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My mom has been in a nursing home for 13 years. She is paralyzed on one side and barely functioning on the other. She no longer speaks.


About 8 months ago, she started a slow decline and was put on palliative care. Then she started eating again and even seemed more upbeat. She is now on hospice care, as she began to be less and less responsive and not eating or drinking much. I've noticed periods of what looks like trying to catch her breath. She's always looking at the ceiling and pointing or reaching.


Her vitals are normal, but her behavior and agitation makes me wonder. Yesterday she had a sudden change in appetite and ate all her food. This has been such an emotional rollercoaster. One minute she looks completely out of it and the next she seems to be managing.

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Melly1324: Prayers forthcoming.
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It is very important to know that it is end of life signs vs. a fixable medical condition like others have mentioned. It does not sound like she has good quality of life, but only you can know if her quality was ok, during her upbeat times and eating better times.

Some people have terrible quality of life, but are kept going just for the money they receive at the facility, and other people are easily given up on, when they still want to live. Because, someone has decided they are not worth the trouble or money.
Elderly care is very complicated. Every case and person is a different situation.
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So many possibilities that it's hard to say from this. Fecal impaction and electrolytes being off can cause symptoms that are same as the ones people write off as just a person dying like it's no big deal.
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Looking toward the ceiling and pointing and reaching is clearly a sign that mom is seeing her deceased family members now! Watch some Hospice Nurse Julie videos on FB which are beautiful and discuss this very thing she's witnessed hundreds of times. It's very common toward the end of life to see loved ones from behind the veil.

Best of luck to you.
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Melly1324 Jul 10, 2025
Thank you! I will definitely take a look at her videos.
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First I would say talk to the Hospice nurse and ask them this question.
There have been many videos I have seen where a person, nearing end of life does point and reach for something or perhaps someone that only they see. I would not call this "agitation". If the person does not seem to be upset by these movements or "visions?" It is not something to medicate for.
The breathing may be "normal" for the stage she is in. Search Cheyne-Stokes breating and or Angonal breathing.
You can also check YouTube for Hospice Nurse Julie and watch some of her videos on these topics.
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Melly1324 Jul 10, 2025
Thank you and I will check out the videos.
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Thank you so much for your response. I really appreciate your input and thoughts on this.
It's good to share with people who have witnessed or gone or going through this. It is a lonely road being a caregiver.
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If she is having trouble breathing, morphine may help. Anxiety, there are meds for that. Talk to the Hospice Nurse to make sure that these meds are being given to her "when needed". That the NH nurses are giving these meds. Hospice is comfort care.

Mom eating could be her rallying. This happens in the final stage. A Hospice nurse should be able to tell you when her body starts to shut down. She will not be able to swallow. No more food or water will be given once that happens. Giving food is more harmful than good.
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Melly1324 Jul 10, 2025
She seems to be breathing ok except for those moments that happens maybe about 40 mins apart sometimes less. It's more like gasping. The hospice care nurse suggested oxy for the increased pain.
We have been telling everyone do not force the food or drinks. She eats but very little and slowly. Sometimes I'm afraid the staff at the NH forces her to drink the shakes even though they were told not to.
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Yes, in general she is moving toward the end. But that movement is never straight down. Like the "Simon-Says" games of old, it is one step toward, and two steps back, three steps toward and one step back, and etc.

You are absolutely correct that for family standing witness and waiting for the peace of a final ending, this is an emotional roller coaster. I, as an old retired RN, have seen many through to the end, and I consider it in my own mind the trip of a lifetime. The looking toward the ceiling staring you see may be hallucinations. There is an old saying "He turned his face to the wall". Eventually, if we live long enough, we separate even from those we love, and are on another journey all our own, one that people don't come back from with long stories and pictures, one that we find only at our own last days.
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