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Hi,

My mother has had dementia for the past 9+ years with history of UTI, pneumonia and stroke. She is just back from the hospital. I took her on Friday because she had a temp. of 92 degrees and she was extremely confused and kept saying she was going to die and wanted to see everyone and say goodbye. Though all tests came out negative, at my insistence, Dr. gave her antibiotics and they worked. She was perfectly fine and lucid yesterday. Today she is back with not wanting to eat and has started to say she is going to die so does not want to eat. Is this normal? Does she know something we don't? Her doctor is not very helpful because he did not want to admit her on Friday and wanted to send her back home without any meds - he was reluctant to give her anything.

Help! should I find a different doctor? She has seen him for the past 25 years or so. Do you think this is end stage and she knows?

What should I do?

Thanks in advance

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Thank you ALL very much for your answers... they give me something to think about. I am going to seek out a geriatrician and take her. Her UTI antibiotics are over with. She used to be incontinent but now her pads are rarely wet after a long sleep and this makes me think something is up. Her feet are very swollen too. She did not usually have this in previous years.

She has stopped talking about death but she is still very confused. God bless all the sick and dying and those that care for them :)
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My Mom has been one of those "about to die" people since she had cervical cancer at age 61. She is now 96, and still "about to die" although in good health. With her is for attention I think as she thinks she is the center of the universe.
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" it's sort of amusing to me that suddenly at the age of 80 or 90 something we expect our relatives to behave like cheerful social butterflies or it's considered to be abnormal."

I couldn't agree more, Shakingdustoff. The only thing is, when I feel as though 'people' (meddling family members) are tutting behind my back because my introvert, lifelong depressive mother doesn't want to get out there and make new friends, it wipes the smile right off my face.
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We've had the same experience as Sodonewithsal1 in that posting. My mother has been suffering from mental disorders for several years and for the last year (maybe longer) she has consistently said she was either dying soon (like the same day or week) or that she wanted to die and get it over with. The warnings of an upcoming death are generally related to my sister going out of town or other changes in her routine. The frequency also increases whenever any other elderly relative is getting attention because of health problems. While she has some disabilities and discomfort, and is living in assisted living, she doesn't have any life threatening conditions beyond being 86 years old. Medication for anxiety and depression has helped somewhat, but I don't think she'll ever get any happier than she is now and we've all come to accept this as a permanent condition. At least she does laugh or smile sometimes now so that is something. I suspect your mother's statements are more about her dementia than her pending death. If my mother's pronouncements had been correct, she would have died about 20 times in the last year.
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It is entirely possible your mom DOES know something the rest of you don't. This happened to my mother. I won't go into the details but it shook me to my core. She started to talk about needing "to leave" and that she would "always be with us." The next day she was a bright as a button, then went back to talking about "going somewhere," and in a week she was gone. Be with your mom, talk to her, make her feel safe and loved, and let her say goodbye.
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Oops....this retired RN missed that temp of 92 being stated. If that were a real temp, it WOULD make a person feel pretty darned bad. I once had a bacterial infection that almost had me in a septic condition, and my temps were really high and then would drop really low....I thought I might die! Of course, I understood the disease process too...but PHYSICALLY I felt half out of my head, unable to process and answer doctor's questions and stuff like that. It comes with infections. And as for 'the real end' coming....basically, nothing anyone is trying will help. The person will just sleep more and more, and eat and drink less and less and no meds will stimulate them. Eventually something systemic will take over their body...an infection or such, or they will die in their sleep....so as the person above me said, we can only watch, assess, get them to the doctor and see what improves. It's our job to keep them safe until that last ailment, when it's clear that nothing is going to make a difference. If they 'choose' to quit eating or drinking, we have to try what's available to tune them up, but one day, no tune up will work....
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My husband's grandmother insisted she was about to die for about ten years. Every time someone in the family was planning an extensive trip, she'd say she'd probably die before they got back. If someone was getting married, she'd say she'd probably be dead before the wedding. Holidays? Same thing: she wouldn't live to see Christmas, Easter, and so on. Eventually she did die, at 86. Her prediction came true, as it was sure to, sooner or later.

Your mother's temperature was very low, and that may have been enough to make her feel like she was on the verge of death. Is it always that low?
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So: she was admitted to hospital last Friday, given antibiotics (what to treat, exactly? Do you know?), kept in over the weekend, discharged on Monday feeling fine, and then from Tuesday she's running downhill again, is that right?

If the doctors didn't want to treat her, it's possible they didn't want to order too many tests either. Do you know what they looked for?

There's no harm in seeking a second opinion, and you are perfectly within your rights to do that. If I were you I'd call a reputable geriatrician on Monday morning and take advice; or, if you don't want to do that, you could call your own PCP/GP and seek his/her suggestions.

