What are the signs that a person is near death?
As death nears, the person may:
- Sleep more
- Speak to people not present
- Talk about leaving or talk about a trip or journey
- Withdraw from people or have little to say
- Eat or drink less
- Have trouble swallowing
- Become more confused
- Make moaning sounds
- Lose control of urination and bowel movements
- Have moist breathing or sound congested
- Breathe differently, such as long periods without breathing followed by several quick, deep breaths
- Have blurred vision
- Not hear as well as usual
- Have less pain or need less pain medication
- Have hands and arms or feet and legs that are cool to the touch
- Turn blue around nose, mouth, fingers, toes
What to report to the hospice/palliative care team?
- Changes in the person such as
- Restlessness or anxiety
- Changes in breathing
- Pain or discomfort
- Need for spiritual support or guidance for the person or family
- Concerns that may need help from the social worker, chaplain or other members of the hospice team
- Religious, cultural or ethnic traditions important to your family
- The hospice/palliative team will also ask for information about the funeral home and other arrangements that are wishes of the person, such as organ donation.
What can be done?
The team will work with you to relieve symptoms and provide comfort.
Things you can do:
- Allow the person to sleep as much as he or she wishes
- Include the children in your family in a way that is sensitive to their age and willingness to be involved
- Reposition the person if it makes him or her more comfortable
- Moisten the person’s mouth with a damp cloth
- If the person has a fever or is hot, apply a cool cloth to the forehead
- Give medications as ordered to decrease symptoms such as anxiety, restlessness, agitation or moist breathing
- Write down what the person says, reading it later may comfort you
- Continue to talk to the person and say the things you need or want to say. Remember that the person may be able to hear, even when not able to respond
- Keep a light on in the room, it may be comforting
- Play the person’s favorite music softly
- Encourage visitors to identify themselves when talking to the person
- Keep things calm in the environment
- Open a window or use a fan in the room if the person is having trouble breathing
- Continue to touch and stay close to your loved one
It is important to talk to your hospice/palliative care team about any concerns you may have. During this difficult and stressful time it is important that caregivers take care of themselves while caring for the person who is dying. The team will be there to provide support and comfort.