End-of-life care (5)
- Hospice care: An option when confronting terminal illness
- Terminal illness: Interacting with a terminally ill loved one
- End of life: Caring for your dying loved one
- see all in End-of-life care
Grief (8)
- Grief: Coping with reminders after a loss
- Grief: A Mayo Clinic doctor confronts painful emotions
- Survivors of suicide: Healing after a loved one's suicide
- see all in Grief
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End of life: Caring for your dying loved one
Recognizing when death is near
It's difficult to predict exactly when someone will die. However, in the weeks before death, your loved one may show various signs and symptoms indicating that the end of life is near. Look for:
- Restlessness and agitation. Your loved one may insist on frequently changing positions.
- Withdrawal. Your loved one may no longer want to participate in social events or other favorite activities.
- Drowsiness. Your loved one may spend most of his or her time asleep.
- Loss of appetite. Your loved one may eat and drink less than usual.
- Pauses in breathing. This may happen when your loved one is asleep or awake.
- Difficulty healing. Wounds and infections may not heal.
- Swelling. This may happen in the hands, feet or other areas of the body.
When awake, your loved one may also begin to settle unfinished business or talk about seeing or feeling the presence of loved ones who have died. Your loved one may even say that he or she feels death is near.
Providing comfort
The active phase of dying usually begins several days before death. Signs may include changes in skin color, noisy or irregular breathing, inability to eat and drink, and limited ability to communicate. Although you can't change what's happening to your loved one, you can help him or her feel as comfortable as possible.
| If your loved one: | Try these comfort measures: |
|---|---|
| Is no longer eating or drinking | Keep your loved one's mouth moist with a sponge. Apply lip balm or petroleum jelly to his or her lips. |
| Has labored breathing | Turn your loved one's head to the side. Place pillows beneath your loved one's head, or try different sitting positions. Ice chips, oxygen and a cool-mist humidifier also may help. Ask your loved one's doctor about medications to ease breathing or to relieve feelings of breathlessness. |
| Has incontinence | Use incontinence pads or a catheter to keep your loved one dry and clean. |
| Has blurred vision | Use soft lights. |
| Can't speak | Talk to your loved one in a soothing voice. Hold his or her hand. |
| Is agitated or confused | Be calm and reassuring. Create a quiet and peaceful atmosphere. Limit the number of people in the room, and repeat their names often. |
| Seems to be in pain | Ask the medical team to adjust your loved one's medication or treatment plan. |
Your loved one also may experience a brief, final surge of energy. Though it can be confusing to see your loved one with renewed vitality, remember that this is a normal part of dying. Take advantage of the opportunity to enjoy him or her and say your final goodbyes.
Keeping vigil
For many families, keeping vigil near a dying loved one's bed is a way to show support and love. If you decide to keep vigil, continue talking to your loved one. If you think your loved one would want to share this time with others, invite family members or close friends to show their support as well. Express your love, but also let your loved one know that it's all right to let go.
Previous page(2 of 2)
- End-of-life care: Questions and answers. National Cancer Institute. http://www.cancer.gov/cancertopics/factsheet/Support/end-of-life-care. Accessed Dec. 5, 2008.
- Signs and symptoms of approaching death. Hospice Patients Alliance. http://www.hospicepatients.org/hospic60.html. Accessed Dec. 5, 2008.
- Last days of life: Overview. National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/supportivecare/lasthours/patient. Dec. 5, 2008.
- When someone you love has advanced cancer: Support for caregivers. National Cancer Institute. http://www.cancer.gov/cancertopics/When-Someone-You-Love-Has-Advanced-Cancer/page3. Accessed Dec. 5, 2008.
- End of life issues. Centers for Disease Control and Prevention. http://www.cdc.gov/aging/EOL.htm. Accessed Dec. 8, 2008.
- Moneymaker KA. Understanding the dying process: Transition during final days to hours. Journal of Palliative Medicine. 2005;8:1079.
- Heyland DK, et al. What matters most in end-of-life care: Perceptions of seriously ill patients and their family members. Canadian Medical Association Journal. 2006;174(5).
- Leaving a legacy. American Society of Clinical Oncology. http://www.asco.org/Patient/Library/Cancer.Net+Features/Leaving+a+Legacy. Accessed Jan. 7, 2009.
