Changes in skin color and temp

Question

The elderly retired Colonel for whom I am primary caregiver is, I believe, showing signs that life is ending soon.

His hands, feet, nose, and ears feel cold, even in a very warm room (they keep two fireplaces and radient heat going all the time). His hands look strange - with light yellow fingers, and somewhat mottled palms. His feet are similar, but the toe area isn't as yellowish, just lighter than the rest of his feet. He's cold, and night before last I wrapped him in a flannel sheet I had tossed in the dryer for about 5 minutes, then topped that with a blanket. He was so weak, he only very softly said "I'm cold" when asked if he was okay (that's why I did the blanket thing). I have zero previous experience with this level of decline. I'm just wondering what to expect next. I'm spending this evening and all night with them, then Monday night, and 24 hours Thursday. They are supposed to be flying to their primary residence in California on the 8th. I find that to be very strange, and ill-advised, as both of their children live here. The two children have airline tickets and will be accompanying them on the flight. I, along with another caregiver, will be preparing them and their luggage for the trip.
Hmm. Guess I wonder if anyone else has seen the end of life come preceded by this sort of change in appearance and temperature. It's unsettling. But if any of the caregivers were to actually be there for his journey across The Great Divide, I hope it's me, just because I've earned the title "favorite", and he seems to rest better with my presence. I'm loud, laugh a lot, and make sure we have fun every day. Seems like an odd mix, but it works for them. How do I prepare for what I may have to witness? How do I know the time is getting close?

Ruth1957 · Accepted Answer

It IS hard for Mrs. Colonel. She's a gracious Southern Belle who keeps her Brave Face at her side at all times. We mostly cry in the bathroom. She will be okay, eventually. She's got a great support system. I love her so much. At night, when I tuck her in, if she's sad I take her hands and pray over her. I always kiss her forehead and wish her a restful night. It is my honor to be at her side. Thank you for your thoughtful comments.

vstefans · Answer

God bless you and the family, especially the wife!  Somehow I think it will be hardest for her. But still, it was such a good thing you were there for him, and something you can always hold in your heart. I guess it is a small bonus that someone in the fmaily appreciated you, finally...and we appreciate you for having shared this story..I hope that helps a little.

allshesgot · Answer

Ruth,im sorry to hear but know his suffering is over. you are a wonderful person and the colonel was blessed to have gotten to know you.

Ruth1957 · Answer

On Saturday night the 19th I might have gotten an hour of sleep - maybe two. His breathing was so bad, gurgling, almost the sound of a cry on exhale sometimes. I've never been through this. Amazingly his wife stayed asleep in the next bed as I tended to him in the night. At 5:15am I finally got him into a comfortable position, and gave him a very small morphine dose under his tongue that settled him down. He was non-responsive, but at least the crying out stopped. The next night I came on duty at 9pm and he left this earth just after 10pm. I got to help his son dress him for the daughter to come and say her goodbyes. Surreal. I'm still a bit in shock, but I know he is gone... life is very strange without the Colonel. I'm thankful he simply stopped breathing, and quietly slipped away.

I'm a caregiver. Not family. I think the family sometimes doesn't know what to do with the relationship the Colonel and his Mrs. have with me. But the early morning after his death, his daughter found me and gave me a hug and asked how I was doing. That was a first, and I told her I appreciated it. It was all a blur until the service on Tuesday. When the bugle started playing Taps it felt so final. Now we move on.

The funny stories are coming out on a daily basis. We laugh, and we cry. It's good.

shellybelly · Answer

Somtimes they get a little restless. You can take a warm wet washcloth and pat his head and face.  Some terminally ill get scared at the end.Talk to him and tell him you will be with him and he isn't alone. I am just like you about the part of joked stories and just having fun. I have found out , and many will disagree that there are 5 stages of leaving life. His breathing will slow for sure, and i have noticed on some there legs are locked up. Hard and wont budge at all. I f the body isn't getting enough oxygen you will see blue sometimes red spots all over his body. I always reassure them when the time is very close that i will see them again and they were a friend of mine. It's hard to explain the very end but, I just seem to know. My father's choice was to be drugged heavily and thats what the doctor ordered for him. He said his goodbyes 2 days before he left us. At the end he looked at mom put his hand out and she held his hand and said i love you and, that was it. But, so peaceful. My neighbor wanted to be awake. No drugs unless he asked. I was the only one he trusted to administer them. 3 hours before his time he got scared and restless. I calmed him down with that washcloth and softly but close spoke to him. He squeezed my hand about 1 hour before he passed. That was  a signal to me ''moraphine'' His smart brain was working until the end its just that his body would not. You will know but, I really don't think the trip is a good suggestion. Good luck and God speed for your friend

Ruth1957 · Answer

We do this because we love and care for people. It is richly rewarding. And deeply painful. Thanks to all for comments and support. I made my Colonel cry today, although he could not speak. I thanked him for making me a better person.

