March 2, 2023
The Last Breath
The Last Breath Brings a New Reality
Even when you know someone is dying, watching a loved one take their last breath is surreal.
If they are on life support, once they are removed from it, their breathing may change pretty quickly, and then it stops. Natural death can be different. For several minutes, you watch their breathing change. It becomes shallower, intermittent, until with great finality, they take their very last breath. Then, nothing but silence.
Physical Response to Grief
The emptiness of that moment feels like it would suck you into it if it could. You cry, with a depth of pain that feels like it is tearing right through you. You want to get away form the pain, but there is nowhere to run to. Part of their legacy is tied to you, sewn into the very fabric of your life. In losing others, one can feel like they have lost part of themselves.
Maybe that is why anxiety and feeling unsettled is so common after losing a loved one.
The Heart’s Response
In the acute phase of grief, there is physical and neurological consequence. One’s heart can actually change. Takotsubo cardiomyopathy (AKA broken heart syndrome) causes the heart’s main blood-pumping chamber (the left ventricle) to change shape and get larger. This weakens the heart muscle, and it doesn’t pump blood as well as it should. The symptoms usually last a few weeks, and one’s heart can return to normal function.
The word ‘takotsubo’ comes from the name of a pot used by Japanese fishermen to trap octopuses. When the left ventricle of the heart changes shape, it develops a narrow neck and a round bottom, making it look somewhat like an octopus trap.
The Brain’s Response
Then, there is the brain’s response to grief and loss. One can experience changes in memory, behavior, and sleep. Cognitive effects can also happen. One common one is known as brain fog. These neurological changes are a protective mechanism in order to help us survive.
Perhaps that protective mechanism helps younger folks survive, but the risk in elderly survivors can also increase. The depression, anxiety, and physical changes reduce one’s motivation to get up and move Non-adherence to one’s medical regimen can be compromised, increasing hospitalization risk.
I’m not sure the last breath is an event one can prepare for. The emotional toll can last months or years.
Which is why our hospice bereavement is so important. We provide bereavement support for over a year to those who must move forward but feel like they can’t. Children – both young and old – and other family receive care while the world moves on around them.