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Original poster

End stage Cancer signs of death

19 replies

Neverendingdust · 05/08/2022 20:44

A family member is currently suffering with Stage 4 Oesophageal cancer, around 3 months into a 6 month prognosis. He seems to have taken quite a decline over the last few weeks which have been traumatic to say the least for those caring for him as he’s still at home. I’m just wondering if anyone can shed some light on to whether you think these may be clear signs his body is shutting down and how long people can reasonably last for at this point. This all started around Sunday.

He’s just recovering from sepsis which started earlier in the week. His temperature spiked to 39 then came down but then fell to 33. It seems to have stabilised for now with antibiotics.

He is sleeping most of the day, with few short bursts of energy to shower himself, get dressed and perhaps hold a few minutes of conversation.

His skin is quite pale almost greyish, his hair appears to have thinned despite no chemo treatment.

His mouth now droops slightly, it stays open whilst he’s asleep

His chest moves for around 30 seconds and then seems to not really move at all for 30 seconds during sleep, there’s also slight rattling

Hes very confused, no concept of days, convinced he lived during another time period

His nutrition intake is 1-3 nsures per day with a few sips of tea

Constant pain but not yet on a driver so just taking morphine and ibuprofen also has a patch now.

Had a few soiling accidents

The doctors have issued a ‘just in case’ pack so I presume this means they’re of the opinion it’s sooner rather than later but for how long can this go on for when someone is so malnourished?

If sepsis has now occurred, how soon will it happen again?

OP posts:
AtillatheHun · 05/08/2022 20:52

I did a lot of reading around this while my mother was going from cancer. She was 84. The final stage you’re describing lasted a couple of weeks; about 6 days at the end with the driver and unable to get out of the bed (she had a hospital bed). There were some absolutely textbook processes - the rally of strength two days before death, when she sat up and watched tv and talked, and the weird smell in the room in the hours before. The most common time of day for it to take place is late morning, which was spot on (circadian rhythm related). If he is still able to get up and shower I suspec you have a bit of time together - so sorry, it’s a hard hard time. I hope he goes easily.

BrioLover · 05/08/2022 20:55

Everything Attila said.

I'm sorry you're going through this. I hope he can stay at home. It is probably worth getting the district nurses or his palliative care team in to check on him, as they will be able to advise as to when the driver is likely to be needed etc.

Nidan2Sandan · 05/08/2022 20:59

My grandad had oesophagus cancer and his final days were quiet. He slept most of it, by the last 2 weeks he wasnt eating really at all, maybe a soft biscuit here and there and a few sips of water. No energy for showering or conversation.

The night before he died (he passed around 10am) he was really wired. He was doing odd things like acting like he was unwrapping and eating sweets, constantly needing to be carried to the toilet, speaking to long passed relatives like they were in the room talking to him, and just generally agitated. He then went to sleep and passed a couple of hours later.

Interestingly my Nan died in March and she did the same. She died from dementia but had the same weirdly unsettled night before she passed. Hers was lots of screaming, crying for her Mum, her sister (she passed at age 25) then went to sleep and passed away.

SwimmingOnEggshells · 05/08/2022 21:03

My father had OC, was treated but came back as lung cancer. He slept in his last day, he could hear us but couldn't open his eyes, and then after a while we knew he couldn't hear us anymore. His hands were so cold which I think is a sign the body is shutting down.

It's so heartbreaking to go through, I'm so sorry 💐 it's so upsetting.

Tiredmum100 · 05/08/2022 21:05

I'm a District nurse, we have lots of patients with just in case meds, some written up a months and months before being needed, its always good to have them ready. Is your relative under a hospice or district nurse team? May be worth giving them a ring to see if they can come out and do anything to make things more comfortable/answer questions/ give support.

Mindymomo · 05/08/2022 21:08

My brother died of this. He spent a week in a hospice as he wasn’t eating anything and then he and his wife decided he would stay at home after. The last 2 weeks nurses were coming in twice a day to give morphine injections and he slept virtually all the time, wasn’t eating, just sipping water. On his last evening there was a problem with nurses getting there and he and my sister in law spent a couple of hours with each other when he wasn’t drugged up, which although he was in pain, my sister in law is very grateful to those hours that they had. The next day his breathing was quite laboured although asleep and he died early evening. He was only 52. This type of cancer really is terrible. So sorry you are going through this, it’s a really hard time.

Soontobe60 · 05/08/2022 21:12

Nidan2Sandan · 05/08/2022 20:59

My grandad had oesophagus cancer and his final days were quiet. He slept most of it, by the last 2 weeks he wasnt eating really at all, maybe a soft biscuit here and there and a few sips of water. No energy for showering or conversation.

The night before he died (he passed around 10am) he was really wired. He was doing odd things like acting like he was unwrapping and eating sweets, constantly needing to be carried to the toilet, speaking to long passed relatives like they were in the room talking to him, and just generally agitated. He then went to sleep and passed a couple of hours later.

Interestingly my Nan died in March and she did the same. She died from dementia but had the same weirdly unsettled night before she passed. Hers was lots of screaming, crying for her Mum, her sister (she passed at age 25) then went to sleep and passed away.

This describes almost exactly how my Grandma died. I was privileged enough to be with her during this time.

