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Just looking for help and thoughts--- she is sleeping a lot - vitals still good-- 87 years old - they started her on Haldal and phenobarbital--is the end near? She didn't want any food yesterday-- anyone experience with those types of drugs?

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My Mom would not get out of her bed. She shut her eyes but seemed to be aware what was going on around her. After a week of this she was having a hard time swallowing so I brought Hospice in. She passed six days later.

My GF was with her Mom when she passed. Her Mom said that her feet were cold and then the cold went in waves up her body before she passed.
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tboudreaux1982 Jun 2021
Ok - we had her home on hospice for few months--- she got admitted inpatient hospice on Sat (6/5)
she started having trouble swallowing about 5 days ago. now only water on sponge
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she is still lingering on, no food since Thursday: today will be 5 days- no water intake (only the sponge) her medicine is now being given by suppository- can no longer swallow. my heart is breaking watching this- no urine output as far as i know- they said a small amount when i asked.
shes on Fentanyl (patch) 25 mg and the other two meds listed above. eyes are no longer focused---how long can this last?
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MountainMoose Jun 2021
I am so sorry for you and your family, tboudreaux. You have the difficult but sacred task to escort your grandmother on her final journey. It's so hard as so many of us on this forum can attest.

As you know, the body's an amazing organism. She could pass at any time or she could last for several days or even weeks more.

Doing something is important for us who are waiting. Talk with her in gentle tones of all the things that she has done with and for you. Tell her it's okay to move on, that you'll miss her, but you'll be all right. Play soft music or make the room as quiet as possible. Place photos of her loved ones around her. Read to her portions of her favorite books.

It's quite fine to leave her alone too. There are so many times the dying will not pass until they're alone, which many believe it's because the dying don't want to pass in front of others.

On a strictly technical side, one action that helped me step away from the emotionalism of Mom's passing, was to slip an oxymeter on her finger. I could see Mom's heart's rhythm, its strength of pumping, and watch her oxygen level, all of which gave me an indication that that was her final night.

Wishing your grandmother, you, and your family peace.
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Purple fingers and toes are a big indication.
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tboudreaux1982 Jun 2021
toes didnt have it but i noticed in fingers.
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Her breathing has probably slowed. She is not able to get enough oxygen to her brain. It does sound as if she is shutting down. Very peaceful. Bless you.
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tboudreaux1982 Jun 2021
THANKS
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Mottling of the skin is a sign that things are shutting down.

I am sorry that you are left to wonder what is going on. I would speak with the hospice nurses and ask them questions about what they see and believe is happening. They can give you the best information.

May your grandma have a peaceful passing and may God grant you and your family grieving mercies and comfort during this difficult time.
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As the body starts to shut down, it no longer has a need for food or drink, so if your grandmother is now not wanting to eat, that could very well be a sign that the end is coming.
My husband was on Haldol, Lorazepam, and extremely high doses of Fentanyl during his dying process. My husband's dying process lasted 6 weeks, with him not eating for 41 days, and not drinking for over 25 days, but he was home under hospice care. Had he been in a hospice home, his death would have been quicker, as they are allowed to use stronger drugs there, that they can't use in the home.
And do remember that hearing is the last sense to go, so make sure you leave nothing left unsaid with your grandmother. Praying for peace and comfort to envelope you during this sad time. God bless you.
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tboudreaux1982 Jun 2021
fingers seems purple yesterday
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The haldol is common in the end of life toolkit alongside narcotics, but the phenobarbital is new to me - the aim is to allow the person to float away free from physical and emotional pain. This does sound as though she is actively dying, I'm sorry.
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tboudreaux1982 Jun 2021
also gave a fentanyl patch
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5 days is typically the time spent in an In Patient Unit at a Hospice facility.
Medicare pays for about 5 days Respite, or for symptom or Pain management in an "IPU". Typically after 5 days a person will be transferred home or to a facility depending on where they were before or if this is from a hospitalization you would discuss where you want your loved one transferred.
there are exceptions. Just as a hospital you can pay for days in a Hospice facility IF they have beds available. OR if pain or symptom management can not be controlled they will keep a patient until they are comfortable.
There are circumstances where insurance may cover a longer stay. You should discuss this with the Social Worker or the Head of the Hospice Unit.

there are indications when death is near or End Of Life.
Skin coloring can change
Breathing changes
there are other indications as well.
Not eating or drinking might indicate EOL but that can go on for days or weeks.
PLEASE discuss all your concerns with the Nurse assigned to your Grandma. They will be more than willing to spend some time with you and explain what is happening and what they are looking for.
But please keep in mind that everyone is different and death may come faster than they expect.
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tboudreaux1982 Jun 2021
they gave her a fentayl patch and her fingers looked purple yesterday
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