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My grandmother has been in the nursing home for almost a year now; she has dementia, and today my mom called to tell me that she is receiving hospice care and that hospice told her that my grandmother is "actively dying." I am away at college but am trying to get home tomorrow to see her. What does actively dying mean? Does she have days left, weeks, hours? Additional information: my grandmother hasn't been eating well for quite a time and has lost a lot of weight over the past few years, but she has lost an alarming amount of weight in the past few months. My mom couldn't really get a straight answer from the nursing home about how much food she's been eating recently, but from what I have ascertained, she has barely eaten the past few days. When she was able to, she signed forms stating she didn't want anything like a feeding tube or being hooked up to a machine. Currently she is receiving morphine and diazepam -- I think they started the morphine today. My mom says that her breathing sounds difficult and is rattling a little, and she's mostly unresponsive; they are wetting her mouth every so often, as she lays in bed with her mouth open. My aunts and uncles that live far away are coming to see her. Although I know it will be extremely hard, I want to be there to comfort her and let her know she is loved. My grandmother is my best friend. She was always there when my mom had to work late, and she basically mothered me, and I love her so much. So I guess my question is: what should I be expecting? Are these her final few days?

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MissionMorgan--
I am so sorry to hear this news, but am glad you will make it to be with grandma as she (hopefully) passes gently into that good night.

Morphine and Valium are often used to control pain and anxiety. Organ shutdown hurts...and the meds keep the patient comfortable. The "rattling breathing" is normal, don't let it scare you. She may have moments of "not breathing", but then takes a deep breath and keeps on. Again, normal and don't be scared.

Talk to her, tell her you love her, let her know you are there, She will feel your presence. She's not eating b/c her stomach can't digest anything. Her urine output will lessen and then cease. Again--normal.

No one knows how long this will last, but certainly not weeks. Probably only a few days. Possibly only hours, no one can predict this with certainty.

She'll likely not respond to you, but hold her hand, tell her you love her. And be grateful for having had a wonderful woman in your life. Keep the room quiet and respect this sacred process of passing from this world to the next.

Bless you with comfort and safe travels.
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I want to start by saying I don't have any first hand experience, but it sounds like hours or days at most. Sorry.
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missionmorgan- when I got the call from hospice that my mother was “transitioning” - they meant she was entering the final phase of “active” dying.

They told me to expect a few days to a week. I went immediately anyhow to see my mother and spent a little time just sitting with her.

I’ll always be glad I did as my mother passed about seventeen hours later.

I’m glad her final stage was quick - although she didn’t seem to be in any pain. In fact, when I went to see her she was dressed and sitting in her recliner, appearing to be asleep. I had seen her like that hundreds of times. The thing that was different was her breathing. It was a bit labored and it would completely stop randomly for 30 seconds or so. The first time it happened I thought she had passed at that moment - as I sat there with her. This type of breathing is common in the end - they have a technical name for it but it escapes me right now.

Personally - I’m not sure why I came to this conclusion- but as I sat with my mother, I didn’t want to intrude on what seemed to me to be a sacred moment in time. I did tell her that I loved her - in a quiet voice - and before I left I kissed her forehead gently. I honestly thought I’d see her later the next morning but it was not to be.

