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My loved one is 90 years old, has dementia, diabetes, and has been sleeping a lot (~20 hours a day). Lately however, she seems to fluctuate between good days and bad days. On the good days, she is in good spirits, seems relatively energetic, can walk around a bit with her walker and speak to us. On the bad days, her speech is slurred, her response slow, her energy low, and can barely move around. Is this normal that elderly people may experience this fluctuation in overall energy and behavior? Is this a sign of something else? It is as if it is night and day and we are puzzled at this.

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yes, this normal. in the bad days, probably she feels pains and discomfort, which is totally normal at her age,
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I saw this in my mom as well. But it went on for three and a half years. Some days, we would talk (clearly) about her childhood, and the next day she was hallucinating about men coming through a secret panel in the wall into her room and kids riding bikes down the hallway. I have to say that because your mom is like this doesn't mean death is around the corner, necessarily. Enjoy the good days, and be patient with the rough days. Hugs!
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Seven days before my mo passed she woke up 3 times in the night and walked around the room. She hadn't walked in weeks. The following morning she was bedridden again and never recovered. The nurse said many people get a burst of energy and this is normal. We were all hopeful but it was not to be. I loved her dearly.
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I read alot on hospice and the stages. There can be a rally but that rally can be anywhere from the day of death, days before, weeks befored. Nothing is for sure. I'm dealing with this too. I thought my mom was going to pass this weekend and then yesterday and today she's up alert eating (a little and with diarrhea), bossing me around .
like her normal self It is an emotionally exhausting ride. I have no answers unfortunately.
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When my husband passed away from Leukemia at 48yrs old, Hospice had given
me a book. It's not a lot of reading and I'm not sure it relates to dying from
old age, but I recommend it. It's called Gone From My Sight The
Dying Experience by Barbarba Karnes, RN. I now have my 90yr old mom living
with me. The doctor says she's in perfect health, other than her legs hurting
her and is slow walking. Her blood and organ functions are excellent. And
her stubbornness gets stronger each day! :)
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My daughter, RN, worked in nursing homes for 20yrs. She has said that she had patients who were not eating laying there just waitingvto die. Then one day they r sitting up in bed and eating a good meal. She says when that happens, theycr gone in the next few days. Its their last hurray.
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Is the fluctuation in your loved one's physical and mental abilities happening at the same time as her blood sugar levels are fluctuating???
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My mother has vascular dementia following a massive stroke in July 2014, late-stage according to the doctor at the crisis center. She will be 91 next week. Her condition has been going downhill in distinct steps. There was a step down in Sept and Dec 2016. She has times when she seems pretty good and also bad times. She expects her mother to come every evening. Then she says she wants to go home. I think she expects her mother to come and take her home. She needs assistance with everything she does. She can't sit up or stand up and walk by herself. One day about 3 weeks ago I was working in the kitchen. I looked to the bedroom to see if she was okay and she was out of bed and walked about 10 feet without her walker and was standing by the doorway. Normally she would have fallen over in that situation. I rushed to put my arms around her and help her back to bed. It is just strange that she was able to do that when she has no ambulatory abilities otherwise. I don't know if this is indicative of anything. She seems worse(more confused) since then. I just cope day to day.
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It can definitely happen. It's almost as if, knowing they are about to die, their subconscious wills them to have at least one good day before they are gone.

I had an aunt who collapsed suddenly at home due to a brain aneurysm in the specific part of her brain that controls wake/sleep behavior. The result was absolute unconsciousness - for months. Surgery, therapy, medications - all had no effect on her condition. On December 24th, the nursing home called her husband and children with an urgent message - she was sitting up, eating, drinking coffee, laughing and asking to see them! She seemed almost completely normal, and enjoyed the whole day with her family. Late that night, she fell back into her sleep state and passed away the next day - Christmas day.

There are so many things we don't understand beyond the physicality of death - this is definitely one of them.
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Yes, absolutely, but it's faux. Call it the "last hurrah" if you will. It tricks the caregiver or family member, but it won't last.
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The first 6 months my husband was on hospice care, we all thought he was going any moment. I think he thought so, too, as he talked often about dying/leaving. This past 6 months, he's had good days and bad days, often up walking around, always eating voraciously, sometimes talking. I don't know what to think any more. Just go with the flow.
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