How do you know death is near?

[soocool]

I am so concerned about my dad lately. He is in his 80s and had a pulmonary embolism last year from which he never really recovered from fully. Lately, he has been sleeping a great deal (practically all day) and he is eating less. He calls my sister by my mom's name constantly. Many times he is confused. He does not want to go out. He says he is cold much of the time. I took him to the doctor a couple of weeks ago and all he said was that my father was fine. I asked him if my dad was approaching his end of life and all the doctor said is that we are all approaching death.

My mom passed away 4 years ago from cancer so her death was somewhat different. I feel that my dad is approaching death and my sister is fiercely disagreeing with me. I just don't know what I should be doing.

 

[dragonfly411]

Soocool - I think every person approaches the end of their lives differently, and it would be hard for a doctor to say yes or no without some sort of firm disease with a timeline. That being said, I think that keeping your dad comfortable, and as happy as possible are the best things you could do. Make sure the foods he DOES want to eat are on hand. Make sure his bedding stays comfortable and clean. Provide him with extra blankets, and make warm liquids for him to drink. That's my best advice. (HUGS)

 

[centralsquare]

First of all, I'm so sorry to hear that your father is in this state. Second, I can't believe the doctor said that to you. How unhelpful! What medications is he on? My grandfather had a stroke 15 years ago and was very confused for a while after, but once he transitioned off some meds, he was better...but still towards the end of the day...starting in the evening, he'd get really easily confused. He'd say things like "Bob (his old neighbor) came by last night and we had a lot of fun." We always just said "OK."

 

[iheartscience]

Wow, real helpful of that doctor. Have you considered taking your father to another doctor for a second opinion? It could be that his medications should be adjusted, or he should take a supplement like Ensure. Or maybe he's anemic because he hasn't been eating much? I think anemia can make you tired.

I hope you can find an answer.

 

[junebug17]

Hugs socool, it's tough to see our parents growing old, isn't it? My mother is in a similar situation - she had a stroke last October and never really bounced back from it. She just kind of gave up. She just sits all day long, and doesn't want to go out. (She can walk with a walker, and could go out if she wanted, but I guess the effort just isn't worth it?) She's weak and frail. She doesn't have much of an appetite, but I guess you don't build up an appetite if you are inactive and don't expend any energy. She seems comfortable enough, (she's cold all the time too) but personally I think she's depressed, even though she would never admit that in a million years. Physically, there doesn't seem to be anything wrong with her, but obviously there are physical problems since she had a stroke.

The doctor could certainly have phrased his answer better, but in his defense I guess it's really hard to predict when a person will pass, especially when their physical problems seem to be under control. I wonder about my mother. She could live for 5-7 more years, or she could have another stroke tomorrow. Not to sound morbid, but I'm starting to prepare myself for the possibility that my mother may not live much longer. I stay over her house 2 nights a week, and lately I've been wondering if she'll wake up in the morning. But as I said, who knows, she could also live for quite a few more years. Just hard to tell under these circumstances.

Sorry you're going through this - hard to see someone just sort of "existing" and not enjoying life. It seems to cheer my mother up to talk about her past, and I enjoy hearing the stories. I just try to be cheerful around her, and when we watch tv I try to engage her and make her laugh a little. And I just try to make her as comfortable as possible, and make sure she has what she needs to make her life a little more pleasant (like hershey's kisses ) My goal is to make her as comfortable and as happy as possible.

ETA: Just read the other responses, and I agree that you could take him for a second opinion if you feel the doc isn't being thorough enough.

 

[chemgirl]

Have you taken him to a geriatric mental health specialist? I know it sounds bad, the term mental health specialist, but really its just somebody to consult with about memory, confusion, and problem solving issues. My grandmother is in her early eighties and has been seeing a specialist for about 2 years now. Before seeing the specialist, she was easily confused and had problems remembering appointments and small day to day things. The specialist assesses the patient's status and can recommend medication to help with memory and basic reasoning. Its not a cure, but I have seen an improvement in my grandmother's condition. Its not invasive testing, they'll have him do things like label a clock, count backwards, list items from memory etc.

