End of Life Management in Terminal Illness Cases

When someone you love has been diagnosed with a terminal illness, anticipating next steps can be difficult. While each person is different, and many factors influence the dying process, certain  indicators are common in the weeks, days and hours leading up to death.

Knowing what to expect – and what you can do to help – can ease your worries as you navigate this difficult time. But more importantly than anything, just being present with your loved is often the most valuable action you can take.

End-of-Life Signs

Each person’s end-of-life experience is unique, as it is influenced by such factors as the specific illness, medications being taken, and the person’s overall health. In some cases, these changes may occur over a period of weeks; for others, the process lasts just a few days or hours.

However, a number of end-of-life changes are fairly common, as a person’s bodily functions naturally slow and stop. The following changes are often signs of this process, though not every patient exhibits all of these end-of-life signs.

  • Less interest in eating or drinking. The person may only need enough liquid to keep their mouth from becoming too dry.
  • Not passing fluids regularly. As bodily functions decline and the person eats and drinks less, their output of fluids will also decrease.
  • Speaking and moving less. Activity usually decreases significantly in one’s final days and hours. People may not respond to questions and show little interest in their surroundings.
  • Difficulty communicating. Vision and hearing may become impaired, and speech may be hard to understand. Lack of oxygen reaching the brain (due to decreased circulation or other causes) may contribute to these changes.
  • Restlessness or combativeness. Your loved one may pull on bed linens or clothing, hallucinate, or even try to get out of bed, due to less oxygen reaching their brain. Repetitive, restless movements may also indicate something is unresolved or unfinished in the person’s mind.
  • Becoming very cold, then hot; developing a bluish skin tone. As the end draws near, the body loses its ability to control its temperature. In addition, blood pressure gradually falls, and less blood flows to the hands and feet. Arms and legs become cold and bluish in color as circulation slows. The underside of the body may darken, and it may become impossible to find a pulse at the wrist.
  • Becoming unresponsive or lapsing into a coma. Dying affects the central nervous system, so your relative may sometimes be fully awake, and at other times be unresponsive. Before death, people will often slip into a coma – a deep state of unconsciousness. Even in a coma, though, your loved one may be able to hear sounds and feel something painful.
  • Loss of bodily functions. This may occur around the moment of death, or sooner in patients with incontinence.

Emotional and spiritual end-of-life changes

In addition to physical differences, many people go through emotional and spiritual changes near the end of life. These can include:

  • Giving away belongings and planning their funeral. Some people want to play an active role in distributing their property or making decisions about their final arrangements.
  • Withdrawing. The person may seem detached, unresponsive, or comatose. However, they can usually still hear you and be aware of your presence.
  • Making uncharacteristic statements. Your loved one may say things that seem out of character, or even rude. They may be testing whether you’re ready to let them go. They may only want to be with one person or a select few.

Changes at the time of death

People sometimes think that the moment of death will be dramatic, difficult or painful. That is not usually the case, especially when a person dies while receiving hospice care. Hospice providers work to alleviate patients’ pain and discomfort.

In fact, the signs of death are often subtle. It may take a few minutes to realize the person has died, rather than just being asleep or unresponsive.

What to Do When Death Occurs:

If the patient is receiving hospice care at home, call the hospice organization. Do not call 911 or any other local emergency number. The hospice nurse will help you with any calls to the physician and funeral home of your choice.

Unity First aims at providing the most accessible, caring, and compassionate hospice and palliative care available. We serve those in the Southern California region, and cater to our client’s exact requirements in their time of need. Call us to figure out how we can help you.

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