How can hospice be so certain a person only has two weeks or a month left?

Hospice takes a more 'matter of fact' approach to the signs that end of life is approaching, which you call 'cold'. To hospice, they see this day in and day out. Versus you, who sees this once, twice or three times in your life. To them it's old hat, to you, it's your mother who's dying. I feel your pain, b/c I just went through this very thing with my mother who was on hospice for 2 months and 1 day before she passed away kind of 'unexpectedly' at 95 years old. Which sounds rather idiotic, to say she died 'unexpectedly' at 95, but really, she was laughing and talking to the other residents, and eating her meals, too, the day before she went into her bed, and became semi-comatose,. And then she passed away on the 8th day thereafter, without further ado, it seemed like. She was in no pain, I KNEW that, b/c if she was, her blood pressure would have been very high, she would have been grimacing, and things of that nature, which wasn't happening. That's the signs of pain & struggle; if your mother is not having those signs, then you know the morphine is working and she's not feeling pain.

They are half on the other side and half here, when they're transitioning, is what's happening. I've heard the hospice nurses tell me that twice now, when mom was dying and when dad was dying. We are struggling more than they are, by listening to their breathing and watching their every movement. I remember when my father was transitioning. I was looking at my watch and timing how long it was between breaths.......and I was holding MY breath waiting for him to take his next breath. Needless to say, I was about ready to collapse by the end of his journey myself. When my mom passed in February, I was more familiar with the mechanisms of the end of life journey, so instead of looking at my watch & holding my breath, I was rubbing her arm and speaking to her about how much I loved her and what a great life she'd led instead. I spoke loudly enough to drown out any struggled breathing sounds she was making. I knew that her soul had already transitioned to the other side to be with her family members who had all passed long before her.

I think we daughters know our parents best, which is why we can tell when something about them is 'off' a lot quicker than the staff can in the SNF or the Memory Care. I was practically begging hospice to take mom on before they actually agreed to, b/c I KNEW she was approaching the end of her life, even though hospice insisted she 'wasn't ready' yet in November. Meanwhile, she passed in February, meaning she sure WAS 'ready' in November!! It would behoove the 'experts' to listen to the family members more often than they DO, wouldn't it?

I'm sorry you are going through such a gut wrenching experience with your mom. I know how difficult this truly is, no matter what anyone else has to say on the subject. I also know that your mother will soon be at perfect peace, if she's not already, and for that you can rejoice and know that her suffering here on earth is over. For that I was extremely grateful on behalf of both of my parents; dad who had an aggressive brain tumor, and mom who had advanced dementia, CHF and several cases of pneumonia herself (one of which was aspiration pneumonia).

Sending you a hug & a prayer for peace.

They predict by scientific knowledge for the most part. The breathing you mention has a name and they will explain it to you if you ask. It is called "Cheyne-Stokes breathing" and there are deep breathes, then a period of apnea when the patient isn't breathing, then another deep breath, and in a repeated pattern. Signs a life is in last stages are online if you are interested, including cooling and mottling, discoloration of lower extremities and so on.
Morphine is given to both assist in breathing and to medicate a patient to a level below the level at which we feel pain, even below the level of breathing, so that the bodies seeming struggles for breath and so on are not felt by the patient. That's the blessing of hospice. While hospice medication may mean an earlier death by some minutes, hours, even days, or not can't be known, but there certainly is less struggle for the person.
I am sorry for your loss. No matter the number of year, the amount of a good life, it is still painful to lose those we love and we all grieve differently. Only time can heal our loss and make our memories fond and happy rather than sad.
Continue to speak with Hospice. They are generally very good to answer questions. If they tell you things like "She is transitioning" then ask them to explain to you how they evaluate these things scientifically.
For myself as a nurse I am grateful you have given your Mom this relatively peaceful death; I hope in time you will recognize the great gift this is.
As to how long your Mom can go on like this, that is as individual to her as her own thumbprint is. No one can be certain; we read the signs we have learned and we make "educated guesses" and that doesn't really address grief and loss.
I wish you the best. I feel my Mom and Dad with me throughout my life, and I am 80, still seeing the world through their lives, still celebrating them. Your Mom will be with you always while you live. I know that doesn't address the grief; allow yourself this grief, for a life is worth grieving as it passes. Your Hospice can guide you in seeking grieving support and health ongoing. Their job doesn't end at the end of your Mom's life. They will contact you. Ask them for support.

No one will live long without hydration. Nurses know this, and based on her appearance and urinary output can estimate how dehydrated she is. At some point her kidneys and other systems shut down. This is how they estimate. Mom may know almost to the end that you are there but her thinking won't be clear and her ability to respond will diminish.

Mom isn't suffering, but you are. This is exhausting for her but should not be painful. It's just very hard for her to breathe, much less talk and move. Yes, it is hard to watch but it also gives you the time to talk to her, sing to her (if you are so inclined), confide in her, anything that will give you both peace.

