Questions Surrounding Cause of Death
My father, aged 80, recently succumbed to AML leukemia after a five-month struggle. Although we were aware he was unwell, we were caught off guard by his passing since his cancer had entered remission. Unfortunately, he never returned home for outpatient therapy; the inpatient chemotherapy proved to be detrimental to his health. This treatment led to frequent issues with fluid retention in his body, resulting in low blood pressure and hindering his physical therapy progress. He also experienced two episodes in the ICU due to sepsis and alarmingly low blood pressure, with no infection source found during the second incident. Despite efforts to drain excess fluid from his chest and abdomen, it continued to accumulate, prompting concern from his doctors regarding potential liver complications. The communication surrounding his condition was incredibly unclear. One day, they reported that a CT scan indicated his liver was “lumpy and bumpy,” suspecting cirrhosis and liver failure, which was shocking information given he hardly drank alcohol. However, the following day, additional assessments suggested that his liver appeared to function adequately. The focus then shifted to his kidneys, with concerns about his minimal urine output suggesting he might require dialysis. Fortunately, after being administered medication that increased his urine production, they concluded that dialysis was unnecessary. He was released from the ICU, albeit still feeling quite unwell. The next day, we had discussions regarding hospice care, and within hours, I received a call indicating he was “actively dying,” with his oxygen levels plummeting. He passed away just 15 minutes later. This sequence of events left me bewildered and traumatized. How could someone in remission, well enough to leave the ICU, deteriorate and die so swiftly? The death certificate cited hypoxic respiratory failure stemming from renal and liver failure, with heart failure and septic shock listed as contributing conditions. I am puzzled as to why there was no mention of heart failure during his treatment, and if someone doesn’t require dialysis, can they still be classified as experiencing kidney failure? If the liver tests appeared normal, how could liver failure still be a diagnosis? I can’t shake the worry that my father may have suffered distress during his final moments, although the nursing staff assured me his passing was “peaceful.” In such a rapid decline, could they have administered comfort medication to ease his transition? I regret not having the opportunity to speak with a doctor about my father’s situation. I received only a single phone call from a physician who seemed distracted and struggled to answer my questions. At that moment, it felt futile to pursue further information, especially since he had already passed, but now I yearn for clarity and understanding. Any guidance you could provide would be immensely appreciated. Thank you.
Answers (1)
2/18/2026, 3:50:42 AM
OpenHealth AI
I'm deeply sorry to hear about your father’s passing and understand how perplexing and unsettling this experience must be for you. Your concerns about the rapid decline and the communication surrounding his condition are both valid and important. Let’s break down the issues you raised to provide some clarity.
Key Points of Discussion
- Rapid Decline After Remission: It is indeed shocking to witness such a swift deterioration after a period of improvement.
- Confusion Around Diagnoses: The varying reports regarding liver and kidney function can be understandably bewildering.
- Final Moments and Communication Gaps: Concerns about potential distress during his passing and a lack of detailed communication from healthcare staff.
Explanation of Key Concerns
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Rapid Decline: Even in remission, patients may experience complications from treatment or underlying conditions. Sepsis, organ failures, and fluid retention are serious issues that can escalate rapidly, especially in older adults or those with weakened systems.
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Liver and Kidney Issues:
- Kidney Failure Without Dialysis: It's possible to experience significant renal impairment without needing dialysis if kidney function improves temporarily (for instance, with medication). Thus, one can be classified as having kidney failure (acute or chronic) based on lab results and clinical signs, even if no dialysis is necessary at that moment.
- Liver Function Tests: Liver tests can fluctuate, and while some liver functions may appear normal, other damage such as cirrhosis can still exist, which affects overall liver performance.
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Final Moments: It’s commendable that you are focused on your father’s comfort. Healthcare providers can administer palliative care medications to ease distress during end-of-life situations. This is often done, even if communicated under “comfort measures,” to ensure patients are not in pain.
Next Steps for Understanding and Closure
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Documentation Review: If possible, obtain and review all medical records, including nursing notes and doctor’s entries, regarding your father’s condition throughout his hospitalization. This may help clarify discrepancies.
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Talk to Healthcare Providers: Reach out to your father’s medical team if you can, requesting a follow-up conversation focusing on understanding his care trajectory, the meaning behind the various diagnoses, and the care provided during his last hours.
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Support for Grieving: Consider speaking with a grief counselor or joining a support group for families dealing with loss. It's essential to process these feelings and address the confusion about your father's last moments.
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Palliative Care Inquiries: If you're curious about how palliative care was approached in his situation, asking about the protocols can provide insight into what was done for comfort, including medications.
Final Thoughts
Please remember, it’s normal to seek clarity after a deeply emotional experience like this. Your desire to understand your father's condition and care reflects your love and concern for him. Don't hesitate to reach out for support, whether through family, friends, or professionals, as you navigate this challenging time. If you have any further questions or need additional support, feel free to ask.
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