End Of Life Care: Tips for Caring for a Loved One at the Final Stages of Life

End of life caregiving is an aspect of family caregiving that doesn’t get as much attention as financial or legal matters, and yet it is one of the most difficult and heartbreaking. This article aims to prepare you for what to expect when caring for a loved one during the final stages of his life and how to provide physical, emotional, and spiritual comfort to relieve suffering.

End Of Life Care: What is It?

End of life care is the type of care necessary to keep a terminally ill person comfortable and free from unnecessary suffering as death approaches. It enables your family member to live their final days or months with the highest quality of life possible. This type of care doesn’t occur only in the time before breathing and heartbeat stop. Many older adults suffer from one or more chronic illnesses, and they require significant care for days, weeks, or even months before death. So the end of life caregiving can also encompass long-term caregiving or palliative care.

The end of life may look different depending on the individual’s preferences or choices. Some decide to stay at home and die there. Some may choose to seek treatment in a hospital until the very end. Many people would love to be surrounded by family and friends who are there for them during the final days. As their family caregiver, you can take significant steps to increase the likelihood of a peaceful death for your family members, follow their wishes, and give them the respect they deserve while they are dying.

People who are dying, in general, need care in four areas: physical comfort, emotional and mental needs, spiritual needs, and practical needs. Of course, the dying person’s family needs support as well with both practical responsibilities and emotional distress.

End Of Life Care

Providing Physical Comfort

Discomfort is very common in people who are dying, and it comes from many sources and changes over time. Depending on the causes of your loved ones’ discomfort, there are a variety of ways to relieve their pain and make them physically comfortable. For instance, your loved one may be uncomfortable because of:

1. Breathing problems

2.Pain

3. Digestive problems (Loss of appetite)

4. Skin irritation

5. Bladder problems

1. Breathing problems

The airways of a dying person may narrow as he becomes more and more intolerant to oxygen. This narrowing of the airways can also cause them to become swollen, which causes shortness of breath. Many people who are dying experience shortness of breath, often worse than it did before their diagnosis. They may also experience coughing and choking. In order to help ease breathing for your family member, you may try:

• Using a humidifier in their bedroom to keep the air moist.
• Raising the head of the bed or adding a pillow under the head of the bed.
• Opening a window to get more fresh air into the room.
• Turn the person to one side or elevate their head if they are experiencing discomfort.
• Talk with your doctor about medications that can make breathing easier until death.

2. Pain

The care should concentrate on relieving your loved one’s pain without worrying about the possible long-term issue of drug dependence. Struggling with pain and other symptoms can be draining and make the dying family member more anxious and fearful. The main goal of caregiving should be to keep the dying person comfortable. Therefore, you should:

• Use a pain scale to assess the level of pain and track them over time.
• Keep the room temperature comfortable for the individual.
• Try giving them cool compresses or cold packs that can help relieve their pain.
• After consulting with your doctor, use pain medication or supplements to control pain. 
• Try massage or touch therapy to encourage comfort and reduce anxiety.

3. Digestive problems

The dying can experience bouts of nausea and loss of appetite, which may contribute to pain. Food may not be as enjoyable because eating can make them sick, and they have trouble swallowing. In order to avoid dehydration, you should:

• Offer non-liquid food in small portions. 
• Feed them only if they are hungry and without encouragement from the family member. 
• Offer strong-tasting foods like broth or cottage cheese for the person to eat by themselves or in small amounts with an aide present. 
• Avoid sugary or acidic foods as these may upset their stomach.

4. Skin irritation

A variety of things can cause skin irritation. The most likely is from pressure against the bed or chair that the individual is using. It may happen because the body is shrinking or because he has been lying in one position for too long. Wounds from incontinence, bedsores, rashes, and other skin irritations are also common. You should:

• Change your loved one in a timely manner, following a schedule that works for him. 
• Keep the individual’s skin clean and dry to prevent sores. 
• Consult a doctor about medication or powders if sores develop.
• Use lotion to keep his skin smooth and flexible until it is too late for more thorough care.

Dryness on some parts of a person’s face, such as the lips and eyes, may be a typical source of pain throughout the last stages of life. These suggestions may be useful:

• Keep your loved one’s mouth and lips moist with glycerin swabs and lip balm.
• Apply an eye cream or gel around the eyes gently.
• Try gentle massage or strokes about the face and scalp with a soft cloth or pillow.
• Offer a cool compress to reduce pain due to heat sensitivity for some people.
• Use a humidifier in their bedroom if they are bothered by dryness.
• If your loved one’s mouth looks dry, try giving ice chips or wiping the inside of the person’s mouth with a cotton ball.

