While everyone is different, the majority of hospice patient cases often follow a typical progression. The specifics of this progression are usually unknown to the patients’ friends and family members, however, and that’s why the hospice nurses at Suncrest Home Health and Hospice of Chicago take the time to work with families so they know what to expect from the hospice experience.
What Hospice Is Like
To enter hospice, you must have a terminal illness and a life expectancy of less than six months. While this sounds grim, the truth is that many hospice patients enjoy at least part of their time in hospice visiting with relatives, reading, watching movies and participating in activities. Not everyone arrives at hospice unable to move or speak.
A basic tenet of hospice is that the patient has decided to give up lifesaving measures such as pharmaceuticals and treatments like chemotherapy (although drugs to relieve pain are always allowed). This decision often makes patients feel better for a while, due to the absence of side effects from treatments and the stage of acceptance they have entered.
Signs of Impending Death in Hospice
However, ending lifesaving measures allows the disease to progress unchecked, and swift decline is not uncommon.
When this happens, relatives and friends may fear leaving the patient’s bedside, in case the patient dies while the visitor is away. Our hospice nurses work with patients’ loved ones to help them recognize the signs of impending death. These include:
- Loss of appetite/refusal of food and water
- Loss of control over bladder and bowels
- Falling body temperature
- More time spent sleeping
- Change in breathing patterns
- Onset of or worsening mental confusion
Loss of Appetite/Refusal of Food and Water
Cancer patients who stop chemotherapy to enter hospice see their appetite rebound. Chemotherapy can make patients nauseous and stopping allows them to eat again.
However, as disease progresses, one of the first signs of nearing death is a patient’s refusal to eat. Their refusal may be overt — saying no, raising a hand, turning their face away from the food — or they may simply not be alert enough to chew and swallow the food.
Patients can go much longer without food than they can without water, so while refusal to eat is definitely a sign of decline, the patient can still live for weeks or even months if they are accepting liquids.
Although we always say it is difficult to narrow down a window of time in which to expect death, once a patient begins refusing water, it is usually a matter of days. This is a choice that patients make, and along with pain-relieving drugs, provides for a peaceful and swift end to their lives.
It is always difficult for loved ones to witness, but our team reminds them that death is part of life, and a death with dignity, surrounded by loved ones, is truly a gift.
If you would like more information about hospice care in the Chicago, Illinois, area, contact Suncrest Home Health and Hospice. We’re here to help.
