Section 10: Symptoms of Death

                   SIGNS AND SYMPTOMS OF APPROACHING DEATH

      The fear of the unknown is often much greater than the fear of the known. This information is offered to help to prepare you as a caregiver to anticipate symptoms that indicate approaching death. Although this information may seem frightening to you, our first goal is to help prepare you for what to expect. YOUR PHYSICAL AND EMOTIONAL WELL-BEING IS IMPORTANT TO US. The hospice nurse and your physician are the best resources to help clarify concerns about this information. NOT ALL OF THESE SYMPTOMS WILL APPEAR AT THE SAME TIME AND SOME MAY NEVER APPEAR. All of these symptoms are ways that the body prepares itself for the final stage of life.
           · Decreased need for food and drink. The body will naturally begin to conserve              energy that would be used to eat and drink.
           · Increased confusion. Your patient may become confused about time, place, and the              identity of close and familiar people, including you. This is a result of changes in the              body's metabolism.
           · Increased sleep. Your patient may become difficult to wake up at times. This              symptom is also a result of changes in the body's metabolism.
           · Increased restlessness. Your patient may become restless, pulling at the bed linen              and having visions of people and things that are not there. These symptoms are the              result of a decrease in oxygen circulation to the brain and a change in the body's              metabolism.
           · Incontinence. Your patient may lose control of his urine and bowel movements.
           · Decrease in urination.
           · Decreased clarity of hearing and vision.
           · Irregular breathing. During sleep you may notice the breathing patterns of your              patient change to an irregular pace. There may be 10 - 30 second periods of no              breathing. This symptom is indicative of a decrease in circulation and a build-up of              waste products in your patient's body.
           · Fluids may collect in the back of the throat. You may have heard of this referred to              as a "death rattle". This symptom is a result of a decrease in your patient's intake of              fluids and an inability to cough up normal saliva.
           · Changes in body temperature and coloration. You may notice that your patient's              arms and legs become cool to the touch or that the undersides of the body become              darker in color. These symptoms are the result of blood circulation slowing down.

            WHAT TO DO ABOUT SYMPTOMS OF APPROACHING DEATH

           · Use warm blankets to prevent your patient from feeling overly cold.

 

          

           · Plan your times with your patient when she seems most alert.
           · Remind your patient what day it is, what time it is, and who is in the room with              them.
           · Consult your hospice nurse for suggestions of pads to place under the incontinent              patient and for hygiene techniques for cleanliness.
           · Buy a cool mist humidifier to increase the humidity in the room when oral secretions              build up. Elevating the head of the bed with pillows or the use of a hospital bed will              make your patient's breathing easier. Ice chips, a straw, and cool, moist wash cloths              will relieve feelings of dehydration.
           · Keep lights on in the room when vision decreases and NEVER assume that your               patient can't hear you.

 

          

           · Talk calmly and assuredly with your patient when he is confused so that he won't be              startled or frightened.

                   HOW TO KNOW WHEN DEATH HAS OCCURRED

      If you suspect your patient has died, call your hospice nurse if he or she is not already with you. Signs of death include:
                                            · No breathing
                                            · No heartbeat
                                            · No response to shaking or shouting
                                            · Loss of control of bladder and bowel
                                            · Eyelids slightly open
                                            · Eyes fixed
                                            · Jaw relaxed and mouth slightly open

      Your hospice nurse will help you confirm that death has occurred and will handle calls to the doctor and funeral home for you.

                                               POINTS TO REMEMBER

· It is possible to prepare for the death of a loved one. Know the signs and symptoms of approaching death so that you know what to expect.
· You can help your loved one if you recognize the symptoms of approaching death. Make the patient as comfortable as possible.
· When your loved one has passed away, call the hospice. They will call the doctor and funeral home for you.

                                                                                                          SECTION 11 >