5. Bladder problems (Loss of Bladder): 

People who are dying are likely to have problems with their bladder, including incontinence caused by an inability to sense the need to urinate. This can make them feel embarrassed or ashamed and may contribute to a feeling of isolation. In order to keep your loved one’s dignity:

• Try placing sheets over the bed or chair to absorb a spill. 
• Clean the bed or chair after each use to remove urine.
• Offer them a sponge to place in their underwear to absorb urine. 
• Make sure they have a bedside commode for regular use.
• Don’t take your loved one to the restroom if he can’t make it on his own.

Managing Mental and Emotional Needs

Dying people have the same emotional and mental needs as the rest of us, but their needs may be different. In order to address these issues effectively, you should:

1. Listen to your loved ones with an open mind and heart, giving them unqualified respect. 

2. Don’t assume that you know what your loved one wants or needs because they may express it in a different way than what you would assume they are saying. 

3. Ask open-ended questions rather than yes or no questions. 

4. Encourage your loved one to talk and share his thoughts and feelings. 

5. Ask your loved ones if they would like a familiar friend or relative to be with.

5. Embrace religious and spiritual beliefs as an essential part of caregiving, even if you don’t share them yourself. 

6. Don’t be afraid to discuss death directly because it’s the only thing your loved one is thinking about.

Some family members may experience mental confusion and unusual behavior, making it tough to connect with them. It can add to a person’s sense of isolation and hopelessness.

So here are some tips that may help handle mental and emotional needs:

• Provide physical contact: Holding your loved one’s hands or hugging them helps relieve the pain and make them feel safe.
• Set a calming mood: If your loved one is agitated, try moving them to a different room until they are calm.
• Provide visual comfort: Give them something to look at besides their deathbed if possible. 
• Play music at a low volume: This may help calm your loved one and give a sense of peace to the situation. 
• Encourage mental stimulation: Read stories or poems together, watch a favorite movie, or reminisce about the past. 
• Involve the dying person: Decision-making about end-of-life care can be overwhelming for some people. Encourage them to make choices about their treatment and create a shared vision of the future.
• Talk about feelings: Encourage your loved ones to share their fears and concerns.

Supporting Spiritual Needs

Caring for a loved one during the final stages of life is not just providing emotional and practical care. A person’s spiritual needs are also important because they can help to relieve suffering.

The dying person may want to pray, read the Bible, say special prayers, or make special statements. Although you can’t control these expressions of spirituality, you should be willing to let your loved one do as she wishes if that’s what she wants. If your loved one has enough strength, he may ask you to pray with her.

Spiritual needs may also include finding the true meaning in one’s life, ending disagreements with others, and finding peace with God. The dying person may also talk about his regrets or seek forgiveness from friends and family members.

Friends and family can talk to the dying family member about the importance of their relationship. For instance, adult children may share how their dying loved one has influenced their own lives and the pride they feel for the person. Friends can share how they value years of genuine companionship. Friends and family who can’t be present in person can extend these sentiments in writing, as a card or letter, or by sending video recordings.

Support for Practical Tasks

Someone who is dying needs help with daily tasks such as dressing, eating, and using the restroom. These are known as practical tasks. People who can afford in-home care may have a registered nurse or another caregiver visit during the day to assist with these tasks. A family member can provide the primary caregiver with a much-needed break by helping with some daily chores.

If you are helping your loved one during the last stages of life, here are some tips for helping with practical tasks.

• Make subtle adjustments to assist people with disabilities in doing simple things for themselves if they have a disability such as arthritis that makes it hard.
• Make your loved one comfortable: Turn off the lights, dim the lights, reduce noise if your loved one is sleeping, and remove anything that could be painful such as a denture. 
• Offer to help with simple tasks like bathing, dressing, and brushing their teeth. 
• Allow them to do whatever they want: Give them the freedom to do things that interest them. 
• Speak softly and reassuringly: Use the person’s name when you speak to them. 
• Give your loved one choices about how he wants to be cared for. 

Signs That Death May Be Approaching

1. 

While it is hard to predict when someone will pass away, there are some signs that indicate that your family member’s condition is deteriorating or that death is close. These may include:

1. Restlessness

2. Confusion or Agitation

3. Difficulty swallowing

4. Shortness of breath or labored breathing

5. Changes in the heart rate and blood pressure

6. Changes in vital signs (such as increased heart rate, irregular breathing, fever) 

7. Cold and clammy skin

8. Claim of seeing someone who has already died

Final Thoughts

The end of life is when you will want to focus on the comfort and care of your loved one. You can do this by offering quality care, emotional support, and spiritual guidance. Although it may be hard to see your loved one suffer through the final days or hours, you can give them soothing words and warm feelings that will make them feel relaxed and at peace.

Here in Serenity Senior Care, we offer you assistance with the most complete and personal care in accordance with your own needs and personal preferences. We also specialize in-home care services and are dedicated to providing compassionate end-of-life care for our clients. Please give us a call at 973-338-0124 or visit our website for more information.