Come be my magic medical eightball...

January 27, 2009 3:27 PM

So, my grandfather is dying from Pancreatic Cancer. I think I need some thoughts from someone who isn't my doctor - someone who can make general comments without worrying it will bite them in the ass...

Basically, this a tough old git who was diagnosed two and a half years ago and given 6 months to live. He had my dementia riddled grandmother to look after and kept going. And going. And going.

At Xmas he fell, due to malnutrition. Mid Jan they fitted him with a stent and he ate a little more than he had been. Then, on the 20th, they sent him home. By Friday he'd become confused they admitted him to a local hospital/hospice/rehab place.

When he went in he was technically hypothermic and diabetic. He was getting more confused.

Today the doctors took him off all meds except 30/500 co-codamol and his doctor arranged a DNR from his previous records.

He's confused, barely knows who I am, and can manage barely 2 minutes of conversation an hour. He's refusing water (he's on a drip now) food or medications that aren't painkillers (which is handy). And he's still hypothermic...

Once he says/thinks something, he keeps repeating it over and over until something else appears in his mind. The only independant thought I noticed was that he shouts for the nurse to go to hell whenever he sees the drug trolley.

My question is quite simply this... how long does the old sod have? I know you have no crystal ball, nor his medical records, but should I be thinking days, weeks or months? He's gone down hill very quickly, but i can't get anyone to even give me a damned hint on this one...

posted by twine42 to health & fitness (26 comments total)

I am so sorry about your grandpa, twine42. I'm sending you a MefiMail about my personal experience here.
posted by annathea at 3:33 PM on January 27

IANAD. Anecdotal evidence suggests that once an organism begins refusing water, nature will take its course fairly quickly. I should think a few weeks at most... assuming, not safely, that the hospital does not attempt to override the man's patent will to die.

You have all our sympathy.
posted by Joe Beese at 3:45 PM on January 27

He's confused, barely knows who I am, and can manage barely 2 minutes of conversation an hour. He's refusing water (he's on a drip now) food or medications that aren't painkillers (which is handy). And he's still hypothermic...

When my aunt with breast cancer reached this point, she lasted another two weeks, with the last week being a roller-coaster of "she could be gone any minute"
posted by Brandon Blatcher at 3:55 PM on January 27

With my grandma, that meant it wasn't long it all. A few days, at most. I'm sorry, so sorry. I hope it's longer.
posted by batmonkey at 3:56 PM on January 27

if he can bear it & if it will be helpful, that is.
posted by batmonkey at 3:59 PM on January 27

Yep, when my elderly family members got to similar points, they made it between a few days and maybe two weeks. I'm so sorry.
posted by scody at 4:02 PM on January 27

Once they stop drinking, it's not usually long. I would be thinking days or maybe weeks, months would be pretty doubtful. I don't know how much they are supplementing his fluids, but most hospice places don't do too much of that, because they aren't trying to prolong life at all, just keep the person comfortable.
I'm very sorry to hear about your grandfather.
posted by fructose at 4:03 PM on January 27

From personal experience - days, not weeks.
posted by NoRelationToLea at 4:04 PM on January 27

I watched my grandma like this...she lasted about a week on a fluid drip with painkillers..I'm sorry. It sucks. I hope he doesn't linger and suffer.
posted by Green Eyed Monster at 4:21 PM on January 27

Friends of mine have gone through this with their grandparents etc. It's a matter of days, maybe a couple of weeks. I'm sorry, and my thoughts are with you.
posted by minus zero at 4:28 PM on January 27

Very recently my grandmother (with diabetes) went into the hospital with a common (for the elderly) infection and severe dehydration. She was up then down and I think stopped being able to drink more than a few sips after 7-10 days. She passed away about 3 weeks after entering the hospital (2 weeks or less after all but refusing food and water). No one thing did it (from what I could gather listening to everyone), it was a cascade of complications between systems. But there was no cancer involved. She was very rarely confused.

I'm sorry. This is going to be rough.
posted by K.P. at 4:33 PM on January 27

When my grandfather got like this, he was given a week. He died that night.

I'm so sorry for you.
posted by peanut_mcgillicuty at 4:43 PM on January 27

With my grandmother, dying from liver cancer, it was only three or four days after she got to this point. I am very sorry.
posted by HotToddy at 4:44 PM on January 27

When my grandfather got like this, they gave him a week. He passed that night. I'm pretty sure it was in part because he just didn't want to live helpless like that.

