A dying person's sense of smell may be more acute, and she may find scented candles overwhelming. Natural soy candles are your best bet. You might pair a candle gift set with a warm, comforting fleece blanket. Bring a book to her bedside, and spend an hour or two reading out loud.
You can hold your loved one's hand or offer very gentle massage as long as that seems to be soothing to her. In the last few hours of life it is sometimes better to stop touching the patient so that she can keep her awareness on the dying process rather than on the physical realm she is trying to leave behind.
Generally speaking, people who are dying need care in four areas: physical comfort, mental and emotional needs, spiritual needs, and practical tasks.
End of life care is for people who are in the last 12 months of their life. The aim is to help the individual with the provision of an appropriate care package to live as well as possible and to die with dignity.
Greet as you always have: an air kiss, a big hug, a handshake. If the patient is very sick, they may face away from you, close their eyes or be unresponsive. Don't be anxious. Talk quietly about a time you have shared, or mutual friends who wish them well, or even the weather.
“I often hear from patients that they want to maintain a sense of normalcy during cancer treatment,” she says. “So creating a cancer care package that includes their favorite games or books, snacks or a warm blanket is a great option.”
We hope for remission. We hope to prolong life by averting death through medical treatment and supportive care. Or, if disease progresses, we hope to control pain, side effects, and suffering. We hope for treatments that can cure or palliate and make the disease stable.
“Avoid clichés or platitudes,” notes psychiatrist and author Dr. Marcia Sirota. “Saying things like, 'Everything happens for a reason,' and, 'It's God's will,' can make the person feel like their illness is their fault.” Remarks like “You're strong” and “You'll get through this” are equally problematic.
You can simply sit with them, perhaps holding hands. Hearing is said to be the last sense to go, so you may want to talk, read aloud, sing or play music. Your cultural or spiritual traditions may require someone to be present, and this may also be the time to perform any rituals.
A palliative approach shifts the primary focus from life-prolonging treatments towards symptom treatment and quality of remaining life. End-of-life care is focused on providing increased services and support for the person's physical, emotional, social and spiritual/existential issues as they approach death.
Although it can include end of life care, palliative care is much broader and can last for longer. Having palliative care doesn't necessarily mean that you're likely to die soon – some people have palliative care for years. End of life care offers treatment and support for people who are near the end of their life.
People often think of palliative care as care that is limited to the last few days or weeks of life – but that is only a small but important part of palliative care. You may even think that if you have palliative care, death comes faster – but in fact, research shows that palliative care can help people live longer.
Gasping is also referred to as agonal respiration and the name is appropriate because the gasping respirations appear uncomfortable, causing concern that the patient is dyspnoeic and in agony.
Often, people's skin colour changes in the days before death as the blood circulation declines. They can become paler or greyer or their skin can become mottled. With the loss of oxygen to their brain, they might become vague and sleepy. Some people have hallucinations and talk to 'people' who aren't there.
Those suffering from terminal conditions often experience depression, anxiety, sadness, and a slew of other feelings. These emotions alone are challenging; coupled with a terminal illness, they become debilitating.
They might close their eyes frequently or they might be half-open. Facial muscles may relax and the jaw can drop. Skin can become very pale. Breathing can alternate between loud rasping breaths and quiet breathing.
Opening the window after someone dies is a tradition that hasn't died out. All over the world many nurses and families abide by this practice. It is said the souls of ancestors gather at the time of death of a family member and, regardless, this aids the soul transitioning to the next world.
For friends and family: what you can do
It might be reassuring for the person if you speak calmly to them and hold or stroke their hand gently. Even if someone is unconscious, they may still be able to hear or feel you. If you are worried that they are distressed or in pain, speak to their doctor or nurse.