FINAL DAYS
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The Timing of Death Sometimes you may encounter the patient existing in a sleep-like state for many days and wonder how long this can go on. Death is a process and is unique to each person. During this process, you can benefit greatly from the companionship of skilled professionals who can explain what the changes mean and help you enhance comfort during this time. Please tell us how we can help you during this journey. Sometimes friends and family are present for the death event; sometimes they have literally just left the room and then discover that the person has died in their absence. For family or friends, this may be frustrating or cause feelings of guilt. Our experience is that sometimes people seem to wait for family to leave before they let go and die. Some families and friends feel they must give their loved one “permission” to die, but it can be difficult to say, “It’s okay, you can go.” This is a personal choice and there are no rules or scripts that you must follow. We encourage friends and family to be honest in their grief and in this experience. Do what is comfortable for you. It may make more sense to say “I love you and I’ll always hold you in my heart” or “I will be okay and I will miss you” or to say nothing at all. This is a time of profound change and there is no right or wrong way to handle this situation. It is also normal to feel speechless during this time. How you will know when death has occurred: • No response to gentle shaking. • No breath for several minutes. • No heartbeat heard or felt. • Eyelids often slightly open, but eyes do not move. • Relaxed jaw and mouth slightly open. • Color and/or temperature of the skin changes. If you believe that death has occurred or if you are ever concerned and need physical or emotional com- panionship at this time, call Four Seasons right away. A Four Seasons’ nurse will: • Make a home visit at any time of the day or night. • Determine if death has occurred. • Clean the body and clothe them as you wish. • Call the funeral home when you are ready. • Contact other members of your Care Team as needed. • Inform the patient’s medical provider. • Arrange for medical equipment to be picked up, and properly destroy medications. When death has come, please do not rush if you feel that you need time. It is okay to touch, hold, talk to, and be with your loved one after they die. Do whatever feels natural, whether that means crying, talking, praying, or bathing the body. References: Core Curriculum for the Generalist Hospice and Palliative Nurse. Dubuque, IA: Kendall/Hunt Publishing Company; 2005. Ferris F. International Palliative Wound Care Initiative. Consensus Statement on Palliative Wound Care. Journal of Palliative Medicine, November 2007. Core curriculum for the Generalist Hospice and Palliative Nurse. 3rd ed. Dubuque, IA: Kendall/Hunt Publishing Company; 2010; Tips to Manage Anxiety and Stress. Anxiety Disorders Association of America. Available at www.adaa.org. Accessed: June 27, 2011.
CARING FOR THE CAREGIVER
SELF CARE Caring for yourself during this time is as important as the care you provide for others. We encourage you to utilize all members of your team. We find that individuals benefit if they allow all the team members to be involved. As a caregiver, you may have concerns or questions about caregiving or feel stressed, overwhelmed or even angry at times. Caregiving is a challenging job and requires much hard work and commitment. We want to support you and your loved ones and help you in ways that are meaningful in order to ease any hardship you may feel. You may find these suggestions helpful:
• Eat balanced meals to nurture your body. Choose healthy snacks. • Try to take a few hours away on a regular basis. The time away often will give you renewed energy and motivation to care for your loved one. Sometimes just a walk, a trip to the library or a cup of coffee out with a friend can be the “breather” that you need. • Make a list of names and phone numbers of trusted individuals to call when you are feeling overwhelmed. Maintaining social contacts is essential to your well-being. Try to keep up with at least some of your own activities. Get out, see friends, and continue with your special interests. • Keep a journal and write down your thoughts and feelings. This helps provide perspective on your situation and serves as an important release for your emotions.
• Ask for help. By asking for help, you will find some much-needed relief, and your friends and family will feel good about helping you. • Many people may offer to help. Do not turn them away. In fact, give them a job to do! They can help with laundry, grocery shopping, meal preparation, etc. • Simplify communication with others by utilizing an interactive web-based program such as Caring Bridge (visit CaringBridge.org for more information). • Try to get some regular exercise and sleep. Light exercise and sufficient rest provide physical and psychological refreshment. If your loved one sleeps a lot during the day, you may be able to take some time to rest, too. A neighbor, friend, or one of our trained volunteers may be able to sit with your loved one so you can get some sleep or exercise. This can benefit both you and your loved one. If you are finding it difficult to get sufficient rest, please talk with your Care Team.
866.466.9734
FourSeasonsCare.org
FourSeasonsCare.org
866.466.9734
Four Seasons
Four Seasons
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