She may also be very worried about leaving you. If you know she can't recover, she might need to be told that you will be OK and she can move on. Even if it isn't true it would be appropriate to tell her if you think this is the case. I had to tell this to Dad, and promise him I would take care of Mom. Then I kissed him goodbye and watched while he slowly took his final breaths.

You're overattentive watching every reaction of your mother, because you don't want her to die, and keep hoping for a "miracle" that will allow her to stay longer with you. You're caught in a turmoil of emotions and can't expect to be objective and realistic. That is understandable and many families go through the same unpleasant experience. Hospice's staff deal with people dying every day, so they have become experienced at that. Like nurses in the delivery room of a hospital, who can predict pretty well when a baby will be born. I'm sorry for your impending loss. Sooner o later it affects everybody. It's something we all have to learn to live with.

Pnemonia of any kind is serious in a person your Moms age. Its one of the 10 top causes of death in the elderly.

"she is not responsive, not eating, taking in very little liquid" this means her body is shutting down. The antibiotics were stopped because once on Hospice no life prolonging medication is given. Hospice is for comfort. Morphine is given for pain and ease of breathing. Aspiration pneumonia is caused by not being able to swallow correctly. The food and liquids go into the lungs causing pneumonia. Not being able to swallow can be a sign of the body shutting down.

Why do you notice these things and no one else seems to...I have no answer to it. Why when my Mom was in the Hospital with a UTI was she sitting up and talking one day and the next she couldn't eat her breakfast because she was out of it, why didn't someone notice that. Why didn't the nurse coming on duty after 2 days off read Moms chart and think "this woman can't be released today because she has done a 180." This nurse actually asked me what I thought she should do and I told her call the doctor and tell him Mom has done a 180 and in no way can be released. It was found Moms antibiotic had penicillin in it she was allergic to which was in the Hospital records.

You Mom is 93, her body is giving out and it is a long process. Mom started shutting down 2 weeks before her death. I suggest you don't sit with her all the time. Get out of the room. Go home to rest. Because...you may go to the bathroom and when u come back they are gone. With my Mom it was bringing my nephew to visit. We sat with her for a while. He held her hand and talked to her. I sang her favorite hymn. We left at 1:30 pm. She was pronounced at 1:50pm. Nurse asked if nephew was the last one to say goodbye, I said yes. She said she sees it all the time, they wait for that one person that hasn't said goodbye and when they get there or hear their voice, they pass.

Take this time to tell Mom you love her and you appreciate everything she did for you. Tell her is allright to let go, you will be fine. If she has faith in the hereafter, tell her she is going to a better place.

As a nurse & caregiver, once your LO stops taking in food/fluids it's just a matter of time. Some of the signs we for are their level of consciousness, vital signs, urine output, & the beginning of agonal breathing (abnormal, irregular, gasping, labored breathing). The time frame depends on individual's health, it could be a few days to 2weeks. If on meds for diabetes, heart conditions, respiratory issues, the time is less because it caused earlier complications. Hospice will visit & provide you with meds (unless in a facility) in order to provide comfort, drying of secretions, & personal care to your LO. During this time, spend time with LO telling them that you love them, etc. as they may still hear you. Have family come to say their goodbyes. Spend time going down memory lane about your LO. This provides comfort to everyone. It will take time to deal with grief. Speak with family, friends, counselors, grief support group, pastors/priests, rabbis as needed. It doesn't go away, but you learn how to make it part of your life. I miss my parents and the recent loss of my nephew so much; they hold a special place in my heart. I was with all three in the time leading up to & at the death of my mom. Very difficult, but I'm no longer dealing with the severe grief that I felt at the time of their death. 🙏🙏❤️

If she is not breathing sometimes that is often a sign death is imminent. I’ve watched 3 of my loved ones die in hospice and death can be a struggle. It doesn’t always happen so fast. The hospice people have seen it so much they know the signs to look for. Usually they give you a lot of written information on what to expect so you can be prepared. I think once they have lost consciousness their suffering is minimal. And hospice is all about making them as comfortable as possible with the use of drugs. Sorry you are having to experience this. I found going through this with my loved ones actually helped me to be more prepared for my own death someday and fear it less. Also, please seek grief counseling or attend meetings such as GriefShare. It’s very helpful.

I, too, am horrified that we show so much mercy to putting our pets down when they have no quality of life and yet, we do very little to show mercy to humans. I have looked into the "Death with Dignity" program and feel it will be the appropriate solution for me. I watched my mother die of lung cancer and my best friend die of esophageal cancer. No thanks, that stuff is not for me.

Once she stops eating and drinking, if she is not getting nutrition and hydration any other way (like through an IV or feeding tube), she will go.

The medical professionals are not always right, but are speaking based on statistics and their experiences.

The morphine will keep her comfortable physiologically and emotionally.

i am sorry for your pain. Stay near her if you can. Talk to her while you can. Even if she is not fully aware, you will be glad that you were nearby.

Hospice is not alarmed by interrupted breathing or lack of response b/c this is part of the dying process. They will not be alarmed when she stops breathing completely. Dying becomes very real when you are watching it happen. It is distressing but it not something to be "fixed."