End stages- Pain?


Registered User
Aug 14, 2007
Hi everyone- My mother in law who has had Alzheimer's for the last 18 years seems to be coming to the end of her life. She has been in bed for about for the last year and the nursing staff ensure that she stays on her side so that she doesn't choke on the mucus in her throat/mouth. She is only eating and drinking a little now and only has a little movement. Our concern is that she may be in pain, although there would be no way for her to communicate this. To complicate matters, she is not in the UK and there is no formal dementia/alzheimer's care where she is. Its a $64000000 question but is it likely she will be in pain i.e. from starvation etc? Is there anything we can do as we feel so helpless?
Thanks in anticipation


Registered User
Feb 16, 2009
sadly the end

Hi, It is very hard to watch the end and I can do little more than offer sympathy.

My mother died a few years back from Pneumonia and MID. I suspect that technically dehydration hastened death as no liquid was given in the last couple of days. I do not think starvation is relevant in this situation.

I have heard hospice staff say hearing is the last sense to remain. I believe that the body gradually shuts down at the end of life and I expect that process protects from pain.

Blood pressure might indicate pain but realistically any intervention is likely to cause more distress. Maybe pain relief could be given prophylatically.

Try to recall the happy times

Best wishes Magenta


Registered User
Jan 14, 2010
East Kent

am so sorry to hear about your mum

I do not know if they are available
where your mum lives but worth asking
if they have Butrans Pain patches or
something similar.

they give a low continious dose of
medication through the skin, so are
not invasive.

am sure others will be here soon
with more advice


Registered User
Feb 28, 2005
west mids
I was in a similar situation in may when my mum entered the final stages of her life after 8yrs of AZ.

Mum had been unable to swallow anything other than pureed food and thickened drinks for a couple of months.Following a brain haemhorrhage she became unconscious and an end of life care plan commenced.

The issue of pain was a huge one for me ...in the hospital where I work the philosophy is that it is better to presume someone who cant communicate has pain, and treat it than not to .

Sadly mum was in a different Trust who constsantly assured me that she wasnt in any discomfort , despite developing huge pressure sores.I did get my way in the end and she was started on a syringe driver for pain control.

From the research I have read from the hospice movement I understand that withdrawal of food snd fluids does not cause a person pain but I guess we cant know that for sure.All I can say is that mum died very peacefully and if I was in a similar position again I would ask for exactly the same.

Best wishes xx


Registered User
Jan 30, 2009
Co. Derry
Last moments

I agree with all 3 of above posters - that any intervention may cause pain - you know how you feel when very stiff - there may be that sort of pain, then the suggestion of a light sort of patch - if available - why not - ease the burden of going - which we cannot know about for her but if there is some awareness - then ease it if allowed where she is....but if not - be guided by her face, by lack of any change suggesting distress - I'd prefer the word distress rather than pain - there has been no prior indication of pain - so try to minimise distress by minimising interventions like movement....we cannot know for sure - last poster said - so why not ask for comforting medication...

I'm not sure you are with her - but asking for the simplest of instruction like "I'm here - squeeze my hand" or "Are you OK - squeeze my hand" would be good if possible, followed by "I love you" & if you are not with her - ask for this to be done on your behalf, xxxx