Is my grandmother going through a phase or is this really the end?

2 answers | Last updated: Sep 27, 2016
Pennstater318 asked...

My grandmother has been placed on hospice and is now living with myself and my mom. She has been diagnosed with COPD and CHF. Is there a way to know when she is reaching the end stages of dying? She seems to have no energy, sleeps alot and her appetite has decreased to less than half of what she used to eat. I just want to kn ow if this is some sort of phase that maybe she's going through or if we should be preparing for the end


Expert Answers

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 Nursing Education Consortium (ELNEC), which promotes education in geriatric nursing and end-of-life care.

Your grandmother has been diagnosed with two diseases that affect both her heart and her lungs. Both conditions are using up her energy by making breathing, which we take for granted, extremely difficult for her. She needs to sleep more just to restore her body. The loss of the desire to eat could simply illustrate that eating requires a lot of energy; and, it is difficult to eat when you can't breathe! She probably is "short of breath" and has trouble moving about.

Both COPD and CHF have various stages. If your grandmother is not in the final stages of either disease, she may live a while longer. If she is in the final stages, her body may be preparing itself for approaching death by illustrating the change in sleep patterns, loss of energy, and loss of desire to eat. If her heart disease is not too bad, her lung disease alone may show many ups and downs.

When a person is at the end of their life we see certain patterns. Sleeping more and having no energy results from fighting a disease process for a long time. As death nears, a person can no longer metabolize foods like you or I can"”hence, they lose their appetite and desire to eat. Breathing changes which sometimes can sound rough or coarse are also heard. People may withdraw or seem disoriented or confused. Not being able to control the bladder or bowels is expected. In essence, the body is starting to "shut down." All this is natural.

This is not a phase your grandmother is going through. This is simply nature's way of preparing for the end. I cannot predict how lengthy this process will be, but we say that when families start to see changes from month to month, people may have only months to live. When they see changes from week to week, then generally we are down to weeks. When the changes (decline) appear daily, then we are looking at days. Remember, we are all unique"”we will die just as uniquely as we lived. Celebrate this special time with your grandmother"”care giving, while difficult, can be the most rewarding activity you will ever do!


Community Answers

Bwildbillyjoe answered...

I know how you feel-- my mom has alzheimers,I wonder sometimes about the end. I saw on this web site about a book that is about that exact thing. the name of it is "Final Gifts". It is written by two hospice nurses--Maggie Callanan and Patricia Kelley. I havent finished it yet but has made me feel better about the end of life. I have read alot of books about alzheimers but they didnt answer all questions that I wanted. This book is not about medical facts--its about experiences with the hospice nurses with the patient and their families. So far I REALLY LIKE IT. At one setting I read 50 pages.---I hope if you decide to get this book it will help you. (you can buy it on ebay, amazon.com or other places that are used and dont cost as much) I will be praying for you and your family