There are many ways that you can help someone who is in the active dying phase, even if they do not seem aware of your presence. Talking to them reassuringly and remaining calm is always advisable, and you can touch the patient gently if they normally like being touched.
If the patient is restless, medication may help. Keep in mind that patients who appear unresponsive may still be able to hear you, so it is important to speak respectfully and positively at all times.
If the patient is experiencing incontinence, you may supply them with underbody pads or diapers. Be sure to change their pads or diapers when they become soiled. If that is not possible, use pillows to elevate their head. Some patients may need to be turned onto their side.
The study was published in Cancer. Fifty-seven percent of patients died at the cancer center after admission. Seven of the signs were related to deterioration in neurocognitive functions. Counsel family members, including children. Case managers At MSK, case managers are registered nurses. They help you and your family with discharge planning, including: Arrange for services such as home care, home hospice, or placement in a care facility as needed.
Arrange for nursing visits, physical therapy PT , and social worker visits, if these are needed. Arrange for medical equipment, if needed. Help you find out what will and will not be covered by insurance. Chaplains Spiritual and religious concerns may come up during a serious illness and as you near the end of your life.
Chaplains are available to: Listen to your concerns about illness or hospitalization without judgment. Help support family members experiencing feelings of grief and loss. Provide you with a comforting presence.
Help you with end-of-life decisions. Pray, meditate, or join in ritual with you. Contact community clergy or faith groups for you. Integrative Medicine Our Integrative Medicine Service offers therapies that can complement go along with your other care. Physical and occupational therapy A physical or occupational therapist can work with your family members.
Your therapist can teach your family how to: Position and turn you in your bed and chairs. Adjust your position to make you comfortable. Help you transfer safely from bed to chair or from bed to commode. Do passive exercises for your arms and legs.
These can help you maintain some strength. Back to top Open Communication Coping with cancer is difficult. Back to top Help for Children Who Have a Loved One with Cancer The diagnosis of a loved one with cancer affects every member of the family, especially children.
Back to top Nutrition Advanced cancer can cause issues that can affect your appetite and eating. Try: Honeydew, cantaloupe, watermelon, or other fruits that have a lot of water Puddings Fruit yogurt Cottage cheese with fruit Ice cream, sherbet, or popsicles Soups Macaroni and cheese Meat loaf with gravy Mashed potatoes with gravy Scrambled eggs Milkshakes Nutritional supplements Small, frequent meals are usually best.
Confusion, restlessness, and agitation As death approaches, some people become confused and agitated. Treatment Healthcare providers treat confusion and agitation by addressing the underlying cause when possible. Things your family can do Keep the room well lit during the day. Place a clock close by so you can see the time. Continue to help you wear your hearing aids or glasses when possible.
Give you pain medication. Talk calmly and softly. Promote relaxation and sleep. Give you oxygen, if recommended by your healthcare provider. Give you medication to treat delirium. Avoid doing anything that makes you uncomfortable or fearful. Constipation Constipation is not having your usual number of bowel movements. Treatment There are many over-the-counter medications that treat constipation, such as stool softeners and laxatives.
Things you can do Try to drink liquids, if you can, including water, juices, soups, and ice cream. Diarrhea Diarrhea is loose and watery bowel movements. Depression and anxiety The time leading to death can be very difficult. Treatment Depression and anxiety can be treated with talk therapy, medication, or both.
Fatigue Fatigue is feeling unusually tired and weak. Treatment Medications may help with fatigue. You can take these when you need them. Your doctor, NP, or PA can prescribe them for you. Antianxiety or antidepressant medications may help you feel better overall.
Ask your healthcare provider if you should try them. Sadness can make your fatigue worse. Tell your doctor, nurse, social worker, or chaplain.
Things you can do Try to walk short distances every day, if you can. Sitting up or getting out of bed may help to lessen fatigue if you have a hard time walking. Reading, writing, or doing a puzzle may keep you more alert.
This can lessen your fatigue. Save your energy. Try planning activities for when you have the most energy, such as when you first wake up.
Plan for periods of rest between activities to help you catch your breath. Nausea and vomiting Nausea and vomiting are symptoms that may occur at the end of life.
Treatment Your healthcare provider can usually give you medication to control nausea and vomiting. It may be helpful to drink liquids, such as warm tea. Constipation can cause nausea and vomiting so try to prevent it. If you feel that your pain medication or other medications are causing your nausea and vomiting, tell your healthcare provider. They may be able to change the medication. Eat small meals. Avoid spicy foods. These may trigger nausea due to their smell. Try to eat foods that are bland, such as toast and crackers.
Avoid strong odors and perfumes. Try other techniques, such as acupuncture, relaxation, distraction, and hypnosis. You can do these techniques at home once you become familiar with them. Our Integrative Medicine Service can teach you some of these techniques.
Visit www. Pain Controlling pain is a big part of your cancer care and is very important at the end of your life. Treatment Take your pain medication as long as you can and on a regular schedule. Things you can do Talk with your healthcare provider. Shortness of breath dyspnea Shortness of breath is common at the end of life.
Things you can do Plan for periods of rest between activities to help you catch your breath. If talking makes your breathing worse, shorten your time with visitors. Find a comfortable position.
Sitting up makes breathing easier. Try using a wedge pillow or backrest when lying in bed. Sleeping or napping in a recliner may also make you feel more comfortable. Open a window or use a fan to keep air moving in the room. Point a fan directly at your face.
This can help with shortness of breath. In the winter, use a humidifier. People often breathe through their mouths when they feel short of breath. This can make your mouth feel dry. Adding moisture to the air with a humidifier may make you more comfortable. Drinking warm drinks or sucking on lozenges or hard candy may also help. Do any activity that helps you to calm down and relax. Try prayer, meditation, listening to music, or relaxation exercises.
You may hear gurgling or rattling sounds as the dying person takes each breath. This is coming from their chest or the back of their throat. Raising their head and turning it to the side can help gravity to drain the secretions. Let the medical team know if your loved one has noisy breathing like this. They can sometimes use certain drugs to help dry up these secretions. Sometimes a nurse or doctor can suck the fluid out through a thin tube put down into the person's windpipe, but this is not usually needed.
Hearing the gurgling sounds can be very upsetting, but they don't usually seem to cause distress to the dying person. Their skin might also become pale and look blotchy or mottled. This happens because there is less blood circulation to these parts of the body. Thick socks can help to keep their feet warm. Just keep it at a comfortable temperature. You might hear your loved one say things that make no sense. They may not know what day it is or may not seem to know who you are.
They could even say things that are totally out of character. For example, they might shout at you or physically push you away. This can be very hurtful and upsetting. They are not aware that they are doing these things. It happens partly because of the chemical changes going on inside their body.
At the end of life, the chemical balance of the body becomes completely upset. The dying person then slips into unconsciousness. This is usually right towards the end, maybe only a few hours or days before death. Their breathing will stay irregular for some time and will stop at some point.
Someone dying in their 20s is likely to feel very differently from someone who is And someone leaving behind young children will have different worries from someone whose children are grown up and able to take care of themselves.
As death gets closer they might begin to let go and seem more at peace with things. Others might become very anxious, fearful or angry. Some people could appear to withdraw, even from the people they love and care about. Before the final stages of death, the dying person might talk about wanting to complete any unfinished business. This could mean:. You are likely to feel some very strong emotions during the time your relative or friend is dying.
You might feel that you want to try and change what is happening.
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