I'm so sorry for you.
posted by peanut_mcgillicuty at 4:44 PM on January 27

Guys, I need to go sleep. I know I'm stirring up crappy memories. I'm sorry. It's stupid, but that hadn't occurred to me. Thank you all. I know you've all said something different, but it's helping. Answers, even answers that prove to be 'wrong' for him, are so very much appriciated.

thank you...
posted by twine42 at 4:48 PM on January 27

Oh sweetie, don't apologize. Be good to yourself and know that people's thoughts are with you, that's all.
posted by scody at 4:59 PM on January 27 [3 favorites has favorites]

Definitely don't apologise. Examining the moments of our greatest grief to help someone else through the process is literally one of the missions of life for humans, in my opinion.

Be easy on yourself, do what you can to collect the family and loved ones, and prepare a soft spot in your heart to hold all of the love and good memories close to yourself as this transition works itself through. May strength and love surround you all.
posted by batmonkey at 5:19 PM on January 27 [8 favorites has favorites]

my dad was diagnosed with prostate cancer. despite catching it early and treating it pretty aggressively, they gave him 2 years to live when it spread. he lived out of state, and i saw him last when i went home to visit--it was a major family reunion.

a week or so later, i was back at work in my cubicle in suburbia, when my phone rang. it was my dad, going in and out of delirium, calling to say goodbye. i talked with him for twenty minutes, and then went to a luncheon which turned out to be the it department's last chance to get drunk before y2k hit. when i got home, there was a message from my aunt telling me that he had passed away.

i cherish that moment when he called. when he found out about the luncheon, he encouraged me to go and have a good time. and best of all, i got to say goodbye.

ms puppet didn't have that chance. her father dropped dead while she was away at college.

i guess i'm saying that you need to get your goodbyes in. it's his time to go. make it something to remember without regret. i have gone through what you are about to, and though i can say i have empathy, there is nothing else i can say to help you prepare.
posted by lester's sock puppet at 5:30 PM on January 27 [3 favorites has favorites]

It's very hard to do this. But give him lots of verbal expressions of love, and whatever hugs and touch he seems to tolerate. It's amazing what gets through, and it will help you, as well. He's lucky to have you.
posted by theora55 at 6:55 PM on January 27

I watched my father die from cancer and while his experience wasn't quite what you're describing, it was still really tough. Like everybody else, best wishes and sympathies from over here.
posted by LastOfHisKind at 7:25 PM on January 27

.. and then there's my husband's grandfather. They gook him off of his feeding tube (for several reasons) and he survived for another 5 weeks. It really wasn't pretty and no one prepared anyone in the family for it. I just wanted to throw it out there because when you're expecting days and it turns into weeks, it's a different kind of hell.

Wishing you and your family the best.
posted by chrisubus at 8:05 PM on January 27

Depending upon your grandfather's views and whether he expressed them and how you all feel about this, the (collective) you can refuse hydration. (My brother wanted this, we backed him up, we had to fight with the hospital, but it was what he wanted. (My understanding is that dehydration is part of dying, is not painful when a person is near death.))
posted by ClaudiaCenter at 10:43 PM on January 27

I can't add anything that hasn't been said, but just pass love on. You know we're all hoping for the most compassionate and best ending.

These are things they don't train us for. I hope the good wishes you've gotten here and elsewhere are a comfort.
posted by OneOliveShort at 11:16 PM on January 27

My husband's relatives are in various stages of decline, and we've been spending more time at bedsides in hospices, hospitals and at home than in the past year than I ever imagined we would.

My only advice to you is that you spend as much time with him as you can. You being there helps. It helps both of you process what's happening, because it helps both of you come to grips with it all. Together. Not alone. He may not know who you are, or have much lucidity right now. That can and often does change. My husband's uncle talked to people who weren't there, and thought I was a charity worker he'd known as a child. After about two weeks of this, he became a lot more lucid and was able to acknowledge his daughter, his brother, his nephews... not razor sharp clarity, but he was able to respond to them as they were. Not long after this last flash of himself had happened, he was gone.

I'm not saying you should hang on for the lucid moment, or beat yourself up if you can't be there 24 hours a day. But be there, as much as you can. Even over a phone, hearing your voice helps him know he's loved and isn't forgotten or alone... you saying what you need to say to him, even if he doesn't quite respond how you'd hope, helps you.

All the best...
posted by Grrlscout at 11:41 PM on January 27

My gut tells me days and not weeks.I don't know if I hope I'm wrong or not, I do know that I am hoping he is not suffering and that you and your family are as okay as can be.
posted by KAS at 9:25 AM on January 28

Well, ladies and gentlemen, whoever had 36 hours has just won our sweepstake.

For the future, for anyone in my position who stumbles upon this thread, pancreatic cancer is a horrible disease, but it's pain manageable. I hated watching him die, but I know that his time wasn't bad. It was quick. It was medicated and he was looked after.

As wasy to die go, it could have been so much worse.

To those of you who commented here - I thank you. You gave me the comfort I needed to get through that night. I just needed to know that he wasn't going to be like that forever.
posted by twine42 at 1:45 PM on January 29