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Adapted from:
Spending the Last Day at
Home
Courtesy of
Alexandra Hospital,
Grief Bereavement &
Palliative Teams
Most people prefer to
spend the last days of
their lives in warm,
comfortable and familiar
surroundings, and in the
presence of their loved
ones. Caring for
someone who is dying is
not an easy task.
For a person who is at
the end of life, dying
often occurs slowly,
from several days to a
week and sometimes it
happens in a few hours.
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Tips to Keeping
Your Loved One
Comfortable |
The Environment:
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Maintain a pleasant
room atmosphere.
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Avoid using bright
lights which may be
glaring to the eyes.
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Play soothing music
at low volume near
the bedside.
Music can create a
sense of calm and
serenity for you
loved one.
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Sit and hold the
person’s hand.
Gently massage or
stroke the hands and
feet. Touch
eases suffering and
promotes comfort. |
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Mouth Care:
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Clean the mouth with
glycerin swabs or
moist swabs at least
once or twice a day
to keep the mouth
clean and moist.
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If the person
wears dentures, they
should be removed
for cleansing.
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Apply lip balm if
the lip is dry.
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If the person is
conscious, offer
ice-chips or sips of
water to keep the
mouth moist. |
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Skin Care:
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Turn the person one
every 2 to 3 hours
to
prevent bedsores
due to prolong lying
in one position.
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Elevate the head
with pillows, gently
turn the head to the
side to avoid
prolonged pressure
on the ears.
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Apply normal saline
eye drops twice a
day to prevent
dryness. |
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Hygiene:
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Sponge the person in bed to
maintain hygiene and
to promote comfort. |
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Bowels and Bladder
Care:
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Change
diapers
when
soiled
to
promote
comfort,
use
barrier
cream
to
prevent
the
skin
for
contact
with
excretions |
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Nutrition:
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The person does
not require much
calories at this
stage. Offer foods
in small amounts but
do not insist if he
does not want to
eat.
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Small chips of ice
or frozen juice may
be refreshing in the
mouth if he can
tolerate.
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If the person is
able to swallow,
fluids may be given
in small amount by a
syringe. |
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Spiritual Support:
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Spiritual support
from an organised
religion or through
you own spirituality
beliefs and values
can be helpful.
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Help the person to develop
positive thoughts
and a peaceful state
of mind, in
accordance with his
religious beliefs
and practices.
For example, if he
beliefs in God in
heaven, encourage
him to have faith in
and pray to God, and
to feel confident
that he will be with
God in heaven after
he leaves this life. |
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What to Expect
as Death
Approaches? |
By now, it would be
obvious to you that your
loved one is very frail
and weak. He is
now spending most of his
time in bed and is
asleep more often than
not. He also shows
no interest in food or
drinks and there is
hardly any food or fluid
intake.
This is expected as the
body systems wind down
and the need for energy
(metabolic rate) slows
down as the end draws
near. As death
approaches:
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The person's conscious
level will further
deteriorate and
he may
subsequently lose
consciousness
totally.
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The pulse will get
weaker and the
extremities will
become cool to
touch as a result of
decreased blood
circulation. Keep
your the person warm
with a blanket but
do not overheat
him up.
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Breathing becomes
‘labored’ and he
may appear to be
gasping. There
may be pauses in the
breathing that can
last up to a minute
or so.
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The complexion
becomes pale with a
yellowish hue.
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Throat secretions
may increase.
These often collect
in the back of the
throat and cause a
gurgling sound when
the person breathes.
Turn him to the side
will help him breathe more
easily.
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Other signs may
include increased
confusion, seeing
people or things
that no one else
sees. Reassure
your loved one if he becomes
restless.
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Occasionally, your loved one
may linger on despite
signs of impending
death. This may happen
when he is trying to
hold on to life,
especially when he is uncertain if
the ones left behind
will be able to cope or
if there is some
unfinished business.
This could take place
with much discomfort for
him. What you could do
is to reassure him that
it is alright to let go
of this life. In
other words, give him your permission
to leave this world.
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