Ilikewinter · 05/08/2022 21:16

Hand hold OP, we had similar experience with MIL, again she had a couple of very agitated nights before she passed, she completely shut down, no food, very little fluid, bed ridden and constantly slept, confused and a change in moods, she also had the rattle, I would say she went down hill very fast over about a week and passed peacefully at lunch time.

💐💐 OP

Original poster
Neverendingdust · 05/08/2022 21:22

Thank you all for sharing 💐 It really is absolutely hideous to witness isn’t it.

The hospice are in contact with the family but it’s knowing when to make the call to get him admitted which is proving tricky. I just hope it’s a quick painless end and not a drawn out horror show for him and the family.

OP posts:
EmergencyPoncho · 05/08/2022 21:31

I'm so sorry OP. Agree with the rally of strength just before. Also I think the face changes, in a way I can't really describe. I don't know from this cancer and I'm not a medic, but I've noticed it in a couple of people. Flowers

Original poster
Neverendingdust · 05/08/2022 21:32

Tiredmum100 · 05/08/2022 21:05

I'm a District nurse, we have lots of patients with just in case meds, some written up a months and months before being needed, its always good to have them ready. Is your relative under a hospice or district nurse team? May be worth giving them a ring to see if they can come out and do anything to make things more comfortable/answer questions/ give support.

I think he’s under district nurse with a view to being admitted to hospice but nothing is decided just yet. They’ve been to visit already but haven’t really been forthcoming with their assessment of where they think he is at.

What would you say are the most common final indicators to look out for in patients with oesophageal cancer? His weight loss is shocking, but the odd breathing patterns and drooping of the mouth seem to have started a week ago. His hair appears to have started thinning too.

OP posts:
tiatempo · 05/08/2022 21:39

Hi. I'm a District Nurse and oversee palliative and EOL in peoples homes. Do you have DN or hospice at home input?

It's sounds like he has deteriorated rapidly and is likely that he is beginning to die.

Is a package of care in place and equipment such as a profiling bed? The just in case meds will be injectables so hopefully you are in touch with community services that will administer.

You'll see peaks and troughs, but day to day you will notice he is less able to leave bed, will eat and drink less and sleep more. His swallow may become weak and won't be able to tolerate oral medications.

The aim is to keep him comfortable so if any nausea, pain, agitation or bleeding occur you will need the JICs.

I hope you're ok and the rest of the family have support x

Original poster
Neverendingdust · 05/08/2022 22:19

@tiatempo Thank you for the comment. A nurse from the hospice has been to visit today and said she will call again on Monday and to just keep an eye on things.

A GP diagnosed sepsis a few days ago and recommended a hospital trip which he declined to do, opting instead to take antibiotics.

So far it’s only the JIC meds, he started on the patches a few days ago though.

He doesn’t have the bed yet. He’s sleeping on a sofa as it’s much more comfortable for him than his own bed, he does seem to be in a lot of pain though, constantly wincing and sporadically moaning, hopefully the patch will start to kick in.

At what point do you make the call to request a hospice admission? Do we just wait for the nurse to decide or can the family do it?

OP posts:
tiatempo · 05/08/2022 23:27

Neverendingdust · 05/08/2022 22:19

@tiatempo Thank you for the comment. A nurse from the hospice has been to visit today and said she will call again on Monday and to just keep an eye on things.

A GP diagnosed sepsis a few days ago and recommended a hospital trip which he declined to do, opting instead to take antibiotics.

So far it’s only the JIC meds, he started on the patches a few days ago though.

He doesn’t have the bed yet. He’s sleeping on a sofa as it’s much more comfortable for him than his own bed, he does seem to be in a lot of pain though, constantly wincing and sporadically moaning, hopefully the patch will start to kick in.

At what point do you make the call to request a hospice admission? Do we just wait for the nurse to decide or can the family do it?

What are his wishes? Did he want to go to a hospice or die at home. Whereabouts are you?

tiatempo · 05/08/2022 23:29

Does he have an ACP or ReSPECT form???

Cocolapew · 05/08/2022 23:56

My Dad stopped eating and drinking and slept a lot. He had a lot of hallucinations as well. He temperature would go up and down. Once the driver went in, on a Friday, he lasted 8 days, the Dr thought he wouldn't last the weekend.
I knew the night he would die, there was just something different about him. He had had the wakefulness and talking the day before.
He was at home with a Marie Curie nurse staying with us over night. She thought his pulse was still too strong for him to die but he had had a period of agitation and restfulness, his head and face were cold and he had the rattle in his chest. He died an hour and a half after the nurse arrived.

oranmore · 06/08/2022 08:43

Is it worth contacting Marie Curie or Macmillan for some support?

AtillatheHun · 06/08/2022 09:46

I forgot the agitation. My mum had no strength but somehow kicked off all the covers and was really cold. She also had the hallucinations of king dead family, and about 2 weeks before claimed to have spoken to someone and said that something had happened to him. He’d committed suicide and hadn’t yet been found. There’s definitely a strange heightened sense of spirituality.

Original poster
Neverendingdust · 06/08/2022 10:00

oranmore · 06/08/2022 08:43

Is it worth contacting Marie Curie or Macmillan for some support?

Macmillan are already in contact. I think he’s at that deceptive point where he’s not yet bedridden and having some normal interactions but at high risk of infection and sudden rapid decline.

It’s the uncertainty that makes it difficult when you’re not quite sure if it’s days or weeks and you’re forced to witness the cancer slowly chip away at the person you know and love.

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