How does a doctor estimate how much time is left

Factual Questions
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for a terminally ill patient?

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Two main themes:

  1. What is patient’s functional status - are they bedridden, are they eating much, drinking much. Depending on the answers to these, death can occur quite soon even in a patient without a terminal illness

  2. Statistics and experience - we know from experience, for example, that someone whose liver is full of cancer and is not working properly as a result, will die in days to weeks (cf. a liver full of cancer where it’s still working well, in which case death may be months or even years down the line). Likewise, someone who is taking nothing by mouth and whose family requests no IV fluids, will usually die in a week at most, usually sooner.

For people who are really, really close to the end, you can sometimes get an idea by the way their breathing sounds (“death rattles” etc). Also, if their knees and legs are cold, it suggests that the circulation is starting to shut down. Death will occur in hours.

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Truth is sometimes they can’t.

When my MIL was dying in my home, she exhibited all the symptoms listed by KaulGauss. And the professionals universally kept telling us, “It won’t be long now.” But I listened to that ‘death rattle’ breathing for 10 full weeks. That’s very long time, believe me.

Of course, they were all very surprised she was still breathing every time they saw her during that time. I found comfort in telling myself she wasn’t ready just yet, and that when the perfect moment arrived she’d recognize it and seize it. And, I suppose, that’s what eventually happened.

They don’t have ESP, they just make calculated guesses based on previous experience. But each case is truly individual.

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At least half the time they get it wrong, it seems. And everyone who outlives a doctor’s prediction is inevitably (but understandably) smug about it. “The doctors said I wouldn’t live another two weeks, but here I am!”