A specialist can also refer him to an outpatient program for depression if that's an issue. I don't know what's available in your area, but I used to work as a geriatric psychiatry research assistant while I was in school so I know that many hospitals have programs to get seniors out and doing things. One specific program, called the "Positive Actions and Attitudes" program is for people with early dementia and depression (conditions that often happen simultaneously). The program consists of physical activity like group walks, psychological assessments in the form of puzzles and games, and group talk time. The idea was to guide people to a more positive outlook. I'm sure there are other similar programs out there.

Your dad might be resistant to anything with the word "mental health" in subject line (I know my grandma was!), but the programs really do help. I'm surprised his doctor didn't think to refer him to a specialist to get the process started.

ETA: the specific program I talked about isn't being used anymore for budgetary reasons. There are other programs and a specialist should be able to recommend something if your dad needs one.

 

[artdecogirl]

Soocool, I am sorry you and your family are going through this, being a caretaker for a elderly parent is such a hard thing. I am a RN in a acute care setting but worked with the elderly for many years, I am sorry the doctor responded to you that way, it is a hard question to be asked because we never really know, I have seen people that I did not think would make it through the night rebound and recover from their illness and others that I felt were doing well did not recover so I have learned to never say exactly but he should have been more tactful. The md is probably seeing that his vitals are all fine so physically he is fine but you know him and something is just not right. Is he depressed? or on anything for depression? Sleeping alot, not wanting to go out, loss of appetite all of these can be signs of depression. Did they do bloodwork? There are so many things that could be causing his issues and they seem to be affecting his quality of life so I would push the subject with his md or if needed another doctor. About the being cold thing, I think this just happens, when I worked at the nursing home I would be wearing thin short sleeved scrubs and sweating and if I had a dollar for every resident that asked "honey would you go to my room and get me my sweater?" I would be posting on ps from the deck of my yacht on the mediterranean instead of at the dining room table in my split level house in the midwest... Take care of yourself, you have alot on your plate right now, dust to you and your family...

 

[cookies]

Our body gets weaker as we get older. Feeling cold, not eating much, losing weight, sleeping a lot, losing hearing ability, losing memory, etc, are normal for old people. My grandfather is in his early 90's, and my grandfather in law is in his late 80's. They have had the same problems (cannot think of a better word) as your father for several years. Don't worry, it is just part of the aging process. We will all be like that one day.

 

[TooPatient]

I don't think it necessarily means anything other than he's just getting older and is maybe a bit depressed. There have been great suggestions about having another doctor review his medications to make sure something doesn't need to be changed and even seeing someone who can help with the mental part of life.


BUT...

I believe that sometimes a person just knows when their death is near. I think that sometimes you can even just know when the death of someone you are close to is near.

Enjoy every last minute you have with him. Another 15 minutes or another 15 years -- ENJOY.
Don't get so caught up in finding a doctor to make him better that you miss the little moments that you and your dad could be sharing.
If you have something to say, just SAY IT --- don't wait for tomorrow.

 

[Efe]

I am so sorry that you are dealing with all of this. Having lost my remaining parent within the last year, I understand what you are going through. I would, if possible, take him to another doctor. I would also make a medication list with name of RX, dosage, doctor name and phone number and take it to your local pharmacist for review. Many times, especially with older people who take a lot of different medications, the side effects can contribute to sleeping all day, loss of appetite, etc.

I would also consider a call to your local hospice. They are no longer strictly for end of life care and people can go in and out of hospice care repeatedly. They can send someone out to evaluate him or give you practical advice over the phone.

Hope some of this is helpful. Take care.

