Did I quicken my husbands death?

Edited to add: thank you for your kind words and reassurance. I am going to take them to heart and rely on them when I feel my grief the strongest. It can be hard as a caretaker to care for someone for so long where you do everything to keep them alive and healthy to switch in your mind your new role. We had such a short time in hospice I think it left me with confusion and guilt. My husband’s presence is so missed as he was so loved by many. I will try not to question those last hours and know he’s at peace.

45 male. 180lbs 5’10”. Non-smoker. At death was on Ativan and morphine. Stage 4 colon cancer with metastasis to liver, lungs, abdominal nodes, and malignant pleural effusion and malignant pericardial fluid. One lung was collapsed due to tumor growth in bronchial tubes.

I am under no illusions that my husband was curable past the first attempt at a liver resection. He lived 8 years after a stage 4 diagnosis and I am so thankful for that time for us as a family. All that said, his ending was so quick. We were told in late November 2023 that treatment was futile. We had planned to talk with hospice once we got through our son’s bday and Christmas. Mid December he had 2.5L of ascites drained. A week later he ended up in the ER with sepsis and a blocked small intestine. We got hospice on board a few days into the stay and he was sent home the next day with oxygen. Hospice came by and gave us all the meds they typically do, Ativan (.5mg) and morphine (2mg/ml) being the important ones.

He came home at 3pm on a Monday and was stable on 2L of oxygen. His O2 would drop with any exertion but we were able to keep it managed. He had some light dinner and a piece of cake. We played cards that night with his parents and brother and laughed like we hadn’t in years.

At bed time he was feeling some anxiety and couldn’t get comfortable. Our bed has the ability to raise the head and feet up but he just was not comfortable. We tried the prescribed doses of the morphine and Ativan as they also said for use with shortness of breath as well. It seemed to help a little but in the end he just was uncomfortable. Not in pain though. He’s never really felt anxiety as a condition, but I have. That feeling where you can’t explain it but you cannot be where you are. You just have to be somewhere else. It’s not there is this sense of doom you feel.

I called the on call hospice nurse and she came out around 2am. She doubled both the morphine (so 1ml instead of the .5) and the Ativan. His o2 was not the best, but was ok when he was still. She said to dose him with the double morphine in 2 hrs but the regular Ativan. We got him settled in bed and he finally slept some. He kept having to get up to pee due to taking lasix (sp?) and that took a lot out of him. His 02 would drop to low 70s.

I dosed him again at 4 and 6. After getting up to pee @6 I took his O2 and it was 65 and would not go up. His finger nails were blue and his fingertips were starting to be as well. At this point I woke his parents and called my mom who is a nurse. Once my mom got there she told me to wake the kids up and call hospice. We followed the advice of dosing as above, with the 1ml of morphine and .5 Ativan every 2 hours. He passed away around 10am Tuesday morning, less than 18 hours after leaving the hospital for home hospice.

With all that said, he had told me at the 6am bathroom break that he felt weird on the meds. Like he couldn’t clear his head. I can’t help but feel guilty for giving him the meds. Like, if I hadn’t maybe he would have had more time. Time for our boys to say goodbye and have their dad be awake for it. I have done everything possible in the last 8 years to keep him alive and I feel like I failed in the last days. Did I? Was it too much morphine? Would he have lived a few more days without it?

I also attached his last X-ray from 2 days before he passed and 2 months before in the comments. He had been living with just the one lung for months, but I think the second one looks worse.