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Recognising dying — DGM MCQ

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HardEnd-of-life careRecognising dyingDGM

An 90-year-old man with advanced dementia has stopped eating, is bedbound and has Cheyne-Stokes breathing. He is less responsive, has mottled feet and urine output has fallen. Observations show no single reversible focus. What is the most likely diagnosis?

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Correct answer: E — Last days of life

Reduced consciousness, poor intake, mottling, altered breathing and falling urine output in advanced illness suggest the last days of life. Dehydration may coexist, but the global pattern is one of dying rather than an isolated fluid problem. Recognising dying enables appropriate communication and comfort-focused care.

Reference: NICE NG31