 

[JewelFreak]

It's a tough time, Soocool & you are a good daughter. I second, third & fourth the advice to have him see another dr. -- a geriatric specialist is the best idea if there's one near you. It's so common for mixed meds to cause the things you describe in old people. Depression could also be part of that or independent of it.

Old folks frequently feel cold; I don't think that indicates anything special. Circulation isn't as good as it once was & inactivity can contribute too. Elder-care facilities are kept warmer, if you've ever noticed, and some don't have a/c so as not to chill their patients.

Effe's suggestion to call Hospice is good too -- they are so darned wise & helpful, will not give you a bunch of b.s. & can give you pointers on what to look for & what to do.

Hope things look up & that you have much time to enjoy with your dad.

--- Laurie

 

[marymm]

OP - I won't go into all the details and medical histories, but I was with my father when he died in 2000, and was with my father-in-law when he died in 2010. Based on my experience, I think the time can come when a person may not have (or no longer have) diagnosable ailments that are life-threatening by scientific standards yet all the same the person is visibly failing and no longer responsive to medical treatment.

I don't know if it is a matter of the person being unable to muster the mental and/or physical energy to focus on recovery or if the person has given up hope or interest in life... but my husband and I believe that at the time of their deaths, our fathers essentially no longer had the will to live. For both of them, their worlds had become smaller and smaller, and their grasp on reality less and less -- my father only knew me and my mom by name at the end (I have 6 brothers and sisters); my husband's father only knew him by name. Both were sleeping more and more, and getting frailer and weaker and thinner.

It is worth having your dad checked for depression and/or dementia -- loss of appetite and heavy sleep are linked to depression/dementia, and the right medication and treatment could be just what your father needs to begin to thrive again.

I will say that I knew in the last weeks of my father's life that his death was coming "soon" - my husband also knew this about his father - we both still believe we did all we could to help our fathers, from ceaselessly following up on various medical treatments and avenues, personally nursing/caring for them, and spending time with them trying to bring joy and comfort to them. In the end, all I can recommend is that you feel comfortable you have done all you can to get your father the best medical treatment, and that you have spent quality time with him. Both my husband and I are so very glad we were with our fathers when they died - somehow being there, witnessing it, talking to them, holding their hand, made it more bearable for us -- and our family members who weren't there take comfort that our dads were not alone.

Both of us also had siblings that did not believe death was near - the death of a parent is a hard thing and many people have difficulty facing it. And, even thinking it is coming soon does not prepare you for the reality of it when it does happen. My father died 10 years before my husband's father died - my husband said although he had heard me say how losing my dad was the hardest thing I'd ever gone through and how alone I felt, he didn't understand really what I meant until his dad died.

Do the best you can - get your dad the best medical care, and give him as much comfort as you can - bring out his favorite foods, turn on his favorite music or movies, bring out photo albums, or just be there with him quietly so he is not alone.

 

[swingirl]

I think what the doctor is saying is that the signs are there but there is no way to pinpoint how long some one has to live. It's not a fair question to ask because he could be wrong no matter what answer he gives. Cooling temperature and a lack of appetite certainly are signs that organs are slowing down but people can live like that for a while.

Enjoy the time with your dad and be prepared for anything. I am sorry you are going through this.

 

[soocool]

Thank you everyone for all of your wonderful advice. Dad has been seeing a geriatric psychiatrist about a year after mom had passed. Six months after my mom's death he sold the house and moved into an assisted living facility because he could not cope living in the house without my mom. It was in the assisted living facility that he hooked up with the psychiatrist and he has met with us (the kids) a few times. Perhaps I need to call him again to talk one on one about what I have observed.

I just feel like my dad is slipping through my fingers. My daughter just left for college and he just did not show any emotion, which is so unlike him. When two of his three grandsons left for school, he sat and chatted with them, hugged them, but with my daughter, he just withdrew, went to sleep and when he woke up wanted to go back to the assisted living facility and has not asked about DD since. She even called him and all he said was hi, but he is rather tired and could she call back later. He has a great grandaughter now and he gets angry because she gets showered with attention. I saw him yesterday and brought him cookies that he loves and he said that these are not the cookies he likes. Even the people at the facility notice the change in him.

