Life Support Issues/Life support

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Question
My father was taken off life support at 12 noon today, Nov 27th, 2012. He was diagnosed with Stage 4 pancreatic cancer 1 1/2 months ago. He is 82 year old. How long will he survive if there is no oxygen, no food, no hydration. He already has edema of the hands /feet. My sisters think he is still fighting to surive? How long will he suffer?

Answer
Espie,

I am sorry about your father. The suddenness of his decline must be very hard for your family.
Survival under these circumstances relates to his overall health and hydration. People can live without food but not water. In my experience without water, they live only hours to a few days at the most. The lack of food or fluids does not cause suffering in end stage patients. It has been shown that the lack of fluid causes the body to produce endorphins which actually reduces pain.

It sounds from your letter that he was on life support and therefore needed help breathing. His respiratory failure will accelerate his decline. The hospital likely is giving him medications routinely to reduce any pain or respiratory distress he may be experiencing. These medications will slow his breathing down so that he can take in more oxygen. The hospital is making sure he does not suffer.

How long is a question that is difficult to answer. My sense is that it will not be long. We don't have any power over how long it takes. Where we do have power is in the area of how we use the time that is remaining. Your father knows that he is dying. He may not have had the opportunity to do or say what he would have wanted because of his sudden decline. He may want to know from you and your sisters how much he has meant to you all in this life. He may want to know that you all will be OK after he is gone. Fathers continue to take care of their children no matter what happens. So if you have any remaining time today, you may want to talk to him about these things. He can still hear you as hearing is usually the last sense that we lose.  

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Betsy Murphy

Expertise

My expertise is in end of life care for adults. Identifying when someone is approaching the end of their life. Benefits and burdens of end of life treatments. Managing pain and other symptoms. Providing care for dying patients at home. Advocating for someone who is dying in a hospital or nursing home.

Experience

More than 28 years of experience in hospice care. Currently consulting with hospices to promote access for patients to receive hospice care earlier in the course of their illness. Betsy provides training for hospice marketing staff to effectively work with nursing facilities to help identify eligible patients. She writes Additional Development Request (ADR) letters to Medicare to help hospices get paid for their services and to avoid future claim denials.

Organizations
Hospice and Palliative Nurses Association

Publications
Articles: Clinical Reviews, Advance for Nurses, Nursing Spectrum, Washington Business Woman, www.Ezine.com;www.alz-nca.com.Books: Understanding Medical-Surgical Nursing (FA Davis and Company), Guide to Caregiving in the Final Months of Life (TM Brown publishers).

Education/Credentials
Bachelors of Science in Nursing, additionally trained as a Family Nurse Practitioner and certified as a hospice and palliative care nurse.

Awards and Honors
Outstanding Woman in Loudoun County (VA) by Loudoun County Commission on Women 1997 and 2002.

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