I have been caregiving to a man 86 yrs old for 2 yrs now. Was told by a nurse that sees him that he was in the transitioning stage to the the EOL. He has parkinsons and alzheimers. Within about 2 weeks all he wants to do is sleep. some days he stays awake more other days just sleep. Appetite has decreased he wouldn't eat if we didn't encourage him to.Refuses to drink fluids we push fluids all day.He is getting over a uti right now. He is starting to goto the restroom but no output but he says he is finished. Has issues having a BM. He prays to God alot. Talks alot in his sleep. My question is he transitioning more to the EOL stage.
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 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!
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.
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.)
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.