Is he transitioning to the end of life stage?

About nine years ago, this happened to my mother; all she wanted to do was lie in bed all day long, wouldn't eat, and at times didn't make it to the bathroom in time. I was told this was EOL as her body was starting to shut down. My mother went about three weeks later, very quickly and very peacefully.

When my husband was in hospice, the nurse said that EOL was almost always preceded 2-3 days earlier by a mottled appearance of the hands and feet. When I observed that, I stayed with him night and day, and he did die 2 days later.

My mother-in-law is 93, with Parkinson's, and she has gone through two bouts of this but pulled through both times. The descent into what appears exactly as you describe was usually marked by a fall or a flu or a cold. Family come to visit and she rallies... it's hard to explain. Somewhere in her she rediscovers the will to live and finds new strength. It may be EOL but it may not be.

The Washington post had an article by a doctor whose father had end stage kidney disease but never started dialysis. The doctor was a bit surprised to learn that his father's death wasn't peaceful.

A quote from the article:
"To Dad, hemodialysis represented an existential threat to his dignity, independence and quality of life as he defined it. In this context, his decision against dialysis was understandable. But because of a system-wide lack of information, the last leg of his life’s journey was unexpectedly turbulent and stressful for him and his family."

https://www.washingtonpost.com/national/health-science/a-doctor-is-shocked-by-his-fathers-struggle-with-end-stage-kidney-disease/2015/09/21/d7e80382-4ad3-11e5-846d-02792f854297_story.html?utm_term=.7ff183b399a1

I am not a health care professional, but from personal experience, when a patient no longer eats or drinks, it sounds like end of life. Body is shutting down, doing what it's supposed to be doing to prepare for death.

I have read that end stage kidney disease does not cause pain or discomfort. I hope this will be true for the man you mention. And yes, do call hospice as several here have suggested.

Probably yes. Since you say he prays a lot, he might benefit from talking to someone from his faith or a chaplain. Aside from physical issues there may be unfinished business or things to acknowledge or be freed of on the part of his loved ones (and sometimes caregiver). Hopefully there are supportive family members or others who can help recognize what would help him. I was helped by books and information easily available about what people sometimes talk about or sometimes need reassurance about as they get closer to the end. Not sure if you're family member or not but hopefully they're a positive part of this process for him and that there isn't baggage that could make this stage harder.

Yes, he probably is.

Already answered this post--but I do want to agree that only you or a family member (someone who has "authority") can administer the Hospice meds. Daddy asked for morphine round the clock and we gave him as much as he wanted. Also a ointment form of Valium. You rub it on the think skin of the forearm-in daddy's case. It helped with the anxiety he had. Also, since I didn't think to go wash it off MY hands after applying it, we BOTH had a lovely peaceful afternoon. :) Dad enjoyed a popsicle, occasionally, but other than that, he'd choke on anything. For a man of great dignity, this was beyond humiliating. He'd actually SHOVE a "sippy cup" away--so be gentle with your patient and let HIS behavior guide YOU.

I would bring in Hospice for an evaluation. They will assess him and even bring in a Dr if necessary. They can tell you if he's in the EOL process but can't give you a timeline until the last few days when they're actively dying.

I called hospice in for my grandmother when she was just done. She didn't want to go to the Dr anymore, didn't want to take her medicine, etc. They came in, did an assessment and the next day equipment was delivered and services were started. She has an aide that comes in to bathe her 3x a week, a nurse once a week (it was they're but I saw no reason for the 2nd visit), a chaplain that visits with her and a social worker that gives support to the caregiver and family.

They will be able to guide you and help you. My gram is now bed ridden and can no longer do for herself. She eats when she's hungry and drinks when she's thirsty. Their body knows what it wants and needs.

As for this "cocktail" that was mentioned, if they don't need ativan or morphine you didn't give it to them. Common sense right? My grandmother took her daily medication up until about 3 months ago and has been in Hospice for over a year. Hospice is there to help with whatever his AND your needs are. Make a list of questions and make an appt. There is no need to go through this alone!

EOL is not a diagnosis that is easy to make but what you describe may well be the case. I would just say be thankful for his and your sake that he is calm and sleeping a great deal. He is ready to go which will help him in his journey and ease the job of caregiving. Not passing urine is a critical condition so it would be good idea to have his Dr order some blood tests to see if his kidneys are actually damaged or he has some obstruction such as an enlarged prostate. Your visiting nurse should be able to put a hand on his belly to see if the bladder is distended. Also if the Dr agrees the nurse should be able to draw blood. If he has an obstruction then a catheter can be placed to drain the urine. Hospice is also a good idea at least to have an evaluation. As long as he is pain free and not anxious there is no need to start what many believe is the deadly cocktail of morphine and ativan. Based on the advice you receive continue to offer small amounts of food that you know he likes but don't bother about it being healthy just moist and easy to swallow. Likewise give him liquids that he prefers. Just offer a very small cup or glass that he can easily manage or even a straw or sippy cup. it is very difficult to get a glass to drink when your hands are shaking badly. A couple of swallows at a time is enough but it has to be frequent as long as he can swallow

Starrysky88, my 86 year old husband with Lewy Body Dementia (same pathology as Parkinson's) went through most of those signs as he transitioned to EOL. We called in Hospice. He lived 5 weeks after that. It was a peaceful transition. Hospice was surprised when I reported his death -- they thought he may have months left.

My 94 year old mother was hospitalized with a bad hip break. The hospital did not expect her to live a week. Hospice came in (to her NH) and she improved. Three months later she was discharged from Hospice -- she was no longer judged to be at EOL. She lived a fairly comfortable two more years.

I'm guess I'm just echoing what the others are saying. Nobody can accurately predict EOL. But it is very comforting to have the input of people who have been through this many times. Hospice is a great help for the patient and for the family and caregivers.

Could be, maybe not. Those UTI's do a number on the elderly. I have only had one in my whole life and I was crazy with it--mother has them so often I never know if she's being "her" or has another UTI. (Honestly? She probably always has some level of one, and that is not uncommon.)
Don't force food or liquids. Have Hospice in to evaluate. Keep him comfortable and don't be afraid. Often the EOL is the best, calmest part. When daddy finally did move into EOL care, we were so grateful and felt so relieved. The suffering of Parkinson's can be terrible to watch and I'm sure just beyond horrible to have. It was such a relief to see daddy calm, out of pain (finally) and at rest. And yes, he talked to people we couldn't see.
Good luck to you. Does this gentleman have family? Or are you family? Sounds like you care for him a lot. I am sorry for your having to go through this, but Hospice can make it so much easier and you will feel that you have done your best by your patient. (I LOVE nurses, but nobody really KNOWS when EOL is going to occur. My FIL rallied back from 5-6 deathbeds, so I learned to take all comments from nurses and aides with a huge grain of salt and a smile on my face.)

Starrysky88, it might be time to call in Hospice Care.... this is free to elder through Medicare.   They are like an extra set of eyes and ears for the patient, and they make sure the patient is free of pain.   The Hospice Care doctor can do an assessment and let you know what might be the time frame.   It's worth looking into.

Since the gentleman had a UTI, those antibiotics can do a mean tap dance on one's stomach.   If he is eating very little and not drinking there won't be much of an output.

There will come a time when he will totally refused food and water because it is too painful on his stomach, which will be shutting down.

Well he could be, but dehydration combined with recovering from a UTI could also be the cause. I would be very concerned that he is not producing urine, it could mean his kidney are failing.