I’m sorry that you’re having to go through this difficult time. You are truly blessed to have had a wonderful, loving grandma for so long. At your age you’ll have many good memories of your grandma for years and years to come.
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well my mom got in kinda that towhen she came back from the nursing home she laid in bed for a week only got up for maybe a hour ..then wwent back to bed i gave her a lot of vitamins to get her out of it ..does she have good memory if not she is where she needs to be to her brain it does not matter to her she is getting close to go ..hate to say it but true well if you want to try the vitiman way then google what vitamins to give her if she will take them if she will take them then give it to her if not ..then it is time to accept that she will be going when it is time to go have to go sorry to say that is life ..my mom keeps staying in bed a lot she has dementia to she is 82 ..but did a lot of smoking & i think that is a bad thing that is not helping her to live ...if your grandma is worth try to keep living give her a lot of vitamins & also what i did for my mom is she needs a lot more salt than a normal person to give her that but she may not need a lot ..what i did was to get cinnamon pills in capsule take the cinnamon out throw that away then get table salt in the middle of your hand pour just a little fold your hand up but enough to pour into the capsule close it up then you got a salt pill or see if you can buy some to if high blood pressure just maybe one a day it causes it ... but my mom was in hospice care &she was home so i got her out of it & try to get her to eat or drink anything & if she can eat i get mine baverian cream puff balls in the section where they sell deserts she eats some of them mine does ..so good luck
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how old is she ??
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So sorry to see this! I went through Actively dying with both of my parents last year 6 months apart from each other. Yes its a difficult time but my goal was to make sure that both of them did not pass alone! We spent 4 days at the nursing home never leaving they both passed with in the 4 days. The last sense to go is touch and hearing so always touch and talk to her let her know its okay for her to pass your family will be okay! She needs to know that and you need to let her know. God bless to you and your family!
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Go now, be safe, and say your good byes. Your grandma will hear you. She is a lucky lady to have you for a granddaughter.
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When my husband was at the end of his life we were told he wouldn't live through the day and the family gathered. However, my oldest daughter lived in New Mexico (we were in Minnesota). We made arrangements but couldn't get her on a plane until the next day. To everyone's surprise, my husband (who appeared to be sleeping and was doing the breathe, stop, breathe again routine) held on until the next day. Our daughter phoned just before she got on the plane. She told me to tell Dad she loved him and I said "tell him yourself" and held the phone to her ear. She did, and within minutes after we hung up he passed. It was almost as if he waited for the sound of her voice. I have heard this from others, that some who are passing need that last voice, that last touch. Don't wait to go see your grandma. Just go and let her know how special she is to you. You won't be sorry, and it will help you later as you walk through the grief. Peace be to you and yours at this ever so hard time of saying goodbye.
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It sounds like she's been actively passing for awhile now. They can last weeks or days or hours. The not eating is a natural part of her actively passing. Dehydration is best when someone is passing. The morphine is for her breathing and comfort and any pain issues she had and is most likely in a small dose. The open mouth breathing is part of the process. She may have a burst of energy hours or days before passing. I once saw a be ridden women get out of bed and run up and down the ward 2 days before passing away. This is a good time; life coming full circle. Don't be shocked when you see her. She may only be 70 or 80 pounds. It sounds like her body has been preparing for some time. Also, it's not necessary to continue to invade the person's space by taking blood pressures and stuff like that. Clothing is optional at his point and many times we cut up clothes to lay over them The only time for activity is to turn them as to avoid bed sores. Foley in to avoid diaper and lay a chuck under her for BM. Alternating pressure overlay or mattress. Oral care with sponges on sticks is important. You can make the sponge moist with mouthwash or toothpaste and gently clean (gel for the lips). The oral care is neglected most often. Sponge baths with heated cloths prn. Make sure all the funeral arrangements are dealt with prior to her passing. See you on the other side...:)
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Yes she is dying, my brother was in hospice a few days ago he died Friday. It is so hard to watch them go, but God will give you strength. They put people in hospice when they are in their last state of death. The medicine is to keep them comfortable. Trying and get to see your love one, she would love that.May God be with you. I am having my brother home going Friday. Also my brother had demitmia.
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Hello, sorry to hear about your Grandma. You should make the trip to see her as soon as you are able.
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THE OP's GRANDMOTHER HAS PASSED AWAY:

www.agingcare.com/questions/i-didnt-get-to-see-her-before-she-passed-on-435936.htm
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How difficult for you. Your grandma needs your presence, so go to her. Hold her close with your touch and your love. Tell her how special she always has been, and is, to you. Talk softly of why. She will know you are there and will pass in comfort and peace. How blessed you are to have her in your life journey.
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When my Husband stopped eating it was about 3 days until he died.
He was comfortable.
He did have Morphine.
He was sleeping most of the time but he had been sleeping most of the time prior to this so it was not unusual.
He did have the build up of mucous that causes the "rattle" sound or what some people call a "death rattle". It is difficult to hear but for the patient it is NOT painful. It is important that you do not try to give fluids or food to eat. First the body can no longer process it. And there is a great risk of choking. And do not try to remove any mucous by sticking a swab in the throat to wipe it out that may cause gagging.
Hospice will keep you informed
There are signs that they look for.
Mottling in the skin. That is discoloration.
If she develops a "Kennedy Ulcer" and that can happen VERY quickly usually the time is very short, within 24 hours.

