1 - 2 weeks prior to death
Motor
Urinary/Bowel
Cognitive/Personality/Speech
Physical
- Often, completely bedridden
- Younger patients may still be stubborn about getting up, though requiring assistance
- May hold on to the bedrail or to a caregiver's hand, hair, or clothing very tightly
Urinary/Bowel
- Usually incontinent by now
- May continue to express urinary urgency, without producing anything
Cognitive/Personality/Speech- May find loud or multiple sounds irritating
- After waking, seems confused for several minutes
- Staring across the room, up toward the ceiling, or "through" you
- May look at TV but seem not to be watching it
- May make mention of "getting ready" or "having to go," without knowing where
- May refer to travel, packing, or gathering clothes
- May talk about tying up loose ends (specific to the individual)
- May mention seeing visions in the room (I've heard everything from horses to angels to deceased mothers-in-law)
- Communication seems to take more effort and makes the patient winded or tired
- Doesn't initiate conversation as much, though still giving brief responses to questions
- Agitation may build
- Likes to keep the primary caregiver in sight and may panic when he or she is not in the room
- May seem especially irritable with large groups of visitors or young children (probably because understanding conversations requires more work)
Physical
- Sleeping "almost all the time"
- Can sleep even in a room full of activity and noise
- Harder to rouse from sleep
- Brief, scattered periods of alertness
- Increased difficulty swallowing pills or liquids
- Vision deficits increase
- Eyes may look glassy, milky, cloudy, like "elderly eyes" or "fish eyes"
- May reach toward the head during sleep (may indicate headache pain)
- May have a distended abdomen
- Vital signs are likely to still be good
- May begin to have need for pain management
| < Prev | Next > |
|---|