THE DYING PROCESS

The dying process

Changes you may notice and what you can do to help

• Appetite and thirst

The person’s appetite and thirst may decrease, and they may have little desire to eat or drink. This concerns many carers, but is a natural process and is not painful for the person. Sips of water, or a moist mouth swab will help them. You can ask the nurses to show you how to help with mouth care, if you wish. Attempting to feed someone who is unable to swallow may make them distressed.

• Sleep and alertness

Changes happening in the person’s body mean that they may spend a lot of time asleep, may be drowsy and difficult to wake up. It is best to talk to the person when they seem most alert, and allow them to sleep when they want to. There is no need to shake the person or to speak loudly. It is best to speak softly and naturally

• Temperature

The body’s temperature may change. At one time the person’s hands, feet and legs may be increasingly cool to the touch, and at others they may be hot and clammy.

Sometimes parts of the person’s body become blotchy and darker in colour. This is due to the circulation of the blood slowing down and is a normal part of the dying process.

If the person indicates that they feel cold, use light bedding to keep them warm. Too many bed clothes or an electric blanket may make them hot and restless. Provide good ventilation; a fan to circulate the air and cool damp towels can help if the person seems hot.

• Incontinence

The amount of urine that the body is producing decreases due to the reduced amount of fluid the person is drinking. The urine may become stronger and darker in colour. Many carers are concerned that the person will lose control of their bladder and bowels. This does not happen to all people, but if it does there are pads, easy to use equipment and special absorbent sheets to enhance comfort and hygiene.

A member of the palliative care team will advise you about what is needed.

• Secretions

As coughing and swallowing reflexes slow down, saliva and mucus may collect in the back of the person’s throat, causing a gurgling, bubbling or other noise.

This noise can be a concern to carers, but does not usually cause distress to the person. To help improve the situation you can lift the person’s head and support them with pillows so that their head is turned to one side. Medications can also be given to slow down the production of saliva and mucus and thus improve comfort.

• Breathing

Regular breathing patterns may change. Sometimes the breathing may be fast, and at other times there may be long gaps between breaths. Breathing may be shallow or noisy. This, too, is due to blood circulation slowing down and a build up in the body’s waste products. It is not painful or distressing for the person.

• Restlessness

Due to the decrease in circulation of blood to the brain and to other changes happening in the body, the person may become restless or agitated. To have a calming effect, speak in a quiet natural way, lightly massage the person’s hand or forehead, or softly play familiar music.

Let a palliative care team member know if the person becomes restless or agitated. Medications can be given to reduce the problem.

IKA SYAMSUL HUDA MZ