This stage is also one of reflection. The dying person often thinks back over their life and revisits old memories.4 They might also be going over the things they regret.
Just say goodbye in a way that lets the person know that he or she will always be important to you. If you are leaving for a longer time and unlikely to see the person again, your goodbye may be more emotional. You might acknowledge openly that you don't know whether you'll be with each other again.
Irregular breathing, panting and periods of not breathing may occur. Changes in breathing are very common and indicate a decrease in circulation to the internal organs. While these changes are not usually bothersome to the patient, they can be distressing to family members. Elevating the head may provide relief.
Individual experiences are influenced by many factors, including the person's illness(es) and medications, but there are some physical changes that are common. For some people, the dying process may last weeks; for others, it may last a few days or hours.
Avoid talking in an overly optimistic way, for example, “You'll be up in no time”. Such comments block the possibility of discussing how they're really feeling – their anger, fears, faith and so on. Apologise if you think you've said the wrong thing. Let them know if you feel uncomfortable.
– Your last wishes can include anything you want, including funeral or cremation preferences and plans, body disposition preferences, obituary information, messages to your loved ones, requests for your final days, and personal information like where your will is.
Everyone will have different needs and wishes in their last days and hours. But there are some aspects of care you should do for all patients. These include communicating well, supporting them to make decisions about their care, maintaining hydration, managing their symptoms and medication.
Generally speaking, people who are dying need care in four areas: physical comfort, mental and emotional needs, spiritual needs, and practical tasks. Of course, the family of the dying person needs support as well, with practical tasks and emotional distress.
Hospice has a program that says that no one should have to die alone, and yet this hospice nurse is telling me to take a break? Some patients want to die when no one else is there. Hospice professionals know that companionship while dying is a personal preference.
The first organ system to “close down” is the digestive system. Digestion is a lot of work! In the last few weeks, there is really no need to process food to build new cells. That energy needs to go elsewhere.
You can talk about memories with them, listen to their accomplishments if they wish to share, and speak on joyous occasions you shared together. Some loved ones who are dying will have little to say or even nothing at all. In this case, your presence alone can provide them with comfort.
The importance of relationships led Dr. Byock to conclude that patients who came to positive life closure, were not afraid to say these four important phrases to those they loved: 'Please forgive me,' 'I forgive you,' 'Thank you,' and 'I love you. ' It is that simple BUT it is not easy.
Common themes of last wishes were Travel, Activities, Regaining health, Quality of life, Being with family and friends, Dying comfortably, Turn back time, and Taking care of final matters.
There really are no “wrong words” to say but do avoid using clichés that sound trite or impersonal, such as “we all have to die someday”. Use your own thoughts and feelings if you are close to this person. Let them know how much you think about them and how much you have benefitted from knowing them.
Create memories and stories
If your mum or dad feels up to it, you could sit down and talk about their favourite memories and look back over their life. You could also ask them to tell you about their thoughts and dreams for you and your future.
Hearing is thought to be the last sense to go in the dying process, so don't be afraid to talk. Keep in mind that they person can likely still hear you, even if they appear to be in a deep sleep, so be mindful of what you say to others while in the dying person's presence.
Decompensation progresses over a period of minutes even after the pulse is lost. Even when vascular collapse is the primary event, brain and lung functions stops next. The heart is the last organ to fail.
Others start to cry and feel as though they won't be able to stop. Some people become angry and scared. Or they feel numb, as though they have no emotions. These are all very common and natural reactions.