This is it.
From the time you became a care partner, you knew this day would come. You thought about it logically, had difficult conversations, and made impossible decisions leading up to it. You knew it was coming. You saw the signs. But your heart refused to see what your head knew.
Until today. Today, the doctor declared your elder end-of-life and said that they would keep him comfortable.
What does end-of-life mean, and what do they mean by comfortable?
End-of-life refers to the time before a person’s death when it is evident their body is shutting down, and death is imminent. It’s different from palliative care, which refers to a person who cannot be cured and is supported by the best quality of life possible until they are end-of-life.
What is “keeping comfortable”?
- All unnecessary medications are stopped. Vitamin D, blood pressure and even heart medications are discontinued.
- All regular treatments such as blood work and blood pressure are ended.
- Special care is taken to ensure the skin doesn’t break down because this is painful. The person is repositioned every two hours and a mattress may be ordered which is specially designed to redistribute body position when the elder can’t.
- Impeccable care is taken to ensure the person is clean and dry because this also protects the skin.
- Mouth care is done with soft toothbrushes and a special solution which keeps the mouth fresh and inhibits bacteria. Vaseline is put on the lips and creams on the skin.
- Staff watch closely for any sign of pain. The dying person may not be able to express what they are feeling, but restlessness, grimacing and moaning may indicate pain.
- Often, a port is inserted so that pain medication can be given without constantly needing to inject.
- Talk. The hearing is the last sense to go, and this is your last chance to speak those words of love to them.
- Mouth care. Ask the nurses how to do it. It’s simple and can make your elder feel so much better.
- Rub lotion on hands and feet.
- Sing. Hymns or popular songs you know they love. You never know what might get a response. Even if it doesn’t, they may have heard, and it can only bring pleasure.
- Read scripture, especially familiar verses that bring comfort.
- Be there. That’s all that’s needed, really.
Families ask, “How long?” No one knows. Sometimes it’s just hours, sometimes a day or a week. There are many factors affecting how long a person takes to die. There may be times when you struggle with exhaustion, and you wonder if you can last another day. Remember, you won’t have this time again. Today, this day, or few days or this week, are the end of a long journey you have walked together.
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