2 - 3 weeks prior to death
Motor
- May begin to see weakness starting on the non-affected side
- Affected hand may curl in or be kept close to the centre of the body
- Legs begin to buckle, eventually leading to dead weight when attempting to stand
- If still walking, may wander around the house a little, as if restless
- May find it difficult to hold the head up straight or may slump over
Urinary/Bowel
- Urine becomes dark (often described as "tea-coloured")
- Less warning before urination (more urgency)
Cognitive/Personality/Speech
- Less interest in matters of the home and family, hobbies, or world at large
- Detached, without curiosity
- Harder to have an effective adult-peer conversation
- General restlessness/agitation
- Word-finding difficulties (conversation may be very slow)
- Confusion over what time of day it is (sundowners syndrome)
- Speech may be slurring or trailing off, unfinished
- May begin saying things that sound like awareness that time is growing short
- May begin to seem more "childlike"
- Confused by choices; yes/no questions seem to work best
Physical
- Losing interest in transferring or leaving the house
- Seems to feel safest on one particular piece of furniture
- Begins to have problems swallowing, if not already
- Appetite may become sporadic
- May be sleeping 20+ hours a day, with short alert times between sleep
- May doze back off after eating
- May describe vision changes such as double vision, loss of peripheral vision, or black spots
- No longer interested in activities that require close vision, such as reading
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