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The Terminally ill Patient 

The Terminally ill Patient

If you are preparing for the death of someone you love, I sincerely hope that you receive some comfort and help through your dealings with us.
At Sonja Smith Funeral Group (Pty) Ltd you will find a wealth of information, that you may not have considered.

Here are a few SIGNS AND SYMPTOMS when death is expected AND HOW TO HANDLE THESE:

  • Profound weakness, trouble getting out of bed and difficulty moving around in bed.
  • Trouble swallowing food, medicine and even liquids.
  • Jerking reactions from muscle groups.

How to Handle Changes in Body Function:

  • Help the patient change positions every hour or so.
  • Avoid sudden noises or movements to lessen the startle effect.
  • Speak in a quiet and calm voice to prevent the startle effect.
  • Request liquid pain medication if the patient has difficulty swallowing.
  • Do not push fluids. Some dehydration is normal towards the end of life and also more comfortable for the patient.
  • Apply cool, moist cloths to the head, face and body for comfort.
  • More sleeping during the day.
  • Hard to wake or arouse from sleep.
  • Confusion about time, people, