What signs are there that the end is near?
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 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.
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.
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!
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
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
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
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.
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.
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.
I've heard that patients often take out their false teeth when the end is near. Does anyone else know anything about this? Thanks
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