Last Rally before Death

[Ldgray]

My father in law has been ill with MDS (blood cancer) for about 8 months now. For the last few months he has needed assistance to walk, bathe, shower and get out of bed. He has spent a majority of his time sleeping and has lost a lot of weight due to a lack of appetite and chemotherapy treatments. He was also very hard to engage in conversation, very quiet and reserved. He has been receiving blood and platelet transfusions several times a week since March. Friday he spoke with his dr in the hospital about his desire to go home. He also stated that he wanted to discontinue chemo treatments and would not be coming back to the hospital. The dr. has called in hospice and has told him that hospice would help make him comfortable. This weekend he seems to have gained new life. He has been doing things he has not been able to do in MONTHS! He is walking all around the house, eating like never before and talking coherently about things with family members. Is it too much to hope that he is starting to improve or is this a "last rally" before the end? Does anyone know if these rallies tend to last for several days or just hours.

[kbrn2002, ADN, RN]

I am so sorry. I know from fairly recent experience what you are going through. My father passed away a few months ago after a relatively short battle with cancer, 3 months from diagnosis to death. He had a period of about a day and a half where he seemed to rally and then became mostly unresponsive and passed away less than a week later.

I am not saying this will be the course your father in law follows as everybody is different, but it has been my experience both personally and professionally that these last bursts of energy and strength are not at all uncommon.

Again I am very sorry for what you and your family are going through.

[been there,done it]

No one can call the meaning to his rally .

Hospice needs to be involved if there is a likelihood of death within 6 months. Use their resources.

Best wishes to your family and your father in law.

[firstinfamily, RN]

I have seen this type of behavior in terminal patients many times. Each case is individual and it is hard to predict how long he may actually have. He is most likely feeling better and wants to do as much as he can while he can. Usually after this rally they just wear completely out and usually it is not long after that they pass. Spend this time together, treasure the memories and gather pictures etc, film a video that he can leave for future generations. Ask him to write about his childhood or make a diary to pass on. It is hard to ask these things when the re-energized sick person just wants to live. I don't think we can say a definite number of days, weeks, months. Blessings for you and your family.

[Nienna Celebrindal]

I agree with first. I have worked in hospice and this sounds like a rally. It could be the last itccould be one of several. You never really know. There will come a point though that the hospice nurse will see he won't rally again. You never know when that'sggoing to be until it comes. Every patient is so different. I have had patients I was sure wouldn't make it a week on hospice last months and patients who signed up "early" last days. I hope you all get to make some wonderful memories while he feels well.