Mom has good days and bad...

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Has anyone experienced their loved one being real full of energy one day and then the next just sleeps all day? Mom is 96 and dying of cancer we do not know what kind but it may be in her stomach. She had an Ultra Sound that showed spots on her liver that metastasize from another organ. She did not want further tests done and no treatment. She has been on Hospice for about 21 days now. I am blown away when she still eats a little but she always ends up throwing most of it up. She says it feels like the food is stuck in her upper tummy. She never remembers me, her daughter and then when she does she says oh you are my daughter. I know the Hospice nurse can't say if she is in the preactive stage of dying but has anyone seen this before. She sleeps at least 18 hours a day.

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When my daughter, who had stage 3 ovarian cancer, she also quit eating and drinking and had no urine output. She also would sleep all day long. Dr. said it would do more harm to her and create more pain if we tried to feed her, he said her organs will start shutting down and then pass on. So, we withheld any artificial feeding. A few hours before her passing,her breathing changed to a raspy sound, which I later learned it is called "the death rattle". It not easy watching a loved one go thru this, because we are helpless to do anything. They just need to hear and feel your touch so they know you are with them on this journey. My heart goes out to you. May God give you strength and comfort.
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Yes, absolutely. It is normal for two reasons-she is 96 years of age and she is dying of cancer.
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Talk with her doctor. He or she can and should provide you with the signs as best he or she can so you're able to recognize them.

When my Mother-in-law was dying from liver cancer, the nurse kept coming in the room to swab the inside of Mom's mouth so it wasn't dried out and put chapstick on her lips.

NO ONE, including my husband, asked if they could help the nurse by having her give instructions for one of us to do this job; the nurse could be helping someone who needed her more.

I ASKED. I was raised Pentecostal as we always helped take care of those dying to help the family. Jewish faith basically does not allow for this.

The nurse also explained to me how they time the breathing so I could tell if Mom's time was coming closer.

I talked to Mom like she was alert, the hearing is the last sense to go. My in-laws thought I was crazy. If it were not for this nurse instructing me, the family would not have known that it was time to say their goodbyes, especially my husband, sister and brother.

She passed away with my husband holding her hand and talking with her.
I called my Mom who came to the hospital to sit with me and our daughter sat with her grandmother holding her hand.
My step-sister-in-law was AGHAST!! Our daughter told her that she was not going to let go of grandma's hand until the funeral home came for grandma.

There should be a hospice counselor to help you know the signs too.
If she starts talking to family who you know are deceased....the time is near.
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Full of energy today can lead directly to sleeping all day tomorrow. Sometimes people will stay in an alternating pattern like that for weeks, though usually you can see a pattern of fewer and fewer hours of energy and more and more days of sleeping. If she's already sleeping 18+ hours a day that's probably a good thing.

If she's throwing up every time after eating, maybe she genuinely can't digest food anymore. So here's a hard, direct question: why is she eating nowadays? Sometimes people eat because they feel hungry and other times because they remember liking the taste of a particular food or the feel of it in their mouth. Both of those would be good reasons to offer her a VERY small portion -- just a bite or two. It can be helpful to use a small plate so the small portion doesn't look so forlorn in an empty plate.

Other times people eat because it's mealtime with the family and they imagine they would be rude if they didn't. Or because someone offers and they don't like to refuse.

I haven't met her, so take this advice with a large grain of salt please. But here's how I'm adding it up. She's 96, she has cancer in at least 2 places and one of them is the liver, she doesn't want further treatment, she's on Hospice. I would probably not offer food unless she asks for it, and then only very small portions. I would continue to offer water as long as she doesn't throw that back up, too. If meals have been a social occasion, it would be good to spend the same amount of time socializing with her as before -- just not with eating.

Recognizing you sometimes and not other times is, unfortunately, quite common in this situation. Lots of factors, even if there hasn't been dementia.

For one thing, her waking consciousness may not be all it used to be. She may wake more slowly. If she's dreaming a lot, the dreams may remain present longer into her waking process and she may not recognize you at all or may imagine you to be someone else.

For another thing, she may think of you a lot of the time, but be remembering you in a previous decade -- sometimes one a long way off. If you resemble anyone in a previous generation, she may misidentify you as that person, calling a daughter by a sister's name or an aunt's name. Because she thinks of 'my daughter' as being 10 years old, or 30, not the age you are now.

Liver metastases inevitably interfere with liver function, which can cause some disturbance of consciousness as the blood chemistry becomes more abnormal from the liver not doing its job properly.

Nobody can predict how long someone will live, even on hospice. No one can say when she will enter the active dying phase. But you might ask the nurse whether this looks like 'weeks to months' or whether it looks like 'days to weeks'. From what you've written, it sounds like longer than 'hours to days' but definitely not 'months to years.'
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Yes. My DH would have a wonderful day at PT - but sleep the next day.
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When my husband was dying of cancer Hospice gave me a little book to read that went through the different stages of dying. It was pretty spot on too! Maybe you can ask for the book. Sounds like she's in her last stages to me however. It's hard to watch and I didn't want to believe it myself when it happened to my loved one.
Just take the good days that you can get with her.
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I have been through this with my father and it sounds much like the end of his life. He was 10 years younger than your mom. In the las month he slept most of the time and ate very little. He had esophageal cancer and also said food didn’t go down well. He never made it to Hospice. In the last few weeks of palliative care he had morphine continuously and fluid. At that pint he became very talkative. Once fluid was removed he was gone within 24 hours.
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I know this experience very well and I would venture out to say that it is normal to see this kind of action. Despite my mother having mobility issues, she'll be full of energy and perhaps make plans to go out to places for 3 days in a row at a minimum without properly paceing herself while possibly juggling her p.t. and nursing time which could take place every other day and sometimes both of those events can take place in one day. Eventually she'll crash despite having her hydrocodone she could blow anywhere up to half the day to even the whole day. Sometimes however this could be a sign that she's sick as well.
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