Category: Prognostication

Articles about how to estimate impending death (i.e., last few days of life)

Understanding Terminal Illness Progression: Observable Signs and Symptoms

how people die trajectory
When a loved one receives a terminal diagnosis, it's natural to wonder about the journey ahead. Terminal illnesses follow a unique path, and understanding the signs and symptoms at various stages can help you provide the best care and support. This article aims to guide you through the general progression of terminal illnesses, focusing on observable signs and symptoms as the patient approaches the end of life. The progression of a terminal illness can vary depending on the type of illness, the person’s age, health, and treatment options. However, there are some common signs and symptoms that indicate that the illness is advancing, and the person is approaching the end of life. These signs and symptoms can help you and your loved one prepare for what is to come and make the most of the remaining time together.
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Understanding the Patient’s Question: When Will I Die?

Wirlpool
One common question that both patients (if they are mentally aware) and their loved ones often ask is about the timing of the patient's passing. While the exact answer lies beyond human knowledge, hospice nurses play a crucial role in assessing the patient's journey towards the end of life. In this article, we will explore how to provide a rough estimate using widely followed guidelines.
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Understanding Changes in Palliative Performance Scale in the Last Six Months of Life

Palliative Performance Scale Ppsv2
In the journey towards end-of-life care, understanding the Palliative Performance Scale (PPSv2) and its downward changes in the last six months can provide valuable insights for hospice caregivers, patients, and families. This article aims to break down these changes' month by month, offering guidance on what to expect during this crucial period.
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Significant Signs a Terminally Ill Patient may be Close to Dying

Signs of imminent death
There are typical visible/audible signs that a person may have less than two weeks to live. There are times when we are so close to someone, we may miss the forest for the trees. Please allow me to go over some significant signs that a person with a terminal illness may have two weeks or less to live. If there is sudden onset, within the past 24-hours, any of the following signs and symptoms, please do an evaluation for end-of-life determination as soon as possible (family members seeing these signs should reach out to their hospice provider's 24x7 number):
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Understanding Functional Decline in the Natural Dying Process

In this article, we delve into the critical topic of functional decline in individuals nearing the end of life. Understanding these changes is invaluable for hospice nurses, caregivers, and family members as they provide compassionate care during this delicate phase. We will explore various examples of functional decline and emphasize the importance of documenting these changes to aid in care provision and decision-making.
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Trigger Words for Hospice Nurses: Assessing End-of-Life in Two Weeks or Less

Signs of imminent death
Hospice visits by a nurse should always include a discussion with the caregiver and family members or facility staff about any changes since the last nursing visit. This interviewing process is extremely important because vital signs do not always provide clear indications when a patient is two weeks or less away from death. If we hear or read certain words or phrases in the notes, we should be on high alert for the possibility that the patient is either transitioning towards actively dying or is otherwise close to transitioning.
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Breathing Patterns Before End of Life: Critical Clues for the Last Hours!

Breathing Patterns
This article is intended for family members, caregivers, as well as nurses new and old. As an experienced hospice nurse, I've learned that when a family member or caregiver tells me their loved one is or has "goldfish breathing" or "fish out of water breathing" or "taking guppy breaths" that the patient is now at the end of their life.
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Frequency of Changes in Condition as an Indicator of Approaching Death

In hospice care, it's crucial to identify when a patient is nearing the end of life. One method is by understanding the pace of changes in their condition, often called the "velocity of changes." This article delves into how hospice nurses can recognize and interpret this velocity as a sign that a patient might be approaching the end of life.
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The dying process at the end of life

Body And Soul
Living is a continuum where we start life (scientifically) from conception as a pre-born human being and are actively living from that time then through the birthing process and as we grow from child to adolescent to adult. We are actively living without regard to the quality of life we are living at the time. As we arrive closer to death, we often go through a transitioning phase prior to actively dying. In this article I would like to go over the dying process at the end of life covering frequent questions such as “what is transitioning?” and “how do I know if my loved one is actively dying?” or “what are the phases of dying?” The phases of dying can be broken down into two phases: transitioning towards actively dying and actively dying.
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