We’ve recently walked through hospice care for end of life expectations for seniors. The Hospice facility that we used provided booklets to let us know what to expect over the course. The booklet is highly copyrighted… so I’m not going to attempt to share their information, but AI provides it all anyways. I just never knew to look it up. I think it is important to know these things if you are dealing with aging parents.

So here is what AI says and it goes along with the booklet.

Months prior to Passing

• Decreased appetite and thirst (weight loss and potential for dehydration)
• Sleeps more
• Withdraws socially
• Pain and nausea may intensify
• Risk of infections like pneumonia and urinary tract infections occur

Weeks prior to Passing

• Increased sleepiness and hard to arouse
• Loss of appetite (May stop eating and drinking altogether as the gut slows down)
• Restlessness and agitation, confusion and anxiety (picking at bed sheets and agitated hand movements are normal)
• Increased congestion
• Irregular heart rate, blood pressure changes, may run a temperature (due to the brain’s inability to regulate the center for body temperature control)
• Skin changes (mottled extremities, pale, purplish colors)
• Hallucinations or visions

Days or hours prior to Passing

• Possible surge of Energy
• Unresponsiveness and difficult to awaken
• Erratic Breathing
• Cold hands and feet
• Weak pulse
• Glassy or teary eyes (eyes partially open)
• Waxy looking skin… may see yellowing of skin (also, blue tint to lips and around mouth)

As a family member unsure of how to react to all of this, we were reassured that our mom could still hear us when we talked to her. She could feel us when we held her hand, or touched her arm. She could feel our presence, even when we were quiet. The hospice team does all of their care at this point, which is a relief. Most people don’t know what care needs to be done.

In our case, and most cases:

• Pain medication is given on a routine basis every 4 hours and more often if needed. They judge the level of pain in a non-communicating person by grimaces and leg or arm movements or resistance.
• Mouth care, baths, hair care, and keeping patients clean and dry are done on a regular basis throughout the day. Baths are used to bring high temperatures down naturally, or they remove bed covers as needed.
• Chaplains come by for family and patient support… emotional, spiritual, and just to see if you need anything… snacks and access to beverages are provided.
• Our facility had pet therapy… which cheered us all up as we watched the dog (Penny) interact with her owner and our mom.
• Our facility had volunteers that played instruments softly in the hallways.
• Fresh flowers were kept and changed in the room frequently, and throughout the facility.
• The landscaping around the facility was peaceful and had walking paths with blooming trees, flowers, water falls, and Koi pond. The last two days, I brought my lunch and ate in the garden just outside our mom’s room.

Everyone’s experience will be different because the Lord has made us all so very intricately designed and very individual. These are just a few guidelines to help along the way. We are grateful for all the support our mom and all our family received during this time.

In Memory of:

Carol Gray Rumple Hartman

December 15, 1934 to July 27, 2025

“And now, dear brothers and sisters, we want you to know what will happen to the believers who have died so you will not grieve like people who have no hope. For since we believe that Jesus died and was raised to life again, we also believe that when Jesus returns, God will bring back with Him the believers who have died.” 1 Thessalonians 4:13-14 (NLT)