Don't Say That Word
When Death is Near
Both cancer patients and their families need to know what they can expect when the end is near. Dying is a natural process. During the process the body slowly shuts down. As this process progresses there are natural changes you will notice.
Several weeks before death you may notice your loved one:
Starts to divide their possessions among family and friends. Honor their wishes. They may be ahead of you in the grieving process. This may be a part of the unfinished business they feel the need to take care of before dying.
Feels weak and lethargic and sleeps more.
Is confused. Sometimes medications or complications from their disease will make people confused, so check with the doctor. The doctor will let you know if confusion is normal or not.
Withdraws and is not responding to the world around them. This also is a part of the process of shutting down and disengaging. People spend more time in another dimension as they get ready to travel from this world to the next.
Has difficulty swallowing and is not interested in eating. Often families equate food with love. You may not know what else to do so you cook their favorite food. However, part of the process of shutting down is not feeling hungry. Do not force food on a dying person.
Two to three days prior to death you may notice your loved one:
Has changes in their breathing- starts puffing, has irregular breaths, or their breath starts and stops. This is scary for people. You can call the doctor or nurse to let them know about the changes in breathing or not call. Do what feels comfortable for you.
Sleeps with their eyes and mouth partially open. It takes energy to close the muscles around your eyes and mouth. Dying people are using their energy elsewhere.
Cannot eat and will say, "I can't". Don't try to force them to eat. Continue to offer liquids if they can drink them and trust they know what they need.
Has skin mottling. Mottling is irregular or patchy discoloration of the skin caused by changes in the blood vessels near the end of life.
Has a surge of energy. When this happens caregivers may mistakenly think the patient is getting better or had a remission. Sometimes caregivers get angry or upset when their loved one dies a few days later.
Sees someone waiting for them. The dying often report seeing or talking with relatives who are dead. They may ask if you see them. You can simply state that you do not, and that does not make their experience any less real. It is a comfort to have a deceased loved one come to visit prior to death.
Has a feeling of peace and calmness about them. This is a sacred time. Learn from it.
What Caregivers Can Do
People want to know, "What should I do while someone is dying?" The most important thing you can do is give love and tell them you love them. As you spend time with someone who is dying you can tap into his or her memories of stories about the past, present, or future. Hearing is the last of the senses to go. Talk, sing, or play their favorite music as you sit with them. You can also touch or stroke them.
You may have the feeling they are hanging around or cannot die. This may be because of unfinished business. They may be waiting for a child to graduate or get married, or some other important event in the family. It can be because of something that still needs to be said or someone with whom they need reconciliation. Trust your instincts. You can even ask if there is something preventing them from dying. Some people may need permission to die. They need to know family members are going to be all right. You can approach the subject using the metaphor of a trip. You can say, "It seems your bags are packed. I know you will find the map" or "Can I help you find the map?"
People may have deathbed visions. People who have died and then come back to life report having seen an angel, dead family members, Jesus, or someone significant to them. Many people who have had a near death experience report seeing a bright light and being surrounded by an intense feeling of love. Researchers studying patients who had a near death experience conclude we do not die alone. They see dying as a window to another world. As a caregiver you may not see the vision. However, you can affirm the reality of their experience.
Barbara Karnes, a nurse who lectures on death, states there are three things that determine how difficult death will be. They are:
Amount of unfinished business