Death And Dying

WHAT YOU SHOULD KNOW:

Death is unique to each person. It may be expected if a person has certain diseases that can no longer be cured. It may happen suddenly or unexpectedly in a certain way or place, and may occur within a few seconds or minutes. Persons may suffer for months then slowly die in a short period of time. There will always be a mystery on exactly why, how, or when a person is going to die. Caregivers cannot totally or perfectly tell when a person will surely die. They may only know certain patterns of dying that can help the patient and his loved ones better accept, prepare, or talk about death. Physical examination and laboratory tests may be done to help check changes in health status over time as a patient approaches death.

AFTER YOU LEAVE:

Medicines:

• Keep a written list of these medicines, the amounts, and when and why the patient needs them. Bring the list of his medicines or the pill bottles when you see his caregivers. Learn why the patient takes each medicine. Ask for information about the medicines. Do not let the patient take any medicines, over-the-counter drugs, vitamins, herbs, or food supplements without first talking to caregivers.
  
  
• Make sure all medicine is used as directed by caregivers. Call his caregiver if you think the patient's medicines are not helping or if you feel he is having side effects. Do not let the patient quit taking his medicines until he discusses it with his caregiver.

Follow-up visits:

Keep all appointments. Write down any questions about the patient's condition, treatment, or care. Ask these questions at the next caregiver visit.

Caring for the patient:

• Keep the patient company. Always be willing to listen to the patient, especially as he reminisces about his life. Do simple things together, like watching television (TV) or reading books, or just be with the patient.
  
  
• Help the patient keep his hopes up and keep a positive yet realistic outlook. Help the patient to be calm, composed, and not to be too hard on himself. Teach him to be the first one to encourage himself and find ways to boost his self-esteem. Working together with people whom the patient can trust may help him get through the hard times.
  
  
• Learn more about the patient's condition. The more information about the patient's condition, the better the patient can be understood. Keeping difficult information from the patient should be avoided. Most patients would like to be included in the treatment and care plans that concern them. Work with caregivers and other people to help the patient.
  
  
• Respect the patient's feelings, other emotions, and need for privacy. Let the person express fears and concerns about dying, such as leaving family and friends behind. Reassure the patient that you will follow and honor advance directives, such as living wills.

Continuing care:

A caregiver may arrange services to assist the patient's social needs. These may include home care, school or work reentry, transportation, rehabilitation, and counseling. A caregiver may also refer the patient to different health care providers, services, and agencies. These make sure that care given to the patient is continued as he goes home and his condition improves or worsens.

Bereavement:

The sudden loss and death of a person may cause grief or bereavement. Bereavement is a feeling of sadness or loneliness due to a loss or death of a loved one. When someone dies, the people who were left behind may feel different for a while. They may cry a lot, feel angry, guilty, worthless, hopeless, helpless, or confused.

Coping:

Counseling and emotional support for the patients are given as part of palliative care. They are free to express their emotional needs to someone who is willing to listen. A caregiver may talk to the patient, his family, friends, or those who take care of him. Patients and families may join support groups, or meet other patients and families with the same conditions. Ask caregivers for more information about support groups.

Legal action:

Lawyers and the chosen family member may take care of the directives, last wills, or belongings of the person who is dying. If a person is dying due to a crime or accident, police or other special agencies assistance may be needed.

Signs and symptoms that may occur as a person is dying:

Knowing the normal physical changes as a person is dying can make this time more peaceful. When a person is close to death, a natural series of changes occurs. The following changes are usually not medical emergencies, and they may guide you into making the dying person be as comfortable as possible:

• Body pains, weakness, or gets tired more easily.
  
  
• Changes in activity, such as talks or responds less and less, and sleeps more than usual.
  
  
• Body temperature is cold when touched.
  
  
• Little or no interest in eating or drinking. He may have problems swallowing or taking his medicines.
  
  
• Problems thinking clearly, such as getting confused about persons, time, or place.
  
  
• Skin may look darker and mottled (blue and blotchy), especially on the hands and feet.
  
  
• Troubled or irregular breathing. There may be periods of rapid, shallow breathing or shallow breathing with longer gaps between breaths.

Things that may happen when death occurs:

There is no need to call '911' or a caregiver. The following may be done when death occurs:

• All the remaining tubes, intravenous (IV) lines, and other equipment will be removed.
  
  
• Family members may want clothing that may have been removed or cut away during resuscitation (reviving) efforts.
  
  
• A spiritual counselor may do a religious ritual depending on the patient's or his family's wish.
  
  
• If the patient or family agreed on organ donation, certain body organs or tissue may be taken for donation.
  
  
• The body may be bathed or dressed. The funeral home may be called when the family is ready to have the body moved.
  
  
• You may spend some time with the body. You may touch, hold, or kiss the person's body and say your good-bye.

For support and more information:

Accepting death is very hard. You may feel angry, sad, helpless, or frightened. You may blame yourself, other people, or the caregivers and think something went wrong. These feelings are normal. You, your family, friends, and other carers may want to join a support group. This is a group of people who may also have someone who is dying or just passed away. Contact the following for more information:

• American Academy of Family Physicians
  11400 Tomahawk Creek Parkway
  Leawood , KS 66211-2680
  Phone: 1- 913 - 906-6000
  Phone: 1- 800 - 274-2237
  Web Address: http://www.aafp.org
  

• National Hospice & Palliative Care Organization (NHPCO)
  1700 Diagonal Road, Ste 625
  Alexandria , VA 22314
  Phone: 1- 703 - 837-1500
  Phone: 1- 800 - 658-8898
  Web Address: http://www.nho.org
  

CONTACT A CAREGIVER IF:

• The patient has new signs and symptoms since the last time he visited his caregiver.
  
  
• You or the patient have questions or concerns about his condition, treatment, or care.

SEEK CARE IMMEDIATELY IF:

• The patient asks you to bring him to his caregiver or nearest hospital.
  
  
• The patient feels like hurting himself or someone else.
  
  
• The patient feels pain that is not relieved even by taking pain medicines.
  
  
• The patient feels that he cannot cope with his condition.

Copyright © 2011. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Death And Dying (Discharge Care)