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How much time to expect
I just asked a poster a question. But upon thinking about it maybe I should start it as a new question.
My FIL has VD. Diagnosed 10 yrs now. He had a massive bleeding stroke yesterday. He is on morphine and Ativan. He hasn't eaten or drank for 36 hours. He seems comfortable. Obviously no one knows how long it will be. But it seems some people last much longer than expected without water. Does anyone have any input or experience? My MIL would like to keep him at the hospital it. But if it will be an extended amount of time she would like to take him home. More for the families comfort than his. He isn't aware of his surroundings. Thanks
If it was me, I would contact Hospice care and get them involved. They can help you deal with his illness and have a lot of experience in helping people feel more comfortable in stressful times, both the person with the illness and the loved ones, so they would help him and you.
Hi, I'm an RN with a lot of dementia care experience. I just reposted something I wrote a while ago on what happens when your LO is dying. Hopefully it will give you some idea about what is happening with him. Of course no one can predict when another person will die, but there are clues to the fact that death is near. I also gave you information about what you can do to support him during this time.
Your FIL will be in my prayers
My FIL has VD. Diagnosed 10 yrs now. He had a massive bleeding stroke yesterday. He is on morphine and Ativan. He hasn't eaten or drank for 36 hours. He seems comfortable. Obviously no one knows how long it will be. But it seems some people last much longer than expected without water. Does anyone have any input or experience?
I'll share with you my experience. My husband also had a massive bleeding stroke. I elected not to do any kind of surgery to relieve the pressure on his brain. He was given morphine via IV and Keppra for seizures via IV. That was the fastest administration route to keep him comfortable. If I would have taken him home, he would not have been able to receive his meds IV.
My goal was to keep him as comfortable as possible. After three days, the hospital wanted to move him to a nursing home. I knew he would never survive the trip and it would be cruel to attempt that. He was placed on inpatient hospice. We also were given a room with and extra bed and recliner so I had a place to sleep. My daughter and I took turns doing bedside vigil. He lasted seven days.
The last 48 hours were the hardest as his breathing was much more labored. We were able to start a continuous morphine drip via pump. The last 12 hours of his life he was at the maximum dose. Again, my goal was to keep him comfortable and seizure free. He was comatose but you could tell when he was having pain. I discontinued the oxygen as it wasn't helping much.
It's been six months since he passed and I will always remember those seven days we had together as I walked him home to heaven.
I needed the 24 hour support of the nurses and aides. They would bring me coffee at 3am or a warm blanket. I could spend my entire focus on being with him and nothing else. If I would have taken him home it would have been totally different. Just my experience for what it's worth.
..........were the meds from an IV bag or just pushed through an IV line?
The morphine was pushed through an IV line. The Keppra (seizure med) was mixed in a small bag of fluid and given through the IV port. They would periodically flush the line to make sure it was open.
Does you FIL have a Foley catheter? You can see the diminished output and darker urine color over time. That's another clue.
My Wife stopped eating and drinking and passed after about 5-6 days. Keep a radio near his bed and p-lay his favorite music 24/7 as hearing is the last sense to go. Somebody should hold his hand and tell him he is loved. Thank him for being a good Father/husband/friend---whichever is appropriate. Hugs would be ok and keep talking---read the newspaper or hum along with the music. Make him feel wanted.
If somebody hears his breathing get short, the end is near and hold his hand.
Thanks for the advice beaverdams
Thanks as well Tooserious I never found the other post again but the info on this thread helped a lot.
Update: My FIL lived for 6 1/2 days after the massive bleeding stroke. He was in a coma the whole time but right before his last breath he tucked his hand under his chin. It was the position he usually slept in. He died at the hospital. We never did decide to take him home with hospice as each day death seemed imminent. It is thought that the pressure from the blood did not press down on his brain stem as much as it would in a healthy brain as his brain had shrunk so much. He had no food or IV hydration.
Thanks all for your replies earlier.
mawvkysc, I searched for it and found it for you. I'm going to just copy and paste it here.
As a dementia care nurse for
many years, I've been with a number of my residents when they were dying.
What I can tell you is that it is rare that the death if a person with
dementia is not peaceful. Most simply slip away.
When a person reaches the terminal stage of Alzheimer's disease, they are no
longer mobile and eating and drinking very little. This is the time for
Hospice care if that is the wish of the family. They can help with many of
the needs of the terminally ill, especially pain control and keeping the
person as comfortable as possible. This information is to help you
understand what to expect.
Eventually the person will stop taking anything by mouth at all. This is
because the body is shutting down. It used to be common for families to ask
for feeding tubes at this point fearing their LO would starve or dehydrate.
But a lot of attention has been paid to the dying process in the last 20
years or so and we know that feeding tubes and IVs will not really extend
life by much and can cause discomfort and distress. The reason is that
the body is no longer able to absorb, metabolize or excrete fluids or
nutrition. Forcing liquids or even using IV fluids puts an added strain on
the heart, lungs and other organs which can cause breathing difficulties,
edema and other problems.
We also know that the dying
do not experience thirst or hunger any more.
person who is in this stage is also at risk for infections, blood clots and
pneumonia all of which may hasten the death but they are actually part of the
dying process. If families choose to have the person treated for these
problems, the person may linger a little longer, but death is still near.
After refusing fluids and food, the person will begin sleeping longer and
longer periods and eventually will be in a coma. Soon caregivers may notice
that the hands and feet are cold. Actually, the body is shutting down, and
circulation is reduced in the limbs, preserving blood and oxygen for the body
core and brain. In reality, if a person's temperature is taken at this point,
we might find it is very high. For this reason, although care givers may try
to put extra blankets on the person, if they are still able, they will throw
them off. Better to simply use a sheet.
At this time, there may be some mottling of
the skin, especially on the legs. This is normal and a sign that death is
near. Breathing may sound moist as the swallowing mechanism is gone.
Sometimes suction is used. This stage may last a few hours or even a day or
two. Eventually the person will simply stop breathing and death will occur
when the heart stops a few minutes later.What should family members say or do during this time? I firmly believe that
dying dementia patients are aware that LO are there. I always encouraged
families to talk to the person, stroke their cheek, use lotion for hand or
foot massages, and sing or read to them. On occasion (but not frequently).
families will report that their LO had a moment of lucidity just before coma
set in. At times they have been able to say I love you or goodbye. This is a
special gift, but few of the dying are able to do this. None-the-less, there
are indications that they are at least somewhat aware of their surroundings
and we should do all we can to make them as comfortable as possible and
assure them that they are not alone.
Canadian Alzheimer's Society has published a pamphlet, on line, with
additional information I thought was helpful. Here is their website:
Hope this helps,
you and your family are in my thoughts and it is good you are in the hospital so your father in laws needs and your needs can be met at this time. Know those of us who have gone through this journey of waiting found peace that we each did our best to help our loved one by being there.