But I do think it is a good idea to review his meds to make sure these are not contributing to what he is feeling and to talk with the psychiatrist again. Hugs to all of you.

 

[dragonfly411]

Thank you everyone for all of your wonderful advice. Dad has been seeing a geriatric psychiatrist about a year after mom had passed. Six months after my mom's death he sold the house and moved into an assisted living facility because he could not cope living in the house without my mom. It was in the assisted living facility that he hooked up with the psychiatrist and he has met with us (the kids) a few times. Perhaps I need to call him again to talk one on one about what I have observed.

I just feel like my dad is slipping through my fingers. My daughter just left for college and he just did not show any emotion, which is so unlike him. When two of his three grandsons left for school, he sat and chatted with them, hugged them, but with my daughter, he just withdrew, went to sleep and when he woke up wanted to go back to the assisted living facility and has not asked about DD since. She even called him and all he said was hi, but he is rather tired and could she call back later. He has a great grandaughter now and he gets angry because she gets showered with attention. I saw him yesterday and brought him cookies that he loves and he said that these are not the cookies he likes. Even the people at the facility notice the change in him.

But I do think it is a good idea to review his meds to make sure these are not contributing to what he is feeling and to talk with the psychiatrist again. Hugs to all of you.

Soocool - It sounds a little like a) he misses his wife b) female companionship is harder for him right now and c) perhaps he feels like the oddball only guy around? Maybe without his wife there to help, he doesn't know how to connect with a younger woman such as your daughter, and with how he's been feeling, he doesn't want to have to deal with it? Just some thoughts. Again, I think everyone is individual. I wouldn't say death is nearing so much as your father is aging since your mother/his wife has been gone.

From personal experience, my grandfather has rapidly aged over the past year and a half. He was diagnosed with diabetes 2.5 years ago, and in the past 1.5 years doesn't seem to want to do much to control it beyond take the medicines they tell him to. He will claim he "can't have white rice" or oranges or pineapple, but will eat cookies and bagels all day long. He's become very obstinate, and would honestly argue that the grass is purple just to argue with you. He stays hot, which means the air stays on 70, which means I live in a sweater (I live with them, help care for the animals and farm and upkeep). He gets extremely mad if he's woken after 8PM but will wake up and slam every door in the house just to wake everyone up. He won't go to any restaurants, but doesn't like much of what there is to cook. He won't eat beef, chicken, or most pasta or salads. His feet have gotten worse, but he won't go to a professional to have them maintained. The list goes on. I don't necessarily think death is near for him, but he is aging quite a bit, and it is very noticeable, especially in his demeanor and attitude. I just try to cater to him.... until he tells me I have a curfew... that's where I draw the line. But in all seriousness, I wouldn't take it as your dad losing his grasp on life, he is just aging. Perhaps try to figure out what his interests have always been and try to spark those interests some more. Go out of your way to do things he likes, or talk about things he likes.

 

[iheartscience]

Thank you everyone for all of your wonderful advice. Dad has been seeing a geriatric psychiatrist about a year after mom had passed. Six months after my mom's death he sold the house and moved into an assisted living facility because he could not cope living in the house without my mom. It was in the assisted living facility that he hooked up with the psychiatrist and he has met with us (the kids) a few times. Perhaps I need to call him again to talk one on one about what I have observed.

I just feel like my dad is slipping through my fingers. My daughter just left for college and he just did not show any emotion, which is so unlike him. When two of his three grandsons left for school, he sat and chatted with them, hugged them, but with my daughter, he just withdrew, went to sleep and when he woke up wanted to go back to the assisted living facility and has not asked about DD since. She even called him and all he said was hi, but he is rather tired and could she call back later. He has a great grandaughter now and he gets angry because she gets showered with attention. I saw him yesterday and brought him cookies that he loves and he said that these are not the cookies he likes. Even the people at the facility notice the change in him.

