[can'twait2B1]

My grandmother is in her early 80's and was put in the hospital yesterday. She has suffered from diabetes and congestive heart failure for years. She had a bout with breast cancer a couple of years ago resulting in a masectomy, she also had cancer in the bottom of her right foot which they removed but she has had numerous infections in it since which is why she was put on heavy antibiotics last week.
My grandfather passed away from lung cancer back in 2000 and every since then my grandma has deteriorated. Yesterday morning she was disoriented, won't answer questions when asked or says something off the wall, she cannot control her bladder or bowels and can't walk. This all happened over the weekend. She has been weak but not in the incapacitated state she is in now. She had to have an IV placed in her neck this morning b/c the veins in her hands and arms have shrunk.
Are these signs of impending death? Are there any other than the coldness starting in the limbs that I should look out for? What have you seen in your patients? I don't want to let my grandma go, but I know that she is ready to join my grandpa.
I guess I am trying to prepare myself.
Thanks for your help.

[AlixCoastRN]

Look for irregular breathing with periods of apnea, mottling of the lower extremities, coolness. Check out some of the Hospice web sites for more info- take care of yourself too, and dont' forget to tell her you love her and that it is ok to go. Say goodbye - and it's ok to cry in front of her and tell her you will miss her.

[traumaRUs]

As an ER RN who has (unfortunately) seen a lot - I agree with AlixCoastRN - the mottling, irregular breathing, etc.. However, I am one who advocates family presence so, if the RNs caring for your dear grandmother feel that death is imminent I think I would try to have a family member stay with her. Hearing is the last sense to go.

[EastCoast]

I feel badly for your saddness but i want you to make sure you step away from your nursing role and don't look at every sign as whether she is closer or farther from death. Although she sounds frail people are truly amazing. I woud echo the sentiments previous and make sure to emphasize that you make sure she is comfortable in all aspects.
Lastly, if it does seem that death is inevitable pay attention to the very small things that you will treasure later....take a good look at her hands and memorize them in yours, look at the color of her eyes, tell her you love her a thousand times, and even cut a little piece of her hair for later on down the road to have. Old people are fragile. Please whatever you do don't let her die alone.

Prayers to you.

[can'twait2B1]

Thanks for all of your replies. We lost Granny about an hour ago. I think that I am still in shock,I'm sure it will hit me hard later tonight. I wasn't able to go see her, I am six months pregnant and she was in the isolation unit because of her bad infection. They nurse recommended that I didn't go in there. My dad and uncle were there though when she left us. I know she knew I loved her very much and I know how much she loved me, we never kept that secret, we always told each other how we felt. I just keep telling myself that she is with my grandpa now and they are having a great reunion up in heaven. God Bless you all for what you do. I only hope that I will be as good of a nurse as you'll are.

[Gibbie]

My deepest sympathies to you. I am a seasoned hospice nurse and I want to just share a thought with you. I know without a shadow of a doubt that people dying choose who they want at their side at time of death. Maybe not consciously but more subconciously. People choose to die alone or with someone at their side. I have had people sit for hours, days at their loved one side only to have them die when they leave the room for a much needed break. I have had pts hang on until a certain person made the long journey home, dying peacefully within moments of their getting there. There is a reason you were not suppose to be in there with your grandma. We may not always know or understand the reason. Hold tight to those sweet and precious memories of your grandma. Remember, you were there for her in all other ways while she was very much alive!!

[Dixen81]

My condolences and hugs to you, can'twait2B1. Try to picture her and your grandpa smiling and hugging each other now. Hopefully, knowing that she is finally comfortable and at peace will bring some comfort to you. She was lucky to have such a loving granddaughter.

[VivaLasViejas]

My sympathies and prayers are with you in the loss of your beloved grandmother. Be comforted by the knowledge that she has been reunited with the love of her life in a place of complete peace, where there is no pain, no sickness, no death, and that someday you will see her again.

[Love-A-Nurse]

I too would like to add my deepest sympathy and send a (((((Hug)))) your way.

[jnette]

Warm hugs and condolences, Can't Wait. So very sorry for your loss. But your Gramma is waiting no more... her day has arrived and she continues to love you from a different place.

Again, hugs to you. (((((( ))))))