WHAT YOU NEED TO KNOW: What should I know about death and dying? Healthcare providers can recognize signs and symptoms that mean a person may be close to dying. The person and his loved ones can be helped to prepare for and accept death. A dying person may fear being alone, becoming a burden, or having pain. Medicines and other supportive care can help the person feel peaceful during the last part of his life. What are the signs and symptoms that mean the person may be close to dying? - Energy: As a person nears death, his body changes the way it uses energy. He may stop talking or responding, and begin sleeping more. He may also have pain, weakness, or fatigue. He may not want to eat or drink as his body shuts down.
- Body temperature: The person's body may become cool to the touch because of the decreasing blood flow in his body.
- Breathing patterns: Irregular breathing patterns often change as the body stops working. There may be periods of rapid, shallow breathing with longer gaps between breaths.
- Confusion or disorientation: These may be caused by decreased oxygen in the brain, chemical changes in the body, or medicines. The person may start having problems thinking clearly or seem confused.
- Skin color: Poor blood flow to the skin may cause it to look dull, darker, or mottled (blue and blotchy). This may be most noticeable on his hands and feet.
- Coma: This is when the person is not conscious. A coma may last from minutes to hours before death occurs.
What care can be given to a dying person? End-of-life care can help a dying person face his fears of being alone, becoming a burden, or feeling pain. Healthcare providers provide treatment and care according to the wishes, values, and beliefs of the person. Issues such as organ donation and autopsy will be talked about with respect, sensitivity, and concern. The person's family or friends will be prepared for the person's loss, and will be supported as they grieve his loss. - Continued care: Personal care needs, such as bathing and getting dressed, are given. The person's healthcare provider may arrange home care, transportation, rehabilitation, and counseling services to assist the person's needs. The person may also need a hospital bed, wheelchair, or other medical supplies.
- Emotional and psychological care: Counseling and emotional support for the person and those close to the person may be given.
- Social care: Social workers and other healthcare providers can help the person find answers to questions about practical, financial, or other concerns. They can find answers about insurance benefits, palliative care, or hospice services.
- Palliative care: This type of care is mainly to provide comfort to the person while maintaining his dignity. Medicine may help reduce pain, discomfort, or distress. Palliative care helps him feel comfortable until his death. It is usually given to those who have an illness that cannot be cured and that is expected to lead to death.
- Hospice services: Hospice services aim to improve the person's quality of life during his remaining days. Hospice services are usually given to people who may have a short time to live. Some hospices take care of people at any stage of terminal illness. Hospice can also help the person's family or friends through grief services.
- Spiritual and cultural care: Spiritual care is given depending on the person's needs and religious beliefs. Examples are a special ceremony or ritual, memorial services, and funeral arrangements.
What can I do to help a dying person? - Keep the person company: Always be willing to listen to the person, especially if he talks about his life. Do things together, such as watching television and reading books, or just sit with him.
- Make the person comfortable: Help the person manage stress, and be relaxed and comfortable. Work together with people the person can trust to help him get through the hard times.
- Keep the person involved: Many people want to be included in their treatment and care plan. Avoid holding back information that you think the person should not or does not want to hear.
- Be respectful: Respect the person's feelings and need for privacy. Let him express fears and concerns about dying, such as leaving family and friends behind. Reassure him that you will follow and honor his wishes.
- Help the person create an advance directive: Advance directives are spoken or written legal and medical care instructions. They are made by the person in case he becomes unable to decide for himself later. Examples include living wills, organ donation, and CPR attempts. Without advance directives, someone who has permission will make these decisions for the person.
What may happen when death occurs? There is no need to call 911 or a healthcare provider. The following may be done when death occurs: - All the remaining tubes, IV lines, and other equipment will be removed.
- Family members may want clothing that was removed or cut away during resuscitation (reviving) efforts.
- A spiritual counselor may do a religious ritual depending on the person's or his family's wishes.
- Ask if you can spend time with the body.
- If the person or family agreed on organ donation, certain body organs or tissue may be taken for donation.
- The body may be bathed or dressed. The funeral home may be called when the family is ready to have the body moved.
Where can I find support and more information? - Caring Connections
National Hospice and Palliative Care Organization
1731 King Street, Suite 100
Alexandria , VA 22314
Phone: 1- 800 - 658-8898
Web Address: http://www.caringinfo.org
When should I contact the person's healthcare provider? - The person has new signs and symptoms since his last appointment.
- The person has questions or concerns about his condition or care.
When should I seek immediate care? - The person asks you to bring him to his healthcare provider or nearest hospital.
- The person feels like hurting himself or someone else.
- The person feels pain that is not relieved with pain medicines.
- The person feels that he cannot cope with his condition.
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