Coping with "Moment of Death Guilt" in Grief

[Reviewed and updated September 23, 2024]

Protective parents tend to not die with their children in the room, even if that child is seventy years old.  ~ Barbara Karnes, RN

A reader writes: My mom passed away 28 days ago. She was very sick and I took care of her for the last 10 years - she was living with me. I never left her alone, in fact our family dynamic changed because she was our priority. She was in the hospital for 12 days and everyday I was there for 12 to 13 hours, but could't stay overnight because I have a knee injury and it was necessary to rest my leg to be ready for the next day. On November 30th the doctors told me they couldn't do much for her, just wait to see what happened during the following 24/48 hours.
That day I was there for over 12 hours and a friend came and volunteered to stay with her that night. I did not want to leave...I knew she was dying...but I was in denial. I was expecting her to get better to take her home. I left the hospital at 8 pm, but inside of me I had the urgency to tell her how much I love her, and I did before I left that night. At 12:02 my mom passed away...and this is killing me!!! Why I did not stay with her, I'm the only daughter...it was my responsibility to stay, but I was afraid and in denial. She was alone, my friend left at 11:30 pm and I wasn't there. How can I take this guilt out of my chest...if she is not here to forgive me?

My response: My dear, my heart hurts for you as I read your story, and I am so sorry for your loss. Clearly you have been a loving daughter and a devoted caregiver to your precious mother for so many years, and I have to believe that your mother knew ~ and still knows ~ how very much you love her.

You ask how you can take this guilt out of your chest if your mother is not here to forgive you. I can tell you that you have nothing to feel guilty about, especially the fact that your mother was alone at the time of her death ~ but even as I say that, I know that my words will do nothing to remove your guilt. I can also tell you that the guilt you are feeling is neither rational nor justified ~ but I know that won’t erase the guilt you are feeling now, either. You see, it really doesn’t matter what I say, because the one person from whom you truly need forgiveness is YOU. And forgiveness comes only when you realize you deserve it, you are worthy of it and you are ready to give it to yourself.

If we take a closer look at what is beneath this guilt you are carrying, it may help to know that your mother had far more control over the timing of her death than you did. My friend and colleague Barbara Karnes is an RN who has worked in hospice for many years and has cared for countless dying patients. In her beautiful book, The Final Act of Living, she asserts that we DO have partial control over the time that we die. She writes:

Or how about waiting by my Mom’s bedside for days and leaving the room for a second only to return to find that she has died. Oh, the guilt that goes with that occurrence. It is very important to know, if we are with someone when they die it is because they want us to be with them. If we are not with someone when they die they choose that also. We can take the gift of love and protection that they have given us. Protective parents tend to not die with their children in the room, even if that child is seventy years old (pp. 30-31).

In an article published by Open to Hope, another highly respected grief specialist Dr. Bob Baugher describes what you are experiencing as “Moment-of-Death Guilt” ~ because you were not there to say "goodbye" to your mother.

I hope you will take comfort in these wise words from Darcie Sims, taken from her beautiful piece, Goodbye to Goodbye:  

I was able to be with my mom in her final hours, and I did not say goodbye. I said, 'I love you' And although I was not with my dad when he died, the last words I shared with him as I left his home on what was to be his last night, I kissed him and said, 'I love you.' If you did not get to say goodbye, let go of the hurt you are experiencing. You would not have said it, even if you had had the chance! You would have said, 'I love you.'

When someone we love dearly has died, it is only natural for us to think of all the things we could have, would have, or should have done differently. We are our own worst critics, and it is only human to want to go back and re-do whatever we think we’ve done wrong. Unfortunately, whether it is justified or not, guilt is one of the most common reactions in grief. (See, for example, Guilt In The Wake Of A Parent’s Death ~ and be sure to follow the links listed in the Related Articles section, too.)

I hope this information proves helpful to you, my dear, and I wish for peace and healing to your hurting heart.

Afterword: I have no  words,,,,just THANKS..This is so important to me right now. I'll write back to you with more time, but I need to say THANKS.

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Related:

• Can Sheer Willpower Keep Patients Alive in Their Dying Hours? by Bob Tedeschi
• Caring for a Loved One: The Letter Every Caregiver Should Write by Karyn Arnold
• For Some People Dying Alone Is Not Such A Bad Thing -- Here's Why by Glenys Caswell
• Goodbye to Goodbye by Darcie Sims
• Guilt and Grief: Coping with the Shoulda, Coulda, Wouldas by Litsa Williams
• Guilt In The Wake Of A Parent’s Death by Marty Tousley
• How to Say Goodbye When I'm Not There by Barbara Karnes
• "I Feel Your Death Is My Fault. I'm Sorry I Let You Die." by Barbara Karnes
• ‘Moment-of-Death Guilt’ and Other Issues Haunt Widow by Bob Baugher
• Struggling with How A Loved One Died by Eleanor Haley
• The Burden of Guilt in Grief by Marty Tousley
• The Dying Don't Need Your Permission to Let Go by Lizzy Miles
• The Moments After A Death via Canadian Virtual Hospice
• Three Ways to Address Guilt When You're Grieving by David B. Feldman
• Time of Death: Some Patients Prefer to Die Alone by Lizzy Miles

Image by Ulrike Mai from Pixabay

© by Marty Tousley, RN, MS, FT