FINAL DAYS
25
Death is a process of physical, emotional, social, and spiritual changes. The end-of-life may approach rapidly or gradually over many days. Each person is unique and the transition towards death is often reflects the person’s life and personality. The goal is to honor and respect these changes, and to comfort and support all of you through this process. Four Seasons values life and does not hasten nor prolong the natural process of dying. Physical signs of approaching death: • Increasing sleep, though night and day sleep may switch; eventual inability to wake up. • Increasing weakness, more time resting in bed or in a comfortable chair. • Time and usual routines become less important. • Withdrawal from activities such as visiting with people or watching TV. • Decreased eating and drinking; eventual inability to swallow. • Slower or irregular breathing with pauses between breaths (apnea). • Skin may be cool, become grey-blue, or be splotchy (mottled). • Skin may be very warm often due to low or high-grade fevers not caused by infection. • No control of emptying bowels or bladder. • Decrease in amounts of urine and urine that is dark in color. • A relaxed face and forehead suggests that the patient is comfortable. Frowning or grimacing sug - gest they are having some type of discomfort. • Limited or no swallowing, causing drooling or noisy breathing because of pooled saliva in the back of the throat mouth/throat. • Visions, often of people who have died, are common and can be comforting to the patient • Restlessness or agitation, such as reaching into the air, picking at blankets or trying to climb out of bed. How you can help: • Create a quiet, peaceful, private area. • Limit visitors or lengths of visits if the patient seems agitated. • Continue to offer words of love, support, care, forgiveness, and encouragement that the family will be sad, but ok. Hearing is the last sense that leaves us, so be aware the patient could hear what is said nearby even when they cannot respond. At the very least, they hear familiar voices even if they can no longer understand the words being said. • Gently continue to provide personal care, keeping skin clean, and the mouth moist. See the earlier sections on basic care. • Give medications with the guidance of your hospice nurse as advised by the medical provider. Many medications can safely be stopped, but some should be continued to provide comfort. • Elevate the patient’s head slightly with pillows or by raising the head of the bed, especially if noisy breathing or vomiting occurs. • Take care of yourself. Eat, rest, and drink fluids. Ask for the help you want or need. Four Seasons is here for you.
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Four Seasons
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