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Are there any Hospice Nurses on this site?


Ven

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Hi, Ven, I am not sure if there are hospice nurses but there are some pretty knowledgable people here - maybe you could post your question in Ask the Experts or the Hospice section? Or if it is too personal, maybe read some other posts and PM a person or persons who might know the answer. Good luck. Margaret

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Thanks, Margaret & Ry for the replies.

My question concerns the final "good-bye tear" which some patients shed right before the end of life.

I understand this happens with some patients - I know my friend saw it with her dad. I've done a lot of searching on this subject and can't find any explaination for it.

One nurse said there must be a medical reason for this happening. If the patient is comatose, is the one tear an emotional response or physical?

In other words, is this something the body just does as part of the "letting go" process or is it the patient's way of saying "Good bye and I will miss you, but I must leave now".

I know we have to assume that the patient hears everything all along the way and I've read that they are now thinking that touch is also one sense they keep to the very last.

One Hospice group encourages the family to save that tear on cloth. Then the cloth is cherished and actually worn on wedding and Christening gowns and used for other family customs.

I may never find the answer to this but I know it is heartbreaking to watch that one tear being shed. I'd just like to know if the body does it without the patient's awareness or is it really the patient crying for the last time

Thank You.

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Hi Ven---when my Father died many years ago--(I was not with him but my ex-husband was)---He said that one tear came down his face---

how strange ---this is the first time I ever heard of anybody else that it happened to--

and also the day before my Father died he told my sister a man was in the room asking him to come with him ---and he said he had to go with him---

well there was no one in the room ---

I would be interested in anyone else who had the tear experience

regards

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My Mom also shed one tear, but it was not right before she passed. It was after her stroke. It was the first time I saw her and she could not move at all, but her eyes were open. I was pretty upset and crying and she shed one tear. I will never forget it. She never recovered from the stroke and passed away shortly after.

Lyn

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I found this:

LACRIMA MORTIS: THE TEAR OF DEATH

It must be a heart-wrenching experience to see a single tear roll down the cheek of a person at the moment of his or her death. I. Lichter, medical director of the Te Omanga Hospice, in New Zealand, wondered how often this phenomenon occurred and why. Working with the Hospice nursing staff, Lichter followed 100 patients nearing death.

"The results showed 14 patients shed a final tear at the time of death, and a further 13 within the last 10 hours of life.

"In 21 of the 27 cases, the dying person was unconscious at the time of the last tear. And in all but one case the tear was shed by patients whose death was expected rather than sudden."

Lichter and colleagues wondered if the death-bed tears were emotional in origin or perhaps caused by a reflex action. Notes made by the nursing staff were inconclusive on this matter. Lichter thought of chemically analyzing some of the last tears, because emotional tears have a different chemical composition from those produced by irritation. Unfortunately, a single tear was insufficent for the analysis.

(Morrison, Alastair; "The Mystery of the Death-Bed Tear," Wellington Dominion, August 11, 1993. Cr. P. Hassall)

From Science Frontiers #94, JUL-AUG 1994. © 1994-2000 William R. Corliss

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I had never heard of this --but a medical explanation could be:

the body does react by pushing fluids out at the time of death. More than not do become incontinent of urine and stool at the time of death. Possably this is the fluid (tears) in the tear duct that is expelled.

I don't have any other explanation, I would like to think tho it is their way of saying good bye as they leave this world for the next. Maybe it is a tear of joy for what they see as they leave.

Cindy

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The Hospice in my town agree with you, Cindy, and say it is

a physiological response - not emotional at all.

The RN I spoke with said it is simply a "release of bodily fluid".

I do like your comment about it being a tear of joy for what they see as they leave.

Thanks for the reply.

Ven

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  • 16 years later...

This is a late response but my father passed a few weeks ago and also experienced this. It was the moment I knew he was gone without even knowing about lacrim mortis. He wasn’t seemingly breathing and had no pulse on the pulse ox before the tears but I am hoping he was still with us until the tear point bc even though he was comatose I said everything I needed to say. I hope he had a pulse and it just didn’t register. I wouldn’t forgive myself if he passed while I was asleep. I should have stayed up all night with him knowing how bad he was but I was just so tired.

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Hi Allie, my father also passed away a few weeks ago but did not experience this. 

All I can say is to let any guilt go. Some people seem to wait for their loved one(s) to be out of the room. I wish that had happened in my case, because my father's death was traumatic for me. In the weeks afterward, I've worked very hard to move beyond his passing for my own good. Forgive yourself for sleeping, you had no idea when his end would come. In my father's case, we thought he would die at Christmastime but he lingered for almost 6 months with a very poor quality of life. 

My condolences, and I hope you can find some peace within yourself. 

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@allie0318 I'm sorry for the loss of your father. Please forgive yourself self. My brother was a cardiologist and said sometimes, the patient would wait...for the loved one to fall asleep, get a coffee, step in the hall to take a call. He knew.

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  • 2 months later...

I saw something on my sisters face from across the room it looked like  glitter it's sparkle way soo bright I went over to her and it was one tear,  it was crystal clear and perfectly shaped in the corner of her eye, I wipe it away with my finger and told her it was ok and that we will be ok too and if she wanted to be with Jesus that was fine and we will see her again, I was told that that tear that I saw was called the "final tear" and that sometimes happens when a person transitions from this life into eternity, I was asked if I had wiped the tear away with a tissue? And I did not, I sure wished I  would've, they said that in the final tear were certain enzymes that they studied when patients transition, I googled it and it's true and very interesting I really regret not using a tissue
 to wipe my sisters final tear.

https://www.sasktoday.ca/south/opinion/treasuring-the-final-tear-of-a-loved-one-4125062

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