Hospice Care/bowel shut down


My boy friends mother went into the hospital for a bowel obstruction. She is 90 yrs old. they did find a kink in the bowel when they did surgery. The main problem now is they can't get the bowel to work again. this was over 2 wks ago. They keep running tests that are very uncomfortable for her. She hasn't had any food in all this time and they stopped fluids because they aren't getting anything back out. I fear that this may be the natural process of her body shutting down and they are all in denial about it. It may be time for them to just make her as comfortable as possible. How long can someone stay in this condition.

Hello Jean

I am so sorry to hear about your boyfriends mom.  Often times when a person that age undergoes surgery they don't wake up the same.  The older body just doesn't seem to tolerate and heal like a younger one.  Its unfortunate that the surgeon didn't explain the potential complications before the surgery and she may have not elected to go through with it.  The bowel is especially tricky even in healthy adults.  It always has a difficult time waking up after being shut down by surgery.  The anesthesia and pain medications given during all surgical procedures basically puts the bowel to sleep.  In her case it seems like its just not able to wake up and function.  It is unlikely after this amount of time that it will ever function properly again.  I don't think her body is shutting down naturally as part of the dying process.  The surgery is what caused the initial shut down.  The problem now is dealing with the damage that has already been done.  Eventually her systems are going to shut down as part of the dying process because and essential part of the body's life force is no longer functioning properly.  My guess is that if she is in the hospital they will try to convince her the undergo more surgery like a colostomy and feeding tube.  This may extend her life for a short period but I question the quality of life she will have if she even survives the surgery.  If it were my loved one I would be thinking about how to make her comfortable for the remainder of time she has left.  
Her bowel is NOT going to wake up ever no matter what they tell you that I can assure you.  Its important for you to know and try to help your boyfriend understand that dehydration and starvation although they both sound awful are not painful and are a very natural way to die.  The body moves into a natural process of shutting down when food and fluids are withheld.  Endorphins are released and it makes the process relatively pain free. As a result organs and metabolism start to slow and eventually stop.  If you give the body artificial food or fluids in an attempt to comfort them it does just to opposite.  The failing heart can't respond or process the extra fluids so it signals the blood vessels to divert fluid to the path of least resistance the lungs.  Fluid in the lungs is very uncomfortable and an awful way to die.  Essentially the person drowns and it sounds like they are drowning as well.  In her case food is not going to be tolerated.  If you think of the body like a sink.  What goes down the sink eventually drains from the other side.  If the sink gets clogged it eventually backs up and overflows.  The body does the same thing and in her case the food, stomach contents and even fecal matter will back up into her throat and mouth you get the idea.  It is a terrible thing to watch and experience.
I think I took the long way around answering your question.  Its hard to give you a timeline because I don't know how healthy she was prior to her surgery, if she is on a ventilator now, if she is bed bound but given her age and present condition if all food and fluids including IV are withheld she will live anywhere from 4-7 days.  If they continue IV fluids or TPN and give her a means to excrete waste (stool) like a colostomy bag she could live for months but again quality of life is an issue.  There are a lot of complications that come with artificial feedings.  Continued IV fluids or TPN without a means to excrete waste would be an awful and painful existence for her a person generally usually only makes it through 1-2 weeks but I guarantee she will not die peacefully.  
When a person is about 1-3 days from death you often see a marbled look to their hands and feet, swelling in the feet, moist rattled breathing, cracked lips, periods of apnea, unresponsive to touch, agitation picking at the covers.  Apnea is gaps in the breathing pattern.  It can last 3-5 seconds sometimes more.  They just stop breathing and seconds later they resume regular breaths as death gets closer the period between breaths is longer and longer.  
I hope I was able to answer your questions and offer you some comfort.  If you have a hospice agency that is close to you call them and ask if they will give you a free copy of Gone From My Sight.  Most agencies would be happy to provide you with a copy.  It takes about 15 minutes to read and it will help you and especially your boyfriend understand what to expect.  There is also a book called Hard Choices if you can get a copy of that.  Chapter 7 talks about dehydration and starvation.  I recommend that book for the family members that make her medical decisions if you can get them to read it then they can make an informed decision.  
I wish you and your family the best.  

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Sydney Humphrey


I can answer, provide information, recommend resources or offer examples relating to the majority of hospice, end of life care, death and dying, pain management and palliative care questions. My role in this forum is to provide help to others in the form of information and education.


My love for hospice started when I was honored with an opportunity to become a volunteer at age 15. My assignments varied from sitting with patients to house cleaning. Within six months I decided hospice was always going to be part of my life. I continued to volunteer while acquiring my Certified Nursing Assistant credentials. Once licensed I then began to work as a CNA for the same hospice agency. I applied to Nursing school with the intent on becoming a hospice nurse. During school I worked as a CNA and continued to volunteer. Upon graduation I secured a position as a Hospice Case Manager immediately. I loved that job and am proud to say I have had the honor of sharing the journey to a peaceful death with over 100 patients and their families. It has made me a better person in every way possible. I eventually moved up the career ladder and starting from the bottom in this industry has given me a unique perspective and allows me to have a higher level of understanding and compassion. I am now an Executive Administrator for a large hospice agency and incredibly happy with my career choice and current position but I do miss the hands on care that was such a big part of my life. As an Administrator I am able to mentor nurses that are new to the field and have watched awareness and respect for this industry grow and thrive.

National Hospice and Palliative Care Organization Utah Nurses Association

I am a Certified Hospice and Paliative Care Nurse. I am certified to provide continuing education courses for health care professionals.

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