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My fil’s doctors in icu told us fil wouldnt be eating, drinking or speaking anymore. That he would barely be conscious after his third stroke.
Imagine our surprise on his first day home from hospital on hospice when he consumed two puréed meals, had a bowel movement, hugged his out of town brother and made jokes. Thats all stuff he wasn’t doing in the hospital.
It looked so much like real improvement.
The next day he was noninteractive. He died that night. It’s coming up on a month.

I have read that these rallies happen in a third of cases but have not seen it discussed here yet. So, if you had a loved one on hospice, did you experience anything like this?

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My mother had a couple of rallies on hospice. When she was discharged from the hospital on hospice after an acute kidney injury from antibiotics, pneumonia, and a bone infection in her spine, she was barely responsive. Had failed a swallow test. She'd also been diagnosed with a sudden unmasking of end stage dementia. When she arrived at the nursing home by ambulance late in the evening, she was more alert. The next day, alert, speaking gibberish, but eating a bit of puree food. By the next day she was dangerously mobile and agitated. She spent weeks with hospice trying to find a balance with her comfort meds, because if she was alert she was getting out of bed, had several falls, hit her head and needed stitches. She worked her way around all of the hospice strategies to keep her safe, such as a mattress with raised sides. One day a coupe weeks later, I arrived in her room to find her very different. Very much asleep, the 'death rattle" audible. The weekend floor nurse, who was not experienced with hospice, did not understand that this was a big change for her. I asked her to call hospice. They came and found her o2 sat to be 76 percent, confirmed I was hearing the rattle, and asked me what funeral home we were going to use.

Because she'd been so agitated, we had not brought her dog. He'd been a focus of her agitation in the earlier part of her post first hospital rehab stay, when she could still talk. I felt at this point it was safe to bring him to visit. It was so weird. We got the dog on her bed, and she made a lot of unintelligible noises and seemed more awake, though her eyes still could not focus on us or the dog. She made one real attempt to pet him. By the next day, she was back to agitated and climbing out of bed, tearing her clothes off, etc. She lived another TWELVE days after this.
And her actual passing was so not eventful. I stayed a couple of hours on Thursday afternoon, again trying to keep her in bed and safe. She called my name and told me to 'come sit,' the first time she'd said my name in weeks.

Friday I did not go, as sometimes my presence agitated her more. Hospice nurse reported to me she was "pleasantly confused," and had been fed 40 percent of her lunch. I got a call at 3 am Saturday where they stated she had "transitioned." I had to ask what the meant, I thought maybe they meant transitioned to active dying. No, they meant passed on. The floor nurse said she'd been asleep all evening with no meds on board, again, a big change for her. I was not close to mother, had been drug through literal hell in the final two plus years with her. So I am not sure how I feel about not being there when she passed. I'd told her the day she had the death rattle not to worry, things were ok between us, and that I'd take care of her dog. It was all I could muster.
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Reply to Oedgar23
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My father got kicked out of in house hospice at a hospital because he improved. Mom didn’t want strangers in the house to do in home hospice .( The hospital hospice he had been in was only for those expected to die within days. ) He ended up going to rehab where he rallied somewhat for about a month .
Rehab had gotten extended , but then he started to get weaker again and could not eat . He then went to the SNF upstairs on comfort care rather then hospice because he hadn’t used his 100 days up yet . Mom didn’t want to pay the nursing home bill for his room which would have happened if he went on hospice . Although Medicare coverage declines over the one hundred days , Dads insurance picked up the difference . Again this would not have been the case if he had gone on hospice . Dad died before the 100 days was up , so Mom never had to start paying private for his room ..

He had another rally 2-3 days before he died . He went from confused , sleeping all the time to being alert , oriented and ate 2 big meals . Then he slipped into a coma for 2 days before he died .,

Dad had been waiting for my brother to finally come to see him . He was alert and rallied the two days brother was here .
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Reply to waytomisery
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I had a similar episode with a family member -- an unexpectedly cheerful day with extended family, prior to passing away the next day. It's a very special memory for those of us who were there, like a final gift.
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Reply to MG8522
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Sometimes it expresses as sudden agitation. Happened with my cousin and he was gone the next morning. Happened with my brother, though his final stage stretched out 3 agonizing days he was non-verbal and bed bound from that point of extreme agitation.
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Reply to ShirleyDot
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Wow, so even nursing home workers can be fooled. I now feel less bad about being fooled by the parodoxical sign of sudden “improvement” portending imminent death.
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Reply to PeggySue2020
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My mom wasn't formally deemed to be palliative but she definitely had a rally. I arrived at the nursing home to be told she had been "talking up a storm" when she had been mostly non verbal by then, I was called that very night to ask whether I wanted to send her to the hospital. In retrospect it was clear she had been nearing the end, and it kind of ticks me off that not one staff member gave me a heads up. The RN on duty the next day even expressed surprise at her "sudden" decline🙄
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Reply to cwillie
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