headbanger · Answer

Ruth, you are a dear, dear soul. My thoughts and prayers are with you and the Colonel.

linda09 · Answer

ruth ure a wonderful person . my daughter is a cna , goes to elders home to give em baths and a coompany for an hr to 2 hrs .  they all love her , one time one called her and told her that lady has passed away , oh my daughter flung on to me and bawled onmy shoulder , says that woman is so sweet 1 her kids dont come around mom !! she was so torn up , i tol dher she s much happier up where the lord and all her love ones up there , its better for her , she calmed down some , whew ,  we need more people like u and my daughter ,  my hugs to u ruth !! xoxo

vstefans · Answer

God bless you both!

Ruth1957 · Answer

I posted an update in the "surly bonds" post. The Colonel has, amazingly, still clung to life. He rallied for a short time, and now is very close to death.

allshesgot · Answer

Ahh, im glad his son did the right thing. Its so sad that he can't go to ca one last time, a hard decision im sure. My grandmother was supposed to go home with hospice from the hospital one morning and when my mother went to get her they said she wouldn't make the trip, she passed away a few days later,and my mother in law was fortunate enough that when we told the dr. We would take her home one morning they had her there at home at 11 o'clock that night,many loving people worked so hard to get her home so that she could pass away there. She made it for a week. He will likely fall into a type of coma,sometime in the next few days. I have seen people hold on for two weeks or better, usually within a few days after they start moldeling heavy,then I have gone into rooms of people that seemed fairly ok and noticed modeling and they would be gone in a few hrs. I took over on days for the night shift one morning and as I started dressing a resident, bragging what a good girl she was being for not kicking and fighting me, the pieces slowly started coming tohether and I realized she had passed. They said due to her temp she was probably passing or had just passed as I came in to take care of her, I absolutly lost it. I don't know why,I had taken care of so many that were passing but something about it reaaly upset me. He is so lucky to have you,it sounds like you probably enriched his final chapter.

Ruth1957 · Answer

Thank you, allshesgot.
As of yesterday, he is totally in the wheelchair with just a little bit of standing, supported, for post-toilet cleaning, etc. When his son saw that he was unable to stand, he cancelled all the flights. Today the Colonel cancelled his 35-year membership at the Country Club in California where they "live". Looks like he'll breathe his last breath in Washington, and will never see his old home again. That realization has kicked him in the gut. He was falling asleep already this morning as I got ready to leave after the overnight, and he'd only been up a couple hours.
Last night he was finally comfortable in bed at 11:30pm, and then got up around 3am for a Depends change and repositioning. He did make it to the potty, in the wheelchair, and managed to stand long enough for me to pull things up and down for him. I am afraid he doesn't have much time. We're going to start the .... oh what do you call them.... sheets that allow you to help a patient turn in bed. Because this client is SO demanding and difficult, and very hard on all the caregivers, the agency admin is changing shifts around. I won't have to do any more 84 hour weeks! I'm tellin' ya, I do NOT know how family caregivers do this 24/7. I love the couple deeply, but .... wow. If I get a call that he's failing, though, I'm racing down the freeway for a final hug.

allshesgot · Answer

If it is what it sounds like it may be, he could be within days of his passing id say within a week. It would not be advisable I wouldn't think for him to make that trip. Has his dr. Been contacted? If he is to have life saving measures there may be something they can do. I did see one gentleman completly moddled and in the final stages who was sent out to the hospital and recovered but only for a short time. Normally when they start moddeling along with the palms the fingers will model to, and become cold and stiff. Normaly when someone is in that shape they are to week to get up and most I have seen are bed ridden at that point. They ussualy just leave them in bed and give em comfort mesures. Is he on hospice as well? One important thing is to turn and reposition him every 2 hrs for comfort as well as to prevent painful bed sores.

Ruth1957 · Answer

He has a POLST indicating all life-sustaining actions are to be taken. He was so weak this morning I could barely get him to his chair from the bedroom. His son, daughter, and grandson are all flying with them next Saturday. I have no "say" in the matter...    This morning the Colonel was on the potty and his poor head dropped down, he started fiddling with his fingers, and he said "I'm going to miss you..." to which I replied - "You're not allowed to say that right now." gah. Why do I have to care? :-) No, actually, I'm thankful that I do care, and they know they're loved.

vstefans · Answer

Ruth, I don't think your Colonel will be making that flight, unless there is something treatable like an infection that he gets antibiotics for right away, or severe hypothyroidism. A home hospice nurse could possibly help you. You sure seem to be doign the right thing if they do not want any more interventions for him, keeping him comfortable and in the company of a trusted  favorite caregiver! Have you let the children know about this develoment?  Have they already decided about ER, hospital, other interventions to be done or withheld?

Changes in skin color and temp

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