But like everything in life each person is an individual and "Actively Dying" will happen in its own time.
If she is a private person she may not want anyone with her when she dies so she will wait until someone goes to the bathroom, gets a drink, goes to answer the phone....On the other hand she may wait until she is surrounded by everyone she loves.
Just know she will no longer be in any pain
Give her a kiss, hold her hand..
Give her permission to go
Tell her you will be alright, that her loved ones will be alright. You will miss her, that you love her but you do not want her in pain any longer.
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Yes these are your grandmother's final days or hours. It is wonderful for the family to have hospice services at this time. I hope you arrive at grandmother's bedside to thank her for all she has done for you. If not, rest assured that she knew you appreciate her.
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I am so sorry to hear about your Grandmother. Go see her now and hold her hand.
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PEOPLE!!!!

PLEASE STOP POSTING, missionmorgan's GRANDMOTHER HAS PASSED AWAY.

www.agingcare.com/questions/i-didnt-get-to-see-her-before-she-passed-on-435936.htm
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There are a few on hospice at my moms facility one passed last weekend, they are not put on morphine till the end the death rattle breathing not eating are major signs. Death is part of the life cycle hospice nurses and pastors ease the passing for patient and family.
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I experienced this...it's when she will no longer eat and very limited with drinking fluids. This was when Hospice came in for my mom. Just to let you know what happened with me, my mom sort of went to sleep for a couple of days, but had one more day where she woke up and we were able to talk to her and have a nice visit but was our last. After this, she was pretty much comatose and lived for 4 more days
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It is hard to let a loved one go, but in most cases it is more difficult to let them live when they have no hope of recovery. I am glad that my daughter and I were there when my mother and my husband passed on, but I was also relieved that it was finally over for them.
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I just want to say I'm very sorry for the pain you and your family are going through. Grandmas are so very special. I lost mine at 8 yrs. old, and still miss & think of her often. I am also in college, so I know the stress of school topped with family sickness. Its not easy at all. I think its wonderful to go be with her now. No matter what, she will know your there. Keeping you and family in my prayers at this difficult time. Stay strong, and keep us updated. love and hugs, kelly
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Love1946--It is true that people are put in hospice when they are about to die (assuming they are not already there), but hospice is also designed to provide comfort to anyone who has a terminal condition whose life expectancy doesn't exceed 6 months; that is, one doesn't have to be "actively dying" to be eligible for hospice. Some people may end up staying in hospice considerably longer than 6 months, and some may even recover enough to leave it altogether.
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Actively Dying means the person doesn't want to be rushed to the ER - they wish to allow their body to expire naturally.

This doesn't mean tomorrow - it can be days, weeks, months, years - - - my SIL was on Hospice, actively dying, for about 5 years.

It means not forcing them to eat and generally means no resuscitation.

It is not a time to start neglecting though. If the person is hungry, you are supposed to feed him/her. They are still supposed to be cleaned. Medicines can be optional.
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RayLinStephens answer makes sense.

If grandma has any unfulfilled wishes, then do your best to get them done, so she doesn’t linger on.
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I would be there NOW. When you hear rattle sound it's at end. My dad was sane situation we wet his lips etc. I had to give him morphine to help him relax and go. After a full day of it he passed next morning.
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Hello, Our 85 year old Mother was in a NH receiving hospice care and it took 3 weeks for her to transition. Everyone is different her Dr. told us 1 week or sooner clearly that was incorrect. Her Mother transitioned the same exact way which did take 1 week and she was 94.
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Hola, I am so happy you're able to go be with her at her last final moments, as i was able to see mi very active/beautiful/wonderful NANA, just 1 to 2 weeks prior,and she had transitioned to the other side,rip in heaven suddenly but a full long healthy happy life 2 yrs., only short of 90. I am glad you're able to go and safe traveling to your loving GM." God bless us all.
hugs n blessings. adios.
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Actively dying does NOT mean months and years, it means exactly what it sounds like, the body is beginning to show symptoms of shutting down. This is NOT the same as qualifying for hospice.

BTW, the OP unfortunately did not make it home in time to be with her grandmother. I've already mentioned this twice today but obviously nobody reads previous posts.
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Please go to your grandmother, if you want to see her and say goodbye, she may be waiting for you.....but yes, she is dying, and dying very very soon.
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Active Dying is the final phase of life, which is usually measured in months, weeks, days or hours. Once a person has entered the actively dying phase, the focus of their care shifts from aggressively treating medical problems to providing comfort or palliative care.
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