What to expect when a person with cancer is nearing death

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This information is written for the caregiver, but many patients want this same information for themselves. In it are some signs that death may be near and give caregivers some ideas about what they can do to help lists.

People often use this time to gather the family to say goodbye to their loved ones. They can take turns with the patient, hand in hand, talking to the patient, or just sit quietly. It can also be a time to perform religious rituals and other activities the patient wants before death. It is an opportunity for many families and friends to express their love and appreciation for the patient and for each other.

It is important to have a plan for what to do after death, so that people with the patient know what to do during this very emotional time. If the patient is in palliative care, hospice nurse and social worker will help. If the patient is not in hospice, talk to your doctor about it so that you will know exactly what to do at the time of death.

Not all of the following symptoms occur, but may help to know about them.

Possible changes in bodily functions

  • Profound weakness – usually the patient can not get out of bed and has trouble moving around in bed
  • needs help with almost everything
  • less and less interest in food, often with very little food and fluid intake for days
  • pills and medicines difficulty swallowing
  • More drowsiness – the patient may doze or sleep most of the time if pain is relieved, and can be difficult to wake or wake
  • may appear

  • lips to fall
  • Short attention span, you can not be able to concentrate on what is happening
  • confusion about time, place or people
  • ability to cooperate with caregivers
  • Limited

  • sudden movement of any muscle , shake hands, arms, legs or face

What can caregivers do

  • Help around the patient and change position every 1 to 2 hours.
  • speak in a calm, quiet voice and avoid noise or sudden movements to reduce the chances of surprising the patient.
  • If the patient has difficulty swallowing pain pills, ask about getting liquid pain medications or pain patch.
  • If the patient has difficulty swallowing, they do not give them solid foods. Try ice chips or sips of liquid.
  • Do not push fluids. Near the end of life, some dehydration is normal. It is also more comfortable for the patient.
  • Apply cool wet cloths to the head, face and body for comfort.

Possible changes in consciousness

  • More sleeping during the day
  • difficulty waking up or waking from sleep
  • Confusion about time, place or people
  • Restless, may pick or pull the bedding
  • you can talk about things unrelated to the events or people present
  • may have more anxiety, restlessness, fear and loneliness of the night
  • may After a period of sleepiness and confusion, have a short time when he or she is mentally clear before returning to semi-consciousness

What can caregivers do

  • plan your time with the patient when he or she is most alert or during the night when your presence may be comforting.
  • When talking with the patient, recall or what you are and what day and time it is.
  • Continue pain medication until the end of life.
  • If the patient is very restless, try to find out if they are having pain. If you think they are, administer medications as prescribed breakthrough pain, or consult your doctor or nurse if necessary.
  • When talking with a confused person, use, confident tone, smooth to reduce the chances of startling or frightening the patient calm.
  • The soft, caressing, holding and rocking palpation are usually very helpful and comforting.

Possible changes in metabolism

  • The patient may have less interest in food. (The patient has less need for food and beverages.)
  • mouth may dry (see “Possible changes in secretions” below)
  • may no longer need some of his medicines, such as vitamins, replacement hormones, medications for blood pressure and diuretics, unless they help make the patient feel

What can caregivers do

  • Put lubricant or petroleum jelly (Vaseline ® ) on the lips to prevent drying.
  • ice chips from a spoon or sips of water or juice from a straw may be enough for the patient.
  • Consult your doctor to see which drugs can be stopped. Medicines for pain, nausea, fever, seizures or anxiety should be continued to keep the patient comfortable.

Possible changes in secretions

  • mucus can accumulate in the back of the throat. This can cause a rattling noise with breathing that is very painful to hear, but not usually uncomfortable for the patient.
  • Secretions may thicken and increase due to fluid intake and less because the patient can not cough

What can caregivers do

  • If they increase the secretions of the mouth, keep them loose by adding humidity to the room with a cool mist humidifier.
  • If the patient can swallow, give ice chips or sips of liquid through a straw. This may help thin secretions.
  • Change the patient’s position – turning them off can help drain secretions from the mouth. Continue to clean teeth with water and a soft toothbrush or foam buccal swabs.
  • Certain medications can help. Ask your doctor or nurse about them.

Possible changes in circulation and temperature

  • arms and legs may feel cool to the touch as circulation slows down
  • The Skin arms, legs, hands and feet may darken and look blue or mottled (spots)
  • Other areas of the body may become darker or lighter
  • skin feels cold and dry or wet
  • The heart rate can be fast, weak or irregular
  • blood pressure may drop more and become difficult to hear

What caregivers can do

  • Keep the patient warm with blankets or quilts light.
  • Do not use electric blankets, heating pads, etc.

Possible changes in senses and perception

  • Vision may become blurry or dim
  • Students can not be resized
  • may have difficulty closing the eyelids
  • hearing may decrease, but most patients can hear even after they can no longer speak.

What can caregivers do

  • Leave indirect lights on as vision decreases.
  • Always assume that the patient can hear.
  • Continue to talk and touch the patient to reassure them of his presence. His words of affection and support are likely to be understood and appreciated.

Possible changes in breathing

  • Breathing may speed up and slow due to reduced blood flow and accumulation of waste products in the body
  • the patient may grunting while breathing
  • the neck muscles may seem tight to help breathe
  • Mucus in the back of the throat may cause noise or gurgling with each breath
  • the patient can not breathe for periods of up to 10 to 30 seconds

What can caregivers do

  • put the patient on his back, or slightly to one side.
  • Increasing the patient’s head can give some relief.
  • Use pillows to support your head and the patient’s chest at an angle or raise the head of a hospital bed.
  • Any position that seems to make breathing easier is OK, including sitting up with good support. A small person can be more comfortable in his arms.

Possible changes in elimination

  • Urine may become darker and decreasing the amount
  • The patient may lose control of the urine and feces

What can caregivers do

  • pad bed beneath the patient with layers of disposable waterproof pads.
  • If the patient has a catheter to collect urine, the nurse will teach you to care for him.

signals that death has occurred

  • Breathing stops
  • Blood pressure can not be heard
  • pulse stops
  • eyes stop moving and may stay open
  • the pupils of the eyes are large, even in bright light
  • control bowel or bladder can lose because the muscles relax

What can caregivers do

After the death which is fine if you sit with the person for a while. No rush to do anything immediately. Many families find this is an important time to pray or talk together and reaffirm their love for each other and for the person who has died.

If you have an agency or hospice home care involved, call them first. If you have completed funeral arrangements, calling the funeral director and doctor are usually all you have to do.

If the patient dies at home and not under palliative care, caregivers are responsible for calling the right people. Regulations or laws about who should be notified and how the body should be moved differ from one community to another. Your doctor or nurse can get this information for you.

One important note: If you call 911 or emergency medical services (EMS), even after an expected death at home, the law often it requires that EMS try to revive the patient or take them to a hospital. This can complicate the situation and delay funeral plans. Make sure your family and friends are ready and know exactly who to call, so do not dial 911 in confusion or panic.

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