How do you know when it is time? What are the signs?

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I saw some questions like this on here somewhere but can't find them again.

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The cessation of bladder and bowel activity I certainly noticed, and the absence of appetite is common in cancer patients that I've known. I did hear the breathing you've described.
Talking to a person in a coma is difficult for some people to do, but it should always be encouraged. Just talk about anything because the sound of your voice is soothing. Read something aloud if that is a more comfortable way to get used to this. Touch and hold the person. I've lost 2 husbands, and some of what I did may have helped them, but I know it helped me. The first died in 2006 and was in a coma for several weeks. I talked to him about ordinary things. I told him when I had to leave and when I'd return. I let him know I was in the room and reading or sleeping. I held his had and stroked his face. I told him what I knew about his condition and prognosis. I talked about the other people who had visited him, including our daughter. He was awake part of one day, and I asked if he had been able to hear me, and he nodded yes. I had to find a chair and position his bed (a special kind) to do this, but I could lay my head down and put his arm over me. That certainly made me feel better, and perhaps it helped him. I think he was still very scared about what happened to him. His death was very unexpected.

My other husband died in February of liver cancer, so we knew what was coming. Near the end he had periods of "unwakefulness" that did not seem so much like sleep as unconsciousness. I did the same thing really for him as for the first: held his hand, talked to him, kissed his face, swabbed his mouth when it was dry, etc. He was agitated but not conscious during one period of the last week. He had a regular bed, and I was able to lie down beside him (sort of, just so he could feel me) like I did when we slept at home. I told him that I would want him here forever, but that I understood that he couldn't be. I would be there for as long as he wanted to be there, and I would understand when he wanted to go, but when and how he wanted to go was up to him and no one else. He relaxed and seemed to sleep with better BP and heart rate. I moved him to a room where he could see the window and treetops, and he definitely seemed to notice. My stepson (so much like his dad) and I got to know each other much better staying together at the hospital, and I'm grateful that we had that time to love his dad and learn to love each other more.
I still talk to them, and that still helps me, and I hope it is meaningful to them. Yes, I feel that they are around. They are rather alike in many ways, and I know they could have been friends under other circumstances. I suspect that one of them has said to the other "You know, she's still telling us what to do," to which the other just grins.
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Having worked in the medical field, I know this is hard but you have to consider what the person would want and the quality of life ..are they comfortable? Are they in pain? Can they still communicate? Yes talk to them , please, we were always told they patient could still hear..hold their hand talk to them,read to them, talk about current events, past events, the family..even in a medically induced coma, patients can still hear..as medical professionals we were told to tell the patient to go towards the light if they wanted to let go if they wanted, it was their decision..God bless
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good info from eyerish. hopefully hospice is involved. they dont carry comfort meds around but when the patient becomes terminally agitated the meds are just a phone call and a trip to town away. you cant communicate very well in the agitation phase but you can talk to the dying while theyre in a morphine coma. tell them you think they can hear you and you love and appreciate them.
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You'd think I would know how to just pull up articles and discussions for you but I have no clue how to get to them. But they're here. Don't give up. Other folks around here know how to do that stuff. There are also articles on end of life issues that were written by people who run agingcare.com. I wish I could help you get to them!

If your loved one is on hospice they will have tons of materials on the last stage of life and what to look for. Signs.....symptoms.....

Different people experience different things but there is one universal sign and that's Cheyne-Stokes breathing. A deep, raspy breathing that could sound like gurgling deep in the chest all the way up to the throat. Many people become alarmed at this thinking their loved one is laboring to breathe but they're not. It's just another physiological sign that the body is shutting down and there's no need for alarm. It took my dad several days to die and he had Cheyne-Stokes breathing. When I work hospice cases I always see it as well.

Another normal, nearly universal sign is the cessation of bladder and bowel movement. This happens in late stage end of life. If there is a catheter the urine may look red (but not bloody). Extremely concentrated. Eventually there is no output whatsoever.

I've also experienced people (my mom and some of my patients) who become almost damp. It's not perspiration, it's fluids being secreted from the body. There is no odor, no texture, just a very light silky dampness.

There is so much going on in the body at the end of life, these are just a few things I have experienced with my dad and in my career.

Sometimes the fingernails will take on a bluish tint from lack of oxygen to the extremities.

I've also seen people in this state suddenly awaken. They're verbal, maybe a little hungry. This doesn't last and I always tell people to consider it a gift. My dad also did this. He had 2 days where he was in that coma-like state and then one day he kinda awoke. He was confused and scared but very much aware of what was going on around him. I stayed with him like that for a while for my own sake. I comforted him and held him and then agreed when hospice suggested we up his meds a bit to alleviate his anxiety and fear. He died 4 days later without waking up again.

People can last days in a coma-like state especially if they're being medicated for comfort. In my job I experienced a gentleman who was in that state for 2 weeks which was agonizing for the family. It was such a relief when he finally passed away.

I'd do a google search on end of life signs and symptoms. You'll probably be directed to a hospice site and they're experts on this. And please keep looking here for others posts on the subject and their experiences. This site is so huge and I've seen this subject discussed and written about so many times. I could just kick myself for not being able to navigate you in the right direction. But I'm sure someone who can will come along soon.
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