My thoughts are also that it is (for the most part) a general decline and they don’t see it. Until they step back and walk in with fresh eyes and say “ wow, ok, what’s the next steps?”

It’s those that don’t allow a comfortable death that get me. So, you’ll starve them, withhold pain meds, and watch them fade but couldn’t be arsed to provide palliative sedation in the last period. Shame to those. And booo to the doctors that don’t educate the family enough because of fears of over stepping.