How to face your elder’s last days with courage

We all have our own version of comfort food. For me it’s rich Greek yogurt almost anytime, or homemade soup with almond bread, toasted, on a cold night. Maybe an herbal tea, but only the fruity kind. None of the green stuff.

Or comfort clothes. In this hot weather it’s shorts and a loose top with strappy sandals. In winter I live in hoodies and tights. When we are home, comfort is at the top of the list.

But what about when your doctor says they are going to keep your elder at end-of-life “comfortable”? What does that mean and where do you fit in?

Medications and treatments are stopped

• Most medications to treat ongoing diseases (with the exception of insulin, and sometimes antipsychotics ) will probably be stopped at the discretion of the doctor. Each doctor handles this differently, but usually anything not necessary for comfort is discontinued. Definitely all vitamins and anything else given to sustain life will be cancelled.
• Ongoing treatments such as blood work, blood pressure monitoring or anything invasive will be stopped.
• If they are receiving wound care, this will probably be continued as it provides comfort.

Skin is given special care

Paper-thin skin breaks down easily and even the slightest opening can be painful. Because someone at end-of-life usually has poor nutrition, their skin can be fragile and requires extra effort. Elders should be repositioned every two hours to prevent skin breakdown, and be kept clean and dry. They are changed, washed and powdered/lotioned more frequently. A special mattress, which is like lying on air, or a sheepskin is sometimes ordered.

Mouth care

Even though they aren’t eating, bacteria can grow quickly in the mouth and cause painful sores. The mouth is cleaned frequently with soft toothbrushes or swabs and a special solution which is refreshed daily. Vaseline keeps the lips hydrated and prevents painful cracking.

Pain-free

As much as possible, a person at end-of-life should be kept pain-free. Staff and others should watch closely for signs of pain, such as restlessness, grimacing or moaning. Usually a port is put in so that medication can be delivered to the person in a non-invasive method.

 

What can I do?

It’s common to feel helpless as your elder’s life wanes and the medical community remains in charge.

But you have a role.

• If you are comfortable, ask staff to show you how to do mouth care.
• Rub their favourite lotion into hands and feet.
• If they liked music, play their favourites. Hymns, show tunes, whatever brought them pleasure. Hearing is the last sense to leave at death.
• Read, recite scripture or favourite poems.
• Be there.

You have no idea how important you are.

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