I'm sure it's true that some people do feel that their systems are beginning to shut down. It doesn't mean they're right; but they're not necessarily wrong either. Certainly I wouldn't be content to end all discussion of diagnosis and treatment just yet - how can it hurt her to keep asking? Meanwhile keep her hydrated and comfortable as well as you can, and don't hesitate to call on medical help if her symptoms worsen. Best of luck, please update x
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I can ans. both as an RN and as the daughter of a Dad with dementia. I think if the person is saying they are going to die AND they have quit eating, have no interest in things around them and have no signs of illness, it could be possible that physically they are 'shutting down'. Depression and withdrawal are bad signs. But physical illnesses, as several have said, can make one feel like they are dying too! I would suggest an MD who is a geriatric specialist, as those docs have decided they ENJOY caring for the elderly and, perhaps, will spend more time talking, supporting, looking and diagnosing. Now, with dementia, and, at least with MY DADDY, I hear all the time that he is probably going to die. However, he IS 92y and has lived longer than any of his relatives, and knows this most of the time. I live out of town, so invariably when I talk to him and tell him I am coming to see him, his response is a variance of: " Well I don't know if I am going to be here or not....I may be 'checking out'....I may be gone..... or 'Don't count on seeing me. I don't know if I'll be here tomorrow'. Sometimes, I ask questions because he is in a facility and at times, he thinks it's a hotel, and he has to check out and travel somewhere else tomorrow... but if he can clarify that he means he's going to be gone 'permanently'.....he really doesn't say the word die to me....then all I do is say something like, well, I hope it works out that you are still around cause I AM coming. I want to give you a big hug....I love you. I am bringing you this that or something else that he might like to focus on. Or...if it's I am coming for an occasion....a holiday or his birthday for example....or if other family members are the ones I am saying are coming....I just focus on 'the occasion' or the people who are coming to see him.....and in general, we can refocus on him looking forward to what is coming. I know he doesn't remember it for long, so I repeat it with different calls and ask my Mom to remind him what is going to happen tomorrow, etc. IF he stays focused on he won't be around, then I just get direct and say, " Well, Dad, I sure know that you are 92, and no one can stay around forever, but you sure sound good and healthy for now, so I am expecting to see you tomorrow!" That usually fixes it, or he says something like: " You mean I am 92??!!" And then he'll say, "Well, no wonder I am tired!" and we'll just go in discussion wherever he wants to go. He is seldom depressed sounding. But a couple years ago, he DID stop eating, lost 20 pounds, was sleeping all the time, no interest in talking, said he wasn't sick, but he just wanted 'all this over with'....so his doctor put him on an anti depressant drug that was supposed to also stimulate appetite and it turned him around within a couple weeks. With your Mom, have you been able to figure out if she's 'just talking' because perhaps she is 'afraid' of the dying part? If she is just physically weaker and more tired, a good doc should ascertain if she's anemic, or has still a chronic UTI...as others have suggested. IF it appears more depression, perhaps to consider one of these anti depression pills that stimulates appetite would be worth checking into. Sometimes, I think the elderly person is trying to let us know that they are just tired of what life has become....and then they just need to know that we will be there to help them and love them all the way to the end. If they have been involved with a religion or church, perhaps ask if they want some time to discuss things with their pastor too?
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How old is your mom?Is she on any anti anxiety meds?
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Accept the process....death is a very small part of life but still a vital part of it all.
There are no random acts of ANYTHING in the Universe....
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Accept the process....death is a very small part of life but still a vital part of it all.
There are no random acts of ANYTHINMG in the Universe....
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i think people can feel their system grinding to a halt . there are probly exceptions where elders are just being negative but my mom asked me only hours before the terminal agitation / morphine / ativan , how she was going to get out of " this one " . i suspect she was being poisoned by failing organs .
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Sometimes 2 rounds of antibiotics are needed. Thyroid problems can
Also create problems for someone with dementia.My mom is the same way daily.Does she live at home? If the doctor is not caring or seems like he doesn't care, yes seek another doctor or have a stern talk.There are MOBILE DOCTORS, that will come to your house.God Bless
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I do think that sometimes people have a premonition that the end is near. I also know of people in terminal states who have lived through memorable occasions, such as their anniversary, birthdays, etc. Our feeling was that they knew their time to pass was close but they wanted to just live through one more memorable event. Somehow they managed to hold onto until that milestone occurred.

So, yes, I do believe that your mother may sense that her life is close to ending. On the other hand, after reading your post a few times it seems as though she was happy one day and sad the next. What changed? What meds is she on?

It's not clear to me whether she's living at home with you, at home alone, or in a facility. That may make a difference. If she's alone, it's understandable that fear may arise when she's alone and not around her daughter.

What do YOU feel about her current doctor? Has he/she been responsive in the past? Do you feel he/she has an adequate knowledge of aging and its related issues?

It wouldn't hurt to get a second opinion, but I would be wary of ANYone who is gung-ho on medicines and would suggest prescribing a cocktail of anti-anxiety, dementia, etc. meds.

The other thing I would ask be done is blood work. If, for example, she's anemic, the weakness may in her mind be a sign of impending death.

And don't forget that UTIs affect older folks in a way different from younger ones. My aunt had repeated bouts with UTIs, had Lowey Body Dementia, and hallucinated vividly with onset of another UTI.

If your mother is still on antibiotics for the UTI and it hasn't yet been cured, that may contribute to her anticipation of impending death. Or it may be that your mother has had chronic UTIs and never really completely gotten over them.

You mention also that she has dementia. That may also be a factor in her perceived closeness to death.

Over the years we've found a number of good, well qualified and very caring and concerned doctors, some who've gone out of their way to help my father.
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