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Does anybody know how we can tell if our loved one is approaching the "home stretch"? My father (in his 90's) has weakened so much, physically and mentally, and yet he still seems to have much spiritual strength. His fingernail beds have taken on a paler, milky bluish color, and he is having more trouble hearing and comprehending me when I speak to him. During these past several caregiving years, I have relied on my intuition to tell me what to do, and I will continue to follow my instincts, based on my love for Dad. The staff hasn't indicated to our family that time is running out, so I am still planning (in my mind) for long-term care. Has anyone else observed the type of fingernail bed color that I am describing?

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Thank you everyone, for your input. A while back when I asked one of the nurses how much time he thought my Dad had, he said that Dad could have "years" and that Dad "has a lot of strength". Then I look at Dad's milky bluish fingernails and poor health and feel confused. It makes it all the harder for family caregivers to cope when we are getting vague "messages" from staff, signals of "denial" and so forth....Not knowing when the end is near or will come is so difficult. I wish staff and the medical pros would be more frank and forthcoming about the realities going on. I know that they don't know when the end will be either....It just feels like they don't want to talk about the D word (death). It makes me feel like I am treading water.... I appreciate all of your input.
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My moms NH is kind of the opposite. It's not that they are all gloom and doom - it's more like each nurses aid is terrified my mom is going to die on their shift. It's a fairly new place and they haven't had a death there yet. Plus the majority of the staff is probably under 35. It's almost like I am comforting and reassuring them instead of the other way around!
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anne123, listening to your instincts is good, but accepting what they tell you is the hard part. When the BP cuff just says ERROR and the fingertip oximeter can't get a reading, the end is very near, within a few hours.
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Midkid58, I ran into the same "upbeat" remarks from the Staff at my Mom's long-term-care.... I had learned enough from this website and from Hospice to know that my Mom [98] wasn't going to rally back to her old self.

I also agree, the truth would have been better, especially for my Dad to hear as he was thinking that Mom was going to come home very soon as she ate a good meal or was trying to get out of bed to walk. The trying to get out of bed was just delirium, Mom being very restless. Thus Dad was surprised when Mom passed. I wasn't.
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My dad, FIL, grandmother all had the cold hands and milky-bluish fingers and toes. It's as if the heart is just keeping the blow flow to the brain. NH's are usually "upbeat" about the patient's condition--they were trying to get Grandma up walking the day before she died, saying she's be home in no time! I "get" the kindness these folks were showing us, but the truth would have been better. In daddy's case, we knew he was leaving us and we were all there with him. It was sweet an beautiful. I wish you peace at this time.
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Thanks, Rainmom....I will look into that google search. My thoughts are with you also as you care for your mother. Love will pull us through and give us strength.
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Anne - last night I googled "hospice signs of death". You might want to look something like that up. I looked because I think my mothers time could be near. I found the information very helpful - it included both physical and behavioral signs. I am sorry to say that yes, it did list a change in nail beds - mainly looking very pale or bluish indicating a lack of blood flow to the fingers and toes i.e. poor circulation and perhaps a weakening of the heart. It also mention to look for the hands and feet to be cold to the touch.
My thoughts are with you.
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