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How do hospice know when end is near

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joyfh

New Member
After hospital release George and go into re-hab ..we are not sure if or how he will respond to re-hab..all we can do is try..if he can not they will call and tell me..then we have to go to plan 2..Hospice...maybe home with hospital bed ect...I did ask for 7 day care with hospice..
Dr. said his body is shutting down...well he is 91 and has a hard time recovering from any trauma for instence the carbuncle..I thought it would never heal..also just put him in bed..weak, fell and put him in hospital..I have seen him get weaker and weaker..so I know his body is weak and he will either perk up with re-hab or not..
I do remember when he had Physical Therapy with home health care and he did every thing she ask and was walking out side..so what can I say...the mind is willing but the body is not...still is he dying? JOY
 

mariellenl

New Member
I have seen your struggle with what is going on with George and how difficult it has been for you. If the doctor is saying his body is shutting down and is recommended that hospice be called in then yes, he is dying in the opinion of the medical professionals. Has he entered the active dying process? I would say no since they are willing to send him to rehab rather than straight home with hospice.
Huge Hugs,
Mariellen
 

joyfh

New Member
Today his vital signs look good but he is sleeping a lot. very little to eat...now with a cathader he just might have to keep it on..I heard that it took 4 hours for them to get the catheder in the right positions...it was to much pain for George to handle. good thing I was not there..I would not be able to handle that..but they didn't want to take it out of fear of infection and the urologist wanted him to keep it in because he didn't want to go through that pain any more..poor baby..we are trying the re-hab but if he is not able to respond to the treatment like they want they will send him home..with hospice...they will get a hospital bed in the I will have to re-arrange the livingroom for a bed...and lots of help...

When my family went for lunch that is when the uroligist came in damn it..he said he wants the cathader in then in about 30 min. Dr. Lee came in and without reading the chart said tomarrow we will get the cathader out and see if he can go to re-hab..without the strains. so it really made me upset and want to hit the wall...we have to go by the specialist to keep the cathader in for his health even the hospice lady said that..gee what a life...JOY
 

mariellenl

New Member
The question is: how much do you want to put him through? Do you believe rehab will give him enough quality of life to make it worth it for him or do you believe it is time to make him comfortable and let whatever is going to happen happen? If you think the rehab will help then do it, but if you think he is better off at home with medications to keep him comfortable then bring him home and skip the rehab.
Hugs,
Mariellen
P.S. in answer to your original question, hospice knows when the end is near because there is a specific set of changes that occur in the body and mind when a person begins their preparation for departure from this world. If you ask your Hospice advocate they can give you a booklet that describes the signs seen months, weeks, and days before someone passes on.[This Message was Edited on 07/08/2008]
 

daughterjustice

New Member
Oh, how sorry I am to see the sadness of your updates. And the catheter? Awful. I'm so sorry they did that to him.

You have shared that George's body is shutting down but didn't mention what specifically was changing. His vitals were good in your previous post.

The truth is, no one knows if the end is here or not....only after our loved one dies can we say, "oh, so and so was right, Mom was dying." I only have my time with my Mom; George's progression could be very different, but here is what I can share.

Mom refused food and fluids on April 20....all meds, everything. My brother, her only other child, arrived that evening. We didn't know if it was a one day blip. She'd had a TIA the week before, which was resolving. April 21, Mom began having seizures...Grand mal seizures hit on April 22. We started dilantin April 22/3, and she began to eat and drink again. I seriously believe that her refusal on the 20th was life saving; she'd have aspirated and died badly in my arms if she'd had food in her stomach. She somehow knew what she needed and how to save herself, so she refused anything by mouth until after the dilantin began. Then she ate normally for a week or so.

The ending of meds, or the gift of her last days, was her return to a more lucid stage. Not sure she was without dementia, but she was surely much better than she had been in a year. Whatever it was, that time, that week after April 20 was a blessing and a gift.

Mom ate her last full meal on May 1 (maybe 2...can't recall at the moment.) She took her last sucks of water off the toothette on May 3/4. She died May 12. She lived MUCH longer than ever believed possible without food and fluids.

In three weeks (I start counting the day she refused anything by mouth), we were told to say our good byes six times. She would die in minutes or hours. But she didn't. It wasn't until May 9, a Friday, that her vitals changed and her heart was weak and thready. Until then, her urine grew more and more concentrated, her bowels didn't move for two weeks but she still had bowel sounds (she had these until the end), but her vitals remained stable. She would spike a fever from time to time, and her blood pressure would spike sometimes, but nothing ever really changed and stayed changed...it always went back to normal.

George may be dying. I don't know. I wish I did. I wish I could give you a time and a date (I wanted that so much), so you could be exactly where you need to be in those last moments, wherever that is. It would be so much easier than the wondering. The wondering and watching and helplessness....it's the most horrible thing I've experienced in a very long time.

I didn't really know what to believe about Mom. I thought she would die any minute on more than a few days. I sat up one night counting her breaths and timing apnea like I was timing birth contractions. By the time she died, despite the horror of watching her decline, I had stopped thinking she would die. I know that sounds totally nuts, but after making the nurses wrong 5 times, you know, I figured she would be here a lot longer.

The Friday before she died (Monday morning), she had apnea episodes of 40 seconds...then she resumed normal breathing. She had the "fish out of water" breathing for 16 hours...every book I read on signs of end of life says that comes minutes to a couple hours before death. Mom defied all the stats in all the books.

Perhaps something in my rambling is useful or helpful in someway. I hope so. If it is just a sad daughter's ramblings, forgive me for placing them in your replies.

I'm so sorry for all you and George are enduring.

Love,
Suzanne
 

joyfh

New Member
He is not going to re-hab..I truly don't think at this time it will help him..he needs to be home for his last days..Hospice will be here..we already have a hospital bed, oxygin..night table..hopefuly he will be home some time today. I don't think he will last 6 months..not eating but a few bites maybe water..but I don't force him..
Family is with me also hospice...I want to cry...my poor husbnad..please God don't let him suffer..take him soon. JOY
 

mtndewmama

New Member
I can feel your pain and anguish in your words. When he suffers, you suffer. It hurts me to see you in such turmoil. I can only offer you my thoughts and prayers and a huge cyber hug...((((((HUGS))))
Love & Hugs,
Debra
 

joyfh

New Member
Thanks for all your lovely post..it is very comforting to here from all of you..I also say with this kind of sickness.I have morphine for pain..when I see fit..pray that George will not have to suffer..that is all I want..JOY
 
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