I found out that my dad needed to go on hospice care 16 days ago due to lung cancer. He passed away two days ago. In the two weeks that I had to deal everything, the most frustrating thing for me was not knowing what the next stage would be. I wanted to know what to expect. I wanted to know the signs to look for to know that we were really in the "end stages". What I found after reading messages boards, doing research, and talking with people was that every story is different. There are common themes and similarities, but no definite signs that will tell you what to expect or when to expect it.
With that being said, here are the stages that my dad went through. They may be similar and helpful for some:
Day 1: Was mobile and even able to drive himself to the store early in day and communicate almost normally, but was exhausted early and often. At night, sleep was restless. Appetite was light but ate 3 times. Legs and feet began swelling.
Day 2: Not as mobile. Driving out of the question. Needed assistance walking and used wheelchair at times. Less appetite. Trips to the bathroom became more difficult and exhausting. Could not stand alone. Would doze off frequently while talking with someone. Legs and feet experienced a lot of swelling since day one. Legs began to break out in small sores. Swelling due to the cancer had spread to liver, other organs, and now effecting the kidneys. Restless sleep due to frequent urination.
Day 3: Less appetite. More pain and tiredness. Swelling of legs and feet continued. Morphine and Adavan (sp?) added to meds. Trips to the bathroom became harder and more exhausting, used wheelchair more. Also used a portable urinal to save energy and clothes. Sleeping more frequently at kitchen table. Dozed off in mid-sentence. Seemed to have trouble with connecting his thoughts. Some confusion set in. Restless night of sleep. These symptoms continued to worsen over the next couple of days.
Day 5: Ate small bites of food a couple of times a day, but none would equal a full meal. Fluid in-take was still good. Increased pain.
Day 8: Swelling of legs and feet continued to points that one would think were impossible. Some sores on legs began to bleed. Appetite diminished. Connecting of thoughts seem to be more difficult. Loss of bladder control. Would say he needed to go to the bathroom after it was too late. To this point, he had refused a catheter and hospice would not install one because they were afraid he would pull it out. Sleep at night was very restless.
Day 9: Catheter installed. Even though confusion and exhaustion set in, he insisted on keeping a doctor's appointment. Doctor said that cancer had matastasized to the brain. Still able to sit at table and be around other people. Appetite going. Talked in sleep to people that were not there (like deceased parents and realitives).
Day 10: Swelling of legs diminishing. Feet were still swollen. Virtually no appetite this day. Some blood in urine. Still taking in some fluids.
Day 11: Only out of bed for a short time. Slept most of the day. Feet swelling also diminishing. No appetite. No fluid intake. Increased talking to people not there. When calling out for someone, could only call out one name. Managed pain with medication. Slept at night as he did most of the day. Sleep apnea occured frequently, sometimes taking 15 seconds in between breaths.
Day 12-13: Same as above except for the fact he did not get out of bed at all. It appeared as he had had a stroke. Left eye and edge of mouth drooped. Little communication.
Day 14: Extreme pain early in the day. I moved his head to adjust position and he cried out in pain. That was the first time he cried out. To that point, he would say he was in pain or moan slightly. Increased blood in urine. Swelling on legs and feet were completely gone by mid-afternoon. Later in day tempature began to rise. Blood pressure dropped to 78 over 72. Pain increased. Hospice recommended increased morphine to make comfortable. Could not swallow liquid medicine without assistance. Breathing became labored. Pulse rate, which had been in the mid 80's, dropped to 54 bpm. His feet and toes were bluish in color for days, but his hands and fingers also began to blue. Beds under fingernails were white in color instead of a healthy pinkish. By 6:30 pm, he was gone. At the very end, his breathing went for labored/snoring-like to the "fish out of water" gasping. Lips also became bluish.
That's my dad's story. As I said before, by sharing the past few days of his fight with cancer I hope it helps to have another story out there to compare with the many others.
Good luck to and God Bless all who are going through similar situations.