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It's About Life
By Betsy Murphy, FNP, CHPN
percent of Americans will die suddenly. The remainder of
us (90 percent) will decline slowly, growing weaker
until we die. Because this process is so gradual, we
often donít recognize that a loved one is approaching
the final weeks of life. This may be why most Americans,
around 80 percent, die in institutions, despite the fact
that most Americans polled (85 percent) voice that they
want to die at home. Perhaps the reason could be that we
simply do not see it coming.
It is only
natural that we would want to deny how seriously ill our loved
one is. Denial protects us from the painful reality that we may
soon lose someone precious to us. While denial can help us to
cope, it also may interfere with making a plan that will
guarantee that your loved oneís final months are spent in the
place they choose, surrounded by friends and family.
preparation, on the other hand, will allow us to choose where
death will occur, participate more fully in our loved oneís
care, make better decisions and achieve a measure of control
over the coming months. We will feel peaceful despite living
with uncertainty. In the future, after our loved one has died,
we will reflect back on these final months, and be left with the
deep comfort that comes from knowing that we did our best for
someone we love at a very difficult time.
So what are the
signs that an elderly person may be approaching the final months
of life? There are many indicators, but in this article, we will
discuss three common signs: weight loss, progressive weakness
There is a great
deal of research that shows that
weight loss by itself is a powerful indicator that an
elderly person is approaching the final months of life. Just
five percent to 10 percent loss of weight in six months can be
significant. If a person is in a nursing home, it has been shown
that as little as 10 percent loss of weight in six months will
carry 85 percent mortality in the next six months. Weight loss
is so significant that it can be an indicator for hospice care.
It is commonly understood that elderly people approaching the
final months of life naturally stop wanting food and fluids.
indicator is increasing dependency.
Loss of weight leads to loss of muscle which leads to
progressive weakness. This may start with having difficulty
getting up from the chair. It progresses from needing assistance
to transfer to being chair bound to eventually being mostly bed
bound. This immobility also puts an elderly person at risk for
skin breakdown and pneumonia.