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Who are you caring for?
Which best describes their mobility?
How well are they maintaining their hygiene?
How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
Which best describes your loved one's social life?
Acknowledgment of Disclosures and Authorization
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
Remember, this assessment is not a substitute for professional advice.
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Every death is .Do not blame the doctors for giving what may appear as misinformation. they are rarely with the patient during the time leading up to death. they often give over optimistic estimates and there are many reasons for this. They don't want to be the bringers of bad news or feel that their treatment has failed and most of all simply don't know. Many patients will also not accept that they are dying and insist on continuing treatment and artificial nutrition. At times this is to achieve a special goal, like an upcoming birth, graduation or anniversary. Patients will become weaker, sleep more, be reluctant to eat or drink and turn visitors away. Urinary output will become less or cease completely. Seeing what I describe as spiritual visitors is also very common. often people they recognize. but sometimes complete strangers. When you pinch up a fold of skin it is slow to return to a flat state. The color of the skin may become blue especially at the extremities and feel cold. it may become difficult to feel peripheral pulses or measure blood pressure or even hear a heart beat .if measurable the pulse may become rapid and blood pressure fall. terminal agitation can become a problem and medication should be available to calm this. Pain often becomes much more severe in the final hours and higher doses should be available to treat this. Eventually the patient may slip into unconsciousness and the breathing take on the pattern described as Cheyne Stokes where the breathing can cease for as long as a minute then resume with a big sigh. This can happen up to about two weeks prior to death. Another distressing symptom is what are called terminal secretions which do not always happen. the patient will produce copious amounts of secretions from the mouth and nose. Unless you have been regularily suctioning because of a trach do not attempt to suction, it will only make the throat sore and not improve the condition. Turn the patient on their side and allow the secretions to drain out. there may be a rattling sound often described as the death rattle although this is fairly rare. With certain cancers of the digestive system the breath may become putrid in the final days. this is nauseating for the caregivers and you can try putting something like vasiline in your nose or wearing a mask sprayed with a little perfume. It disappears on death and the room can be quickly aired out. As you see signs of approaching death notify family members so they can say their goodbyes if they wish. Allow but don't force young children to see the dead person. during a terminal illness it is fine to allow even very young children to help in the care with tasks like bringing in drinks or the newspaper or just sitting and talking to the patient if they wish.. When you think the person is close to death in the last days they appear to rally and seem to be improving. This is rarely true so expect death within 48 hours but enjoy those hours and let them eat or drink anything. The moment of death is usually calm as a feeling of peace descends. one troubling thing is something called Agonal breathing. After the heart stops the patient may take a few breaths and you are nio sure they have really gone. I have no idea why it is called that but there is no agony involved, it happens too in animals that are being euthanized. I hope this has help clear some of the mystery and I will be glad to answer further questions
Refusing to eat, then refusing to drink, also telling people that they see loved ones who have already passed, can be signs that a person will soon be dying. On the other hand I've seen cases where hospice has told the family that death would be "in the next ____ hrs or days, and they have been very surprised to find the loved one lasted much longer. If they are not communicating, and have terminal restlessness, there is no way to know what is going on in their minds. Months after my father died, I had a dream in which he told me "the reason that I kept trying to get out of bed was that I thought it was time to go to work". Just a dream? maybe, but I like to think Dad was sending me a message. There have been some other interesting things that have happened within the family. Perhaps it's wishful thinking, but I like to think he is aware of our happenings here on earth.
yea, my mother was calling out to her previously deceased brother johnny for help as she was failing. delerium.. i told her johnny was smoking pall mall reds in hell and couldnt help her. a very disturbing time, humor is about all i had left to offer.
Reading the pamphlets offered by hospice organizations may give you some insights.
My husband died of dementia. In the last year his overall health declined to the point where he could no longer do activities he had before. Going places became so hard that the effort usually outweighed the benefits. We only went out for very special things. In the final weeks his eating became quite irregular. He spent increasing time in bed. (More than 20 hours a day at the end.)
