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Knowing What to Expect
The Hospice staff realizes that this period of time is one of the most difficult times for the family to live through, sometimes because “fear of the unknown” is greater than fear of the known. Our desire is to be as honest and straightforward as possible in helping you through this period, so we offer you this information to help you prepare and anticipate symptoms which are indicative of approaching death. Your physician and the Hospice team are available to help you clarify your concerns about this information. We want to relate each possible symptom to you in order to decrease your fear if one should appear suddenly and give you some guidelines about what you can do about the symptoms. The symptoms described are indicative of how the body prepares itself for the final stage of life, and not all these symptoms will appear at the same time and some may never appear.
1. The arms and legs of the body may become cool to the touch and you may notice the underside of the body becoming much darker in color. These symptoms are a result of blood circulation slowing down. Keep warm blankets on the family member to prevent him/her from becoming overly cold.
2. The Hospice patient will gradually spend more and more time sleeping and,
at times may be difficult to arouse. This is a result of a change in the body’s metabolism. Plan to spend more time with the patient during those times when he/she is most alert.
3. Your family member may become increasingly confused about time, place, and identity of people around him/her. This is also a result of metabolism changes. Remind your family member what day it is, what time it is, and who is in the room talking to him/her.
4. Incontinence (loss of control) of urine and bowel movements is often not a problem until death becomes imminent. Your Hospice nurse or home health aide can help you obtain pads or diapers to place under the patient for more comfort and cleanliness, or the doctor may order a catheter.
5. Oral secretions may become more profuse and collect in the back of the throat. You may have heard this referred to as the “death rattle”. This symptom is a result of a decrease in the body’s intake of fluids and inability to cough up normal saliva. Elevating the head of the bed with pillows or obtaining a hospital bed will make breathing easier. Swabbing the mouth and lips with lemon-glycerin swabs will help to moisturize.
6. Clarity of hearing and vision may decrease. You may want to keep lights on in the room when vision decreases. Never assume that the patient cannot hear you, as hearing is the last of the five senses to be lost.
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