On Death and Dying - Three Signs That Your Loved One is Approaching the Final Months of Life

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When we have a very ill loved one, it occupies our thoughts constantly. Our mind has a way of sifting straight through the data that we hear from their medical providers, rejecting the negative and keeping tight to the positive. Even when confronted with the data that our loved one's situation is dire, we may continue to refuse to see death as a possibility.

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There are many reasons that we do this. First, most of us have never watched someone die, so we don't undoubtedly know what that may look like. Second, we are unable to interpret the physical changes that we are seeing in our loved one. Third, when we allow ourselves to consider that they may die, it can feel like a betrayal, which makes us feel worse.

Our denial is an foremost mechanism that we use to protect ourselves from feeling overwhelmed by our emotions. For a time, it can help us to get straight through the demands of the day. If used for too long a time,however,it can rob us of living what time remains with our loved one. We may miss the chance to make plans that assure their comfort. Even worse than that, it can result in the loss of many foremost shared moments that may reserve us long after they are gone.

So how do we know when their loved one is approaching their final months of life? For many patients, it is simpler than you think. Only ten percent of Americans will die suddenly. The remaining ninety percent will have a slow decline. So what are the signs? First, most patients caress weight loss. In elderly patients 10% loss of weight is important and may be an indicator that they are on a downhill trajectory. That is why weight loss is one of the criteria for patients to enter hospice care. This weight loss will not be reversed with supplements or medications. Weight loss occurs for a whole of reasons. They may not feel hungry or may have issue swallowing. Sometimes eating makes them feel ill and food tastes are altered by the medications that they are taking. Regardless of the reason, if they are in their final months of life, feeding them more or distinct foods will not make them live longer and may instead, them more uncomfortable. Most patients in their final months are also weaker. Frailness may begin with having difficulty arising from the chair as their thigh muscle is often the first to grow weak. This Frailness progresses from their needing aid with walking to being chair bound and then to being bed bound. Often families will insist that they be seen by a physical therapist to "get them walking again." If they are truly in their final months, this will not work.

Another sign that they are in the final months of life is that they originate infections. Elderly patients tend to get infections in the bladder and lung. As swallowing becomes difficult, they may cough and inhale liquids into their lungs causing bronchitis or pneumonia. This is called aspiration and is often seen in patients in the final months of life. Antibiotics will work initially but will have less power with repeated infections. Aspiration, once started, often reoccurs. Rescue depends on the power of their cough but because their lungs are weakened, their cough is ineffective. For this reason, pneumonia is the whole one cause of hospitalization and death in patients who are in nursing homes.

Losing someone is painful. We never feel ready for the loss. But study shows that those of us who do confront the reality of a loved one's impending death will emotionally do great after they are gone. We will have the chance to share in their journey and assure that they are comfortable. In our care giving, we will have the chance to thank them for the gifts that they have given us in this life. Finally, we will have time to say goodbye and to let them go with love.

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