But I do think it is a good idea to review his meds to make sure these are not contributing to what he is feeling and to talk with the psychiatrist again. Hugs to all of you.

I would definitely take him to the psychiatrist, because it sounds like there have been some serious changes in his personality. My grandparents went into a nursing home (mostly because my grandfather was very ill) and once there, my grandmother was diagnosed with depression. She's now on anti-depressants, and the change in her was remarkable. She probably should have been on anti-depressants for years before she was finally diagnosed. It's very possible that he is just depressed and medication could definitely help that.

 

[chemgirl]

Thank you everyone for all of your wonderful advice. Dad has been seeing a geriatric psychiatrist about a year after mom had passed. Six months after my mom's death he sold the house and moved into an assisted living facility because he could not cope living in the house without my mom. It was in the assisted living facility that he hooked up with the psychiatrist and he has met with us (the kids) a few times. Perhaps I need to call him again to talk one on one about what I have observed.

I just feel like my dad is slipping through my fingers. My daughter just left for college and he just did not show any emotion, which is so unlike him. When two of his three grandsons left for school, he sat and chatted with them, hugged them, but with my daughter, he just withdrew, went to sleep and when he woke up wanted to go back to the assisted living facility and has not asked about DD since. She even called him and all he said was hi, but he is rather tired and could she call back later. He has a great grandaughter now and he gets angry because she gets showered with attention. I saw him yesterday and brought him cookies that he loves and he said that these are not the cookies he likes. Even the people at the facility notice the change in him.

But I do think it is a good idea to review his meds to make sure these are not contributing to what he is feeling and to talk with the psychiatrist again. Hugs to all of you.

I think you should bring this to the attention of the psychiatrist. I don't want to be alarmist, but childish/argumentative behavior is really common in the early stages of dementia. Hopefully that's not the problem, but best to have professionals involved just in case. Hugs! Hope you get good news and your dad feels more like himself soon!

 

[Autumnovember]

nevermind...don't want my post to upset anyone.

Soocool...I am so sorry about your dad, I hope that he is not at the end of his life and that his psychiatrist is able to help him out.

 

[Clairitek]

Thank you everyone for all of your wonderful advice. Dad has been seeing a geriatric psychiatrist about a year after mom had passed. Six months after my mom's death he sold the house and moved into an assisted living facility because he could not cope living in the house without my mom. It was in the assisted living facility that he hooked up with the psychiatrist and he has met with us (the kids) a few times. Perhaps I need to call him again to talk one on one about what I have observed.

I just feel like my dad is slipping through my fingers. My daughter just left for college and he just did not show any emotion, which is so unlike him. When two of his three grandsons left for school, he sat and chatted with them, hugged them, but with my daughter, he just withdrew, went to sleep and when he woke up wanted to go back to the assisted living facility and has not asked about DD since. She even called him and all he said was hi, but he is rather tired and could she call back later. He has a great grandaughter now and he gets angry because she gets showered with attention. I saw him yesterday and brought him cookies that he loves and he said that these are not the cookies he likes. Even the people at the facility notice the change in him.

But I do think it is a good idea to review his meds to make sure these are not contributing to what he is feeling and to talk with the psychiatrist again. Hugs to all of you.

I think you should bring this to the attention of the psychiatrist. I don't want to be alarmist, but childish/argumentative behavior is really common in the early stages of dementia. Hopefully that's not the problem, but best to have professionals involved just in case. Hugs! Hope you get good news and your dad feels more like himself soon!

Chemgirl gave great advice. The childish behavior being a sign of dementia was the same thought I had when I read about his attitude towards his great grandaughter. My grandmother went through a stage like that as well.