There are doctor or palliative-care team can assess whether the changes represent disease progression or something potentially treatable, such as an infection, dehydration, medication effect, or some changes that can occur during the final year of life, particularly in someone who has advanced frailty or a serious progressive illness. But these signs cannot reliably predict that someone has only one year left. Many can also occur with treatable problems.
Five changes clinicians may watch for
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Increasing weakness and frailty — needing progressively more help with walking, bathing, dressing, or other daily activities.
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Reduced appetite and unintentional weight loss — eating and drinking less over time.
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Spending more time sleeping or resting — with less energy for normal activities.
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Increasing dependence — previously manageable daily tasks become difficult or impossible.
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Repeated infections, hospitalizations, or complications from an existing serious illness.
These signs are most meaningful when several occur together in someone who already has an advanced, life-limiting illness. They aren’t a countdown clock.
Changes much closer to the end of life
In the last days or hours, a person may become increasingly drowsy or unresponsive, have very little interest in food or fluids, produce much less urine, and develop irregular breathing or cool/mottled hands and feet.
If an older person’s condition is changing, a doctor or palliative-care team can assess whether the changes represent disease progression or something potentially treatable, such as an infection, dehydration, medication effect, or depression.
If you’re concerned about someone specific, tell me their age, medical condition, and what changes you’ve noticed, and I can explain what they might mean.