He'd been on antidepressants for many years (following a head injury). The drug worked and he did not display signs of depression. This was true right up to the end.
my mother stopped eating and drinking and in fact knew she was dying and even asked me how was she going to get out of this. ( dying ) . she was gone in 3 days . her digestive system had ceased to function. she did sleep a lot cause her heart was failing. she required haldol the last 3 months of her life because of constant hallucinations / delusional thinking. terminal restlessness followed by terminal agitation are signs of end of life.
My dad withdrew and didn't want to watch TV or do anything. Lots of sleeping. He was just very passive and calm/quiet near the end. His doctor (a geriatrician) thought he was depressed and wanted to start him on anti-depressants. I thought he was dying, since he was a year into his lung cancer diagnosis, where he was given about a year to live. I was right. Shows you how much some doctors understand about the dying process - or maybe how even they're not equipped to deal with it.
My grandmother (dad's mom) saw my aunt (dad's older sis) and my dad. She talked to my dad and felt better. (he died ten years before she did) She told my SIL that my aunt thought she was pretty. This was a week before she died. My MIL's dad, however, saw a man burning not long before he died and was telling her about it. She still brings it up every now and then. I know it hurts her to remember that.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Patients will become weaker, sleep more, be reluctant to eat or drink and turn visitors away. Urinary output will become less or cease completely. Seeing what I describe as spiritual visitors is also very common. often people they recognize. but sometimes complete strangers. When you pinch up a fold of skin it is slow to return to a flat state. The color of the skin may become blue especially at the extremities and feel cold. it may become difficult to feel peripheral pulses or measure blood pressure or even hear a heart beat .if measurable the pulse may become rapid and blood pressure fall. terminal agitation can become a problem and medication should be available to calm this. Pain often becomes much more severe in the final hours and higher doses should be available to treat this. Eventually the patient may slip into unconsciousness and the breathing take on the pattern described as Cheyne Stokes where the breathing can cease for as long as a minute then resume with a big sigh. This can happen up to about two weeks prior to death. Another distressing symptom is what are called terminal secretions which do not always happen. the patient will produce copious amounts of secretions from the mouth and nose. Unless you have been regularily suctioning because of a trach do not attempt to suction, it will only make the throat sore and not improve the condition. Turn the patient on their side and allow the secretions to drain out. there may be a rattling sound often described as the death rattle although this is fairly rare. With certain cancers of the digestive system the breath may become putrid in the final days. this is nauseating for the caregivers and you can try putting something like vasiline in your nose or wearing a mask sprayed with a little perfume. It disappears on death and the room can be quickly aired out.
As you see signs of approaching death notify family members so they can say their goodbyes if they wish. Allow but don't force young children to see the dead person. during a terminal illness it is fine to allow even very young children to help in the care with tasks like bringing in drinks or the newspaper or just sitting and talking to the patient if they wish.. When you think the person is close to death in the last days they appear to rally and seem to be improving. This is rarely true so expect death within 48 hours but enjoy those hours and let them eat or drink anything. The moment of death is usually calm as a feeling of peace descends. one troubling thing is something called Agonal breathing. After the heart stops the patient may take a few breaths and you are nio sure they have really gone. I have no idea why it is called that but there is no agony involved, it happens too in animals that are being euthanized. I hope this has help clear some of the mystery and I will be glad to answer further questions
If they are not communicating, and have terminal restlessness, there is no way to know what is going on in their minds. Months after my father died, I had a dream in which he told me "the reason that I kept trying to get out of bed was that I thought it was time to go to work". Just a dream? maybe, but I like to think Dad was sending me a message. There have been some other interesting things that have happened within the family. Perhaps it's wishful thinking, but I like to think he is aware of our happenings here on earth.
My husband died of dementia. In the last year his overall health declined to the point where he could no longer do activities he had before. Going places became so hard that the effort usually outweighed the benefits. We only went out for very special things. In the final weeks his eating became quite irregular. He spent increasing time in bed. (More than 20 hours a day at the end.)
He'd been on antidepressants for many years (following a head injury). The drug worked and he did not display signs of depression. This was true right up to the end.