I originally put this on a quieter board with no response so I’ve added it here instead for broader perspective.
Posted before about this (66 yr old) family member with stage 4 Oesophageal cancer with lung mets, treatment was refused after receiving 6 month prognosis (at almost 4 months now). I’m just wondering how others who have experienced this or work in the field would evaluate his current condition.
He had an infection a few weeks ago which has since been seemingly controlled by antibiotics. This last 2 weeks he has started sleeping between 20-22 hours of the day, shutting himself away from others, has minimal urine output, barely eating or drinking anything even in this heat (1-2 Ensures per day, 2 cups of tea at most and very little interest in anything more, the odd ice lolly every other day) His pain was under control using a patch but is now showing signs the dosage may need to increase.
He sleeps very still, you could be forgiven for thinking he had died by the way he looks, his mouth remains open and breathing is very subtle, he no longer snores too which is strange. His hands and feet are pale but not mottled although his overall complexion is a greyish tone.
What is odd is during the few hours he is awake (spread throughout the day in 30 min blocks, at most) he can appear relatively normal, chatting and making jokes for brief moments but soon becomes fatigued again. He is mobile to a point albeit very wobbly.
Hospice at home team are visiting in the mornings but without any regular medical assessment it’s difficult to place where we are in terms of progression.
My question is how long can people survive on just 1-2 Ensures and minimal fluids? He is extremely thin and is essentially wasting away, is this just the gradual decline? Previous cancer death experiences I had were very different situations and not based around malnutrition.
What other signs should we look out for and at what point would you request hospice admission?