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What signs are there that the end is near?

24 answers | Last updated: Aug 23, 2014
loveher asked...
My mom is in hospice right now because she has an artery closing up. She has congestive heart failure and two aneurysms that are inoperable. She is 89 years-old. Are there symptoms of the closing to look for? Every time she has a stomach ache or a pain, my first thought is of the two aneurysms. What will be signs that the end is near? Thank You.
 

Answers
Caring.com User - Audrey Wuerl
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Audrey Wuerl, RN, BSN, PHN, is education coordinator for Hospice of San Joaquin in California. She is also a geriatric trainer for the End-of-Life...
48% helpful
answered...

Frequently, families ask what to expect when the end is near for their loved one. You mention that your mother has congestive heart disease, a condition that is defined as See also:
What is the meaning of dying?
the inability of the heart to supply adequate pressure and volume to important organs of the body, the most important being the heart itself. While this disease begins in either the right or left side of the heart, eventually both sides will become affected.

Usually, there is a lot of fluid retention that can cause swelling of the lower extremeties, or in the lungs. There can be difficulty breathing, much fatigue, as well as numerous other signs and symptoms. Since, your mother has other conditions such as the aneurysms, I will address the things we see as people near death that can be applied to the dying process in general.

Physical signs that death is near include changes in the mental status like increased periods of sleeping, decreased consciousness, and physical withdrawal. The urine can become more concentrated, the skin may feel cool, breathing becomes more difficult, and the person becomes incontinent of urine and/or bowels.

Breathing changes can occur; regular breathing may become irregular with periods of shallow breaths and also periods of 5 to 30 seconds of no breathing, up to 1 minute, which is known as Cheyne-Stokes breathing. You may hear wet, noisy breathing which can be alliviated by repositioning and by special medications that help decrease the secretions. Usually apnea, which is defined as no breathing, occurs for short periods and becomes longer as death approaches.

If your mother is not having pain at this time, she may not experience pain as death draws near. If she is having pain, her medications to help relieve it should be continued. Overall, managing her symptoms, and pain if present, should be the goal now.

Trying to enjoy this time with your mother, concentrating on what she can still do, is most important now. The hospice team will assist you in caring for her and keeping her comfortable. That is what we mean by comfort care. Our entire philosophy centers around a peaceful life closure with dignity and respect.

 

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21% helpful
ERP answered...

I have been witness to my Father's death at age 53 and to my 12 year old son's death. In both cases the doctors who were caring for them were taken by surprise! My son's doctor wanted me to transfer him to another Hospital where they had a treatment that might help him. I was told they wouldn't have a bed for 3 days but, said his Onclologist, he's not about to die. He died that afternoon! When I questioned my Pediatrician he just shrugged his shoulders.

 

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Patk answered...

My Dad died of cancer about 2 years ago and then my mother died just last November. About 24 to 48 hours before they died the feet and hands started to darken and then the back and tailbone later on. Someone said that it was the blood pooling as the organs or the body is shutting down. After I witnessed my dads death, and then when my mother died I pretty much knew when my moms hands and veins started turning almost a black that she only had a couple of days left. I didn't want her to be alone when she died and I stayed with her for 3 nights and on the morning of the 3rd night she just stopped breathing. I hope this might help you but I'm not sure with the congestive heart failure. My deepest sympathy and my heart goes out to you and your family!

 

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Peggy Gillespie answered...

God wanted your Son,you can't go by these Doctors/ Just know that your Son is Proud of you and loves you very much and is watching over you. Not that ,that is any comfort to you but I always want my Husband to be Proud of the way I am carring on knowing he is right beside me. My Husband passed away 7 months ago. Know that your Son is with your Dad andf with Jesus. Get the book Glimpses of Heaven by Trudy Harris its a Beautiful book and she was a hospice Nurse for 22 years and an RN for 50 . The true Stories in that book are of the people that were passing ,its Beautiful Blessing to you stay strong Peggy

 

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Pgoodhart answered...

My Mom died of congestive heart failure at 90 and I can share with you the things that happened up to the end. She was in a nursing home when we had her evaluated by Hospice who told us she most likely had about two more weeks to live accordidng to her condition and their history with death from this. So we decided to take her home (my sister's house) so that we could be with her every minute, and it was the most wonderful decision we could have made. Hospice helped us prepare a room for her and have the supplies on hand that we would need to give her the best possible care we could. The first week was great, our brother flew in from Ma and visited with her for several days, I was able to go from Az to stay the duration and my other two sisters live near by so she had all of us near. We talked to her about our childhoods individually and she answered questions for us and talked about her childhood, her mother, brothers and sisters and her childhood dreams, one of which was to jump out of planes (big surprise needless to say), that she loved to draw and wanted to be an artist, etc.... things she had never mentioned before. I asked her if she was disappointed now that the end was near that she had not done those things and with the most radiant smile she said "no" because i got all of you instead. I guess God thought I would be a better mother than anything else; and she was. We talked about the people she would get to see again when she entered heaven and we even asked her if she could, to deliver messages to them from us. Of course she did not embrace the idea of death and leaving us, but she knew it was coming and seemed to be comforted by us being able to talk about it and tell her how much we would miss her. Of the other loved ones that had already died, it was never where we could say goodbye while they were still alert or with us. My Mom was very much a soft lady and we were able to treat as such while she could still get out of bed. We set the table in the best China and Crystal, even if she was only able to take a couple of bites it showed her we still respected her dignity and grace. She was embarrassed by her cathater bag, so we hung her Louie Vitton purse on the wheel chair and put it in it which gave her a really big laugh. She said the designer would probably drop dead if they knew what the purse was being used for. We let her sit up (out of the bed) when she felt like it and showed no concern when she was ready to lay back down. Just acted as if all of this was the normal day. I tell you this part so that you can see a way that you can have a time with your mother that will forever be so special to you and will help you when the end starts to come and then does come. The last 4 days Mother began to sleep a lot more and talked alot in her sleep. There were times when she seemed to be reliving things that had happened in her life. She gradually had more pain, which we relieved with medication, she ate less and less and could not tell what she was eating as her taste seemed to disappear. At one point thinking water was coffee. She startedd to retain more fluids, with her feet, ankles, legs and face swelling the most. Her urine became darker and there was much less of it. The night before she died she asked to go potty and she almost completely filled the bedside commode with fecis. it was as though her entire digestive system emptied. She slept most of the day she died with most of her conversations being with people that were not present or even living. She had been talking to one brother in particular that had been dead for several years, at one time even saying, "oh no, not now, I don't won't to go now". It seemed that she talked to him everyday until the end. Even though we had all assumed our oldest brother, who was killed by a drunk driver in 1956, would be the one to escort to heaven it turned out to be her oldest brother. About 9:00 pm she opened her eyes and looked to an area of the room where no one was standing and called his name and said is it time now? Then she looked around the room at everyone, smiled and said ok, took a very labored deep breath and closed her eyes. She did not speak again, open her again or speak of pain again. Her heart did not completely stop beating for about another hour and a half. Enough time for us to hold her, kiss her, tell her how much we loved her while life was still there and then she simply stopped breathing and her heart stopped beating. She had left with her brother to be with her mother, sisters, beloved son and grandson (my son,who had also been killed by a drunk driver at the same age as her son). To sing with the angels and rejoice in her reunion with God and His Beloved Son, Jesus. She is there to look over us and try as she always did to keep us on the narrow path. She is there for us to talk to anytime we want to and listens without interutions. Her wisdom will always be with us and love can be felt in the embrace of those WE love. The physical being that was my Mother left that night, but she will live forever in my heart, my beliefs, my actions and the love I share with others. I so hope I have helped you in some small way to know when the end may be near (though no one can tell you for sure), but most of all I hope I have helped you in a big way to see TODAY and what you can share with your mother, and not miss it because you are looking for the end. I will remember you both in my prayers and hope she has a peaceful passing and you a peaceful acceptance. With Understanding and love Phyllis Goodhart

 

38% helpful
Weezie answered...

I really don't have an answer to the question; I only wanted to say that Phyllis Goodhart's letter was beautiful. It brought tears to my eyes. My husband is in stage iv lung cancer; this has been a nightmare for our family for the last 6 months. Thank You Phyllis for sharing your story with us. God Bless You......L Brown

 

24% helpful
Crassshett answered...

My mother is 82, and we just recently brought her home from a nursing home, she has spinal stenosis of the spine so she has her days where her legs work enough and days where they won't do nothing. She has always been the best mom a family could have and I THANK GOD for giving her to us. Since she has been home which has been just a few days her mind just hasn't been the best and her ankles and feets swell and turn real dark. We worry what is causing this, I know she has conjestive heart failure but hse is on Lasix. I worry on what we should do. She is livinf with my sister who is just down the road from me. Has anyone else had this and what can we do. She has adoctor appointment this coming Tuesday.

 

63% helpful
Marly26 answered...

Another area to watch as well as swelling, sleeping for longer periods as well is call "motling". This is where discoloration comes into the nails/toenails. They seem to darken and can sometimes at the toenails move upwards. You wont' see that pinky color of a normal persons' nails, its almost a grey in color. However this doesnt mean that she could actually go right then, it is a sign of coming to the end. As well if she is bedridden, if she has slid down in the bed be careful as to how you move her up. Its an area that many dont' think of but when moved you can actually cut off the airway. If at this point she is taking in fluids, eating even a little does give some hope. If she seems in and/out alot sleepwise, dont' hesitate to check those nails. If you see the motling you wont' forget it, believe me. I have seen it so many times during my years of work that its just something that stays with you. As well when someone is near death, it is so much easier for you to take that persons' hand, talk to them and tell them it okay to let go. Sometimes' they need to hear that from either you or possibly a family member that she may not have seen in sometime. There a reasons' for them to hold on. I know it is hard to do but rest assure her that everything is fine, she need not worry about anyone. This gives' them reassurance and peace of mind. Its' hard for anyone to say this to a parent especially but at least you know in your heart of hearts' that you did the right thing. Take care, dont' lay blame on yourself. I'm sure your mom has lived a wonderful life and she has you a wonderful daughter. You know you have done everything you possibly could have. When she leaves' feel the peace within yourself and know that she has gone to a better place. My prayers are with you.

 

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An anonymous caregiver answered...

God bless her and stay close to her, this will ease her mind if or when she has end stage anxiety, which I found to be quite often. I have worked with oncology patients for 7-8 years, and the anxiety can be overwhelming and close family and reassure the patient.

 

11% helpful
Emily M. answered...

Hi so tired, Interesting question. If you'd like you can post your own question on Ask & Answer here: http://www.caring.com/ask Thanks for your comment! -- Emily | Community Manager

 

mlucille answered...

My husband age 82 has severe spinal stenosis and chf; this past year has been the worst....the pain is severe;keeps him from walking more than 5 feet; can't stand more than 26 seconds. Shortness of breath has gotten worse, he is just starting to use oxygen at night. We try to keep a normal routine...and when he needs to nap , no problem. He worked hard all his life and feels guilty that now all he wants to do is nap and can't even sweep the porch. We are getting a scooter so he can go to the flea markets and look around; go to the mall and check out the stores, which he hasn't been able to do for 1 year. The biggest thing is assuring him that it is okay to take it easy and do only what he is capable of doing. We do wonder how many years are left....but then again none of us really know how long we have to love and live.

 

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An anonymous caregiver answered...

My father died of CHF three months ago and to be completely honest..... there are no signs that the end is near. The symptoms that they already have (the fatigue, the shortness of breath, the swelling, the lack of sleeping) becomes much worse, almost unbearable. But, for him the end was SCA (sudden cardiac arrest). Most people with CHF, over 40%, usually die from either pump failure of sudden cardiac arrest. With my father, he was just sitting on the couch and suddenly started groaning, making bubbles with his mouth, and then he went unconcious. That was it. I believe he went pretty quickly and that he wasnt in any pain, which brings me the most comfort. But, with sufferers of this disease, it is pretty hard to watch them get worse over a matter of years. My advice, cherish every passing day with them, because you never know when it will be their last!!

 

44% helpful
c494246969771 answered...

Hi everyone my name is Christopher and my father passed away at 53 from heart disease. His heart conditions came from over use of drugs and booze. I watched this man drink himself and do drugs to his death. My father was having bouts of conversation with unknown people in the room. The hardest part was watching his turn a grey color and well as his finger nails loss the pink into them. It's hard to predict the end as everyone is different. All anyone can do is tell the story of the losing of there loved one. As I type this this morning I to suffer from stage 4 bone cancer. I looked up this topic because I want to prepare my kids that daddy loves them. It breaks my heart to see the tears roll down my beautiful daughters face ages 7 and 11. My. Family is my world but god has other plans for me , my kids don't understand that I understand where there are coming from as I won't ever walk either down the ulter to hand them off. But if you one in my shoes and are asking the queston just be honest with your kids they are human just like us no need to lie to them about the dying process. It's what every. Human will face in there lifetime. But always assure your dying loved one its ok to let go. I kept begging for my father not to leave me he Hung on for me. But I had a sence of peace of peace run over me it felt as my passed away members all have hugs. But when I kiss my father for the time and whispered in his ear its ok to let go daddy his eyes began to flutter and he began to hum. It was the hardest thing to deal with but I know ill be putting my kids and wife through it. It's going to be a hard pill to swollow but gods ready for me to come god bless all of you wonderful people.

 

25% helpful
Tigge answered...

PLEASE people, if you can read a book call "Embraced by the Light" written by Betty J Eadie. Its about her journey of death and back. You will find so much peace, and will have no fear of death. The key is in beliveing. If you believe, there is EVERYTHING, and if you dont believe..then there is nothing.

God Bless you all.

 

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An anonymous caregiver answered...

Phyllis Goodhart's answer was beautiful. I relived my mother's death when I read it. A few months ago I lost my dad......he slept his way into heaven and I found him on a Sunday morning. He had Chf but there was no indication that he was going to die. I beat myself up, wondering if I missed something which would have helped him. I discussed this with our cardiologist and he said there would have been nothing I could have done and that he felt nothing at the moment of death.......he slept through it. I am still trying to get beyond the grief to the precious memories.

 

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Elizabeth0702 answered...

Phyllis...My husband passed in Jan. Your letter was so helpful to me, and I want to say how beautiful it was. You are a beautiful soul, I can see that, and I'm so sure your mother is with Jesus. Among other things I said to my husband before he passed was that I was envious of the fact that he was about to actually meet Jesus Christ! That conversation happened on the day he decided not to have radiation and let nature take her course. We sobbed for a long time together...then we talked. A LOT. God bless you hun, and thank you for sharing your experience.

 

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Nisha Jacob answered...

My maternal grandmother is 96 - not had anything to eat since the past many days - only having drops of water for the past 1 week. her body is cold , no urine output - she is passing stools continously - she has bed sores - which are painful - and tears flow from her eyes when it pains her a lot.

All the above answers were helpful - because I could not u'stand why she is not even having water - she is nearing death - it's just a question of when now............ I love her so much - i can't take her out of my mind for the past few days (she's away in another city) . I'm going to visit in another 4 days and can be with her only for 3 days! I hate myself - for not being able to spend more time with her! I just hope she passes away peacefully and soon without any further suffering!

 

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lmwade answered...

I lost my mom in January 2013 to CHF; she was 77 years old. In addition to CHF, she was also suffering from mild dementia, a result of several TIAs. While on all of her meds, she was confused a lot and her appetite was virtually nonexistent. When we started Hospice about a month before she died, all meds were stopped except those for pain. Her mind actually became more clear and her appetite returned somewhat. It was at this time that she started commenting on her parents and siblings, all whom had already passed, being in the room with her. The way she talked about and to them, I knew she was surrounded by them. I took comfort in knowing they were there, ready to help her pass over when the time came. It was at this time that she also started doing hand motions while she was asleep, or at least it appeared like she was sleeping. She was definitely not awake. She would move her hands and fingers like she was sewing or drinking a cup of tea. The movements were so exact that you could almost see the tea cup she was holding. I had never heard of this before but since have read that this is like a state where she has one part of her body here on earth and the other part in the next world. It sometimes happens when death is near.
Oh, and a word about Hospice. We had never had the need for Hospice before and this was the first time we worked with them. As Mom had CHF for several years, we were in "life saving" mode every time she suffered a medical emergency. It was really hard at first to wrap my brain around making her comfortable in her last days and not give her the medication that would have previously been prescribed to prolong her life. For me it was an awakening of sorts; I realized that my time with her was now very short. It was ok to admit that she was dying and that she was not going to recover. As a result, I spent every moment I could with her. She and I had quality time together, just lying on her bed holding hands and talking about little things. I had no expectations of anything when I visited her; I just came to spend time with her. We were both able to say I love you many times which is something I will treasure always.
My Mom was a very religious person but she was afraid to die. It was a subject we did not dwell on because it would upset her. When she asked if she was dying I didn't lie to her but instead told her that everyone eventually dies and God would take when she was ready. The night before she died she told my sister that she was now ready, that she was ok with leaving. She was suffered a fatal heart attack early the next morning. I am still very much grieving. Just when I think I have it together, something will be said or I will see something that reminds me of her and I'm right back where I was in January. I know it's a process that I have to work through. It's comforting to know others who have gone through it too are there to listen when I need to talk.

 

64% helpful
David A answered...

My father is currently very close to death. He is 80 1/2 years old. He has suffered with CHF for years now. It started with the lower legs swelling and getting red. If they became brown and warm they would rush him to the hospital as he was with sepsis. But he made it around OK, and was doing the best he could. Eventually you could see the disease start to take its toll. He would have low O2 levels and would get weak and fall. From the different medications, he developed onion skin. When he would fall he would tear large areas of his skin and need to be in the hospital for a few weeks to get stabilized and have the wounds cared for to the point he could go home. The bleeds were deep in his small intestine and caused by the medications for the CHF that were giving him the onion skin. These events would happen about every 6 or 7 months and then he would be fine.

He went on like this for several years and we just accepted it as part of dealing with the condition. Then over the last two years we saw a marked increase in the number and frequency of incidents. My mom is frail and could not lift him. She always had to call EMT ambulance services and they would hoist him up and off to the hospital. The frequency went from 6 or 7 months to 30 days or less. It was obvious his condition was getting worse. We placed him into a rehabilitation home a few months ago and they did wonders for him. I had never seen him look so good. They had the swelling down, his energy up, and medications stabilized. They finally released him after 6 weeks there. He was so happy to be back home in his own room with his TV and lift chair.

Sadly, this lasted only 3 weeks before he swelled up and became weak and fell again. The main problem was the severe swelling was causing him to lose the feeling in his legs and feet. A return to the hospital for a few weeks, and they were having difficulty getting the swelling in the legs to go down. I knew he was getting worse and started to wonder when they would get to the pivot point where the medications would no longer control the fluid build up. We decided to send him to a nursing home as he needed constant monitoring of his condition, and mom could not handle him alone. Unfortunately this new home was poor in that regard and they had to evacuate him to the hospital after only 2 weeks. He was swelled up like the Michelin man. The worse I had ever seen him. His legs were huge, his torso was bulging out in layers and his neck, face and hands were puffed out. He was in the hospital for a month again. This time they again could not get his legs to go down to normal, they remained stiff and full of fluids.

He did not have fluids on his lungs or heart, so we placed him in a nursing home rehabilitation center. It one was a nice place, very nice people, clean, and lots of stuff for him to do. He cried a lot the first week or so there as he wanted to go home. We discussed this option, but it would prove illogical as he needed constant medical monitoring and a home nurse was expensive. He eventually made a few friends there and would go eat his meals in the dining hall with other people. But he was depressed and did not like to watch TV, any more. He loved to watch sports on TV, so this was a change.

Then last Saturday we visited him and noticed he was swelling in the left hand and neck again. The staff knew of this and a slight weight gain from fluid retention. Their doctors examined him and wanted to start a Lasix IV to try to head this off. He was sent to his room on Monday from PT as he could not move he was so weak. Mom said he was puffed up in the face and could not talk on Monday from the sudden fluid build up. I visited later in the day and he looked OK but was having difficulty speaking. He also developed a twitch in his hands that prevented him from holding his shaver or a phone. This alarmed the house doctor who had increased his Lasix so she called in another doctor for a consultation. They both agreed that he should go to the hospital that this was not getting better with the limited facilities they had. I had visited him Tuesday and he seemed fine but still had that twitch.

Late Tuesday they transported him to the hospital. They were administering the Lasix by IV, but he was tired and wanted to sleep all the time. The twitch was caused by his electrolytes being off due to the high doses of Lasix. This was a catch 22 as if they gave him potassium it negates the effectiveness of the Lasix. I was hoping with the hospital attention that he would be improving like he had done in the past. I visited yesterday afternoon, and was saddened to see he was now swelled up all over his body again. He is lethargic and wants to sleep all the time. His urine output is low and its dark. With the Lasix he should be urinating more frequently and producing more volume.

I left crying as I walked to my truck. I can see he is slipping away. He is swelling, he is sleeping all the time. He has no interest in activities, and he is hardly producing urine for all the Lasix he is getting. The signs are that he has reached the point where the Lasix is no longer able to counter the affects of the condition and he is dying. So I am waiting for the dreaded call, and crying in fits as I wait. He is on my mind a lot of course. I'm not sure when the end will be, but my sense is that it is close.

 

50% helpful
commonfan answered...

My grandma just died of it this morning :(((( She had an aneurism 2months ago and had an emergency operation. she started to have fluids in her lungs because of the heart failure and breath eith a lot of difficulty. afew days ago, she was mostly sleeping and talking while sleeping... she started to be too tired for anything and didnt wanted to eat, didnt have any craving... she was tired just for being awake and could barely talk without telling us how exausted she was.... yesterday, she slept the whole days and breath making more noise ( like asthma) and was warmer than usual... we spoke a bit and she felt back asleep saying shes suffering just to breath.... even with oxygen givin and ventolin meds to open her respitaey system .... and her heart rate started to be very unstable this morning... and she died 30-40 min after. :'( , .... i wasnt there at her last moment and i feel guilty of not being there as she mustve been so scared when it all happend... she was 85

 

gratefulbeyondwords answered...

I just want to thank you all. In the past few months, desperate for information, I have returned to read this site again and again. My heart goes out to each of you, your families and friends. May it give you some sense of solace that you have been a cherished guide and information source unrivaled. My heartfelt appreciation, thoughts and prayers go out to all involved. Thank you!

 

 
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