In my work I have followed the process of maybe a hundred people dying of various things that we in everyday language sort of collectively call “dying of old age”. Usually there’s a couple of serious conditions underlying, and a general physical frailty. This is anecdotal, but my experience is that people make a conscious effort to get up in the morning and eat food and move around in the ways they can, until they enter a downward spiral where they for example eat less than they should, which means they get tired, they then stay more in bed, leading to less eating, etc. Something relatively minor like a cold, an aching tooth, a fall, a UTI, etc, can accelerate this quickly. Until they have shorter time awake and more time drifting in and out of consciousness, if they are in pain they will get something for the pain, which usually makes them even less responsive. Then eventually the body starts shutting down, they stop urinating etc, and some days later they die.
In this overall process, there’s a time when making an effort to eat and to be active will prolong life, but it seems so easy for them to just… let go, and soon they will be dead. We (the patient + the health care team) usually talk about this at least once, to know what their wishes are. What surprised me in the beginning was that most old people I’ve talked to say that they are done, so for example if the heart stops they don’t want attempts to save them.
All this together, I think old frail people can “hang in there” for a while if they feel motivated, but of course anything can happen at any time anyways.
That matches my experience. My great aunt lost her husband 15 years ago, but kept going strong and relatively healthy up until 92, then her last sister died (quite unexpectedly) and her health started visibly deteriorating.
After a long hospitalization she got back home, but couldn’t walk anymore. We were prepared to a long recovery, but after some promising days, as you said, she ate and talked less every day that passed, at one point she actively refused to eat and drink and just laid in bad. The last day or two she made noises and laments, but was basically unresponsive, with audible stops in breathing that increased as time got along. The only moments of lucidity were when she needed to go to the bathroom (absolutely physically unable to). We believed it was mostly for pride over wearing diapers and to have a last glimpse on independance.
Then she died and we all agreed at some point she just refused to live on, too old and too alone to handle the world. I wonder how much was a concious decision and how much a simple reduction in self preservation (maybe an automatic response of the body when getting to a real old age? I don’t know).
Anyway, our biggest relief was that we could bring her home, so she died in peace surrounded by family.
In my work I have followed the process of maybe a hundred people dying of various things that we in everyday language sort of collectively call “dying of old age”. Usually there’s a couple of serious conditions underlying, and a general physical frailty. This is anecdotal, but my experience is that people make a conscious effort to get up in the morning and eat food and move around in the ways they can, until they enter a downward spiral where they for example eat less than they should, which means they get tired, they then stay more in bed, leading to less eating, etc. Something relatively minor like a cold, an aching tooth, a fall, a UTI, etc, can accelerate this quickly. Until they have shorter time awake and more time drifting in and out of consciousness, if they are in pain they will get something for the pain, which usually makes them even less responsive. Then eventually the body starts shutting down, they stop urinating etc, and some days later they die.
In this overall process, there’s a time when making an effort to eat and to be active will prolong life, but it seems so easy for them to just… let go, and soon they will be dead. We (the patient + the health care team) usually talk about this at least once, to know what their wishes are. What surprised me in the beginning was that most old people I’ve talked to say that they are done, so for example if the heart stops they don’t want attempts to save them.
All this together, I think old frail people can “hang in there” for a while if they feel motivated, but of course anything can happen at any time anyways.
That matches my experience. My great aunt lost her husband 15 years ago, but kept going strong and relatively healthy up until 92, then her last sister died (quite unexpectedly) and her health started visibly deteriorating.
After a long hospitalization she got back home, but couldn’t walk anymore. We were prepared to a long recovery, but after some promising days, as you said, she ate and talked less every day that passed, at one point she actively refused to eat and drink and just laid in bad. The last day or two she made noises and laments, but was basically unresponsive, with audible stops in breathing that increased as time got along. The only moments of lucidity were when she needed to go to the bathroom (absolutely physically unable to). We believed it was mostly for pride over wearing diapers and to have a last glimpse on independance.
Then she died and we all agreed at some point she just refused to live on, too old and too alone to handle the world. I wonder how much was a concious decision and how much a simple reduction in self preservation (maybe an automatic response of the body when getting to a real old age? I don’t know).
Anyway, our biggest relief was that we could bring her home, so she died in peace surrounded by family.