My grandmother has end stage COPD and end stage lung cancer. She has been on hospice for a long time, over a year. It's been a slow and steady decline. She was still mobile, but then she had a fall 3 weeks ago and broke her hip, she was hospitalized. Now she is bed bound. She was basically refusing to eat in the hospital for days. The doctor said she was very weak and lethargic, her eyes were glazed over and she almost didn't make it through the surgery due to her kidneys not filtering and issues with anesthesia. The nurses tried to get her to eat in the hospital but she wouldn't. Her appetite has significantly declined over the last several years since her diagnosis anyway and since being on hospice. But that was the first time she just stopped eating. Her breathing is getting worse due to COPD. The doctor said that rehabilitation would not be an option at this point because she had no strength and wasn't getting nutrients to build up strength. He said once she stopped eating it could be days to weeks and her organs would start to shut down. She looked pretty bad before we took her home. So we all agreed home hospice was the only option instead of active care. We wanted to give her peace at home. But now that she is back home on hospice, she suddenly wants to eat again. Not very much, a couple bites, she had part of an Ensure and a bite of cake. Her mind was also clearer today. But she still just stares off into space and is withdrawn. She stares at the TV but says she's not watching it. I also don’t think this is the surge of serotonin people talk about before someone passes. Is all this normal? I know she is dying due to chronic illness but I am a bit confused by this roller coaster ride. She seems agitated but her mind seems sort of clear sometimes, others not. Was hoping for guidance or moral support. I don't understand how one day she can be unfocused, eyes glazed over, the next day she is more alert and wants to drink an Ensure. How many weeks or months does this part last? I guess not knowing makes this hard on me because when I mentally accept the end could be imminent she suddenly perks up. The up and down makes it harder on the caregivers. Is this part of the dying process or is this her not wanting to let go?
With my dad, he developed a fever and a UTI which put him in bed. He passed about 15 days later, not eating or drinking, going in and out of consciousness the whole time.
My mother was 95 with advanced dementia. She was fine one day, and very tired the next. She went into her bed to rest, became semi comatose, and died 7 days later. We never expected such a fast downhill slide, but it was a blessing, really, that her misery was put to an end. Same with dad who had a brain tumor. Hospice kept them both comfortable and they passed peacefully with no pain.
Just take what comes with grandma, and enjoy her when she's lucid and able to interact. You just don't know from one day to the next what's in store. Hospice can advise you when death us imminent.
Best of luck with a difficult situation.
My late husband was under hospice care in our home for the last 22 months of his life and there were several times that I was told the end was near, but my husband always seemed to bounce back, until the last time that hospice told me that he would be dead within 3 days.
Long story short, he didn't die in 3 days but did in 41 days and that was without any food for that entire time and no drink for over 25 days.
Everyone's journey from this life to the next is different, so again just enjoy whatever time you may have left with her and make sure that you leave nothing left unsaid.
God bless you.
Great big warm hug!
Ask for the support of their nursing staff for your questions, of clergy for your worries, of social workers for life transition thoughts and grieving.
You are correct that this is all a part of the dying process. To be honest I myself would not encourage high nutrition things such as ensure; they now will prolong the dying process, and I do think it is clear to you that this is the dying process and you are now truly in end of life care and active dying process. Let her eat bites of whatever she wants, but don't try to force nutrition or especially nutricious food to prolong things. Use medications for agitation when needed and don't use them when they aren't needed.
And most of all get Hospice to do their job. Ask them questions that come to your mind daily. If you have a question call them. They are getting ROYALLY PAID these days (once a mission for the nurses they employed they have now become the for profit darlings of hedgefunds. Make use of every penny they have) and are more and more cutting corners. Medicare pays them very well. See to it that they are responsive to your daily questions and needs.
88 is a good long life. You are now ensuring a good death, and that is a great blessing. I wish her peace and hope you get all the support out of hospice that you can wring out of them.
Of course, it’s different for everyone. Usually hospice workers have pamphlets or resources where you can read about the death process. I found for me it was helpful to read about it before it happened.