Getting on the plane to leave was hard, but I really thought I’d come back in a few weeks.
I know overall in the scheme of things it is better that she went the way she did. I would not have want her to go through a dragged out decline and suffer.
Im sensing that you may have lost a loved one due to a slower decline? That way provides more closure with chances to say goodbye for the family. This way is sudden loss, which innately comes with no closure and shocks people. That is what you are sensing in me.
So no, it doesn’t help to say, we’ll your mother was 90, what’s the mystery? That sounds obtuse in summing up things based on age, because within the context of her health, she didn’t seem ready to die just yet.
I’d be careful on how you dispense wisdom on here. It sounds like your situation may be you to have blinders on with other situations. The last thing you’d want to do is make someone feel worse or defensive.
We have a couple of medical professionals who post here; I hope one of them will answer soon.
My mother was found not breathing and no heartbeat while doing rounds at the rehab, not the hospital. So, she wasn’t attached to any machines for an alarm to go off.
I was wondering if the IV from the hospital could have caused a deep vein thrombosis? My sister and I were shocked at the swelling and a pic of her that night, her arms were red.
Otherwise, I’d have to stick with thinking that her heart gave out due to respiratory failure.
Her cardiologist, who did not have privileges at the hospital and didn’t know the situation, said she couldn't have had afib because she had a pacemaker with a defibrillator. He thought he was Respitory Failure.
What I know about her lungs is that her asthma turned into mild ephasemia. She was doing her Nebulizer 3x/day and her steroid 2x daily, but had been getting a lot of mucus all winter. The doctor ordered an echocardiogram in March.
She’s had the pacemaker since 2010 with right sided heart problems. If she lied flat, she would have congestion but she went all this time until early April without congestion.
Her March echo didn’t show anything odd, nor did her ekg. She had some labs for the kidney that might suggest dehydration, and some low hemoglobin.
But, she woke up one morning in early April struggling to breathe and it turned out to be a leaky heart valve. They drained it from her lungs and increased her diuretic.
Then they discharged her but I suspect her CO2 levels were high because she was restless, wouldn’t sleep and a bit confused.
I gave her 7mg of Remeron to get her to sleep after 3 nights of this but that wound up depressing her respiratory system, and I could not arouse her. All I knew was that a benzo was a no go and that 7mg was a small amount. This was in the middle of the night and she had been having some anxiety about breathing.
We got her to the hospital the next day because I could not arouse her out of sleep the following morning.
Her CO2 was at 107 and the doctors were afraid we’d have to intubate her but luckily, the bipap lowered the CO2 to 70, where it remained that way for a few days and subsequently they used the bipap on throughout the day, and it lowered to 20s.
She had an IV for dehydration and some kind of Dexi glucose, but they had to poke her a lot to get an ABG, causing bruising.
She also had a benign goiter in her node blocking her trachea, which didn’t help but was not the major cause of lack of oxygen.
Again, I chalked it up to a COPD exacerbation. I’m not sure how much that last episode affected her heart only to say that her arms, not ankles, were very swollen and red from the IV.
She was able to eat solids and wasn’t confused that next week in the hospital until the night before her death in the rehab, when she said she saw me, and my uncle took a walking tour around the world.
She was sitting up and talking to the nurse. They put her bipap on her but found her at 5:45am not breathing and no heart beat.
They did CPR and got a heart beat and bp back. EMS came and gave her medication and headed for the same hospital but had to ditch that plan and find the nearest hospital. By 6:30am a doctor called me saying she did not make it. Of course it was 4:30am for me.
What a dreadful day. I left her to get on a plane because of my job. She was so bummed out. I said, I’ll be back in no time. I wasn’t able to speak with her in the hospital when I was used to a few times per day at home. So it’s like she just vanished. Gone. Like she just vaporized. That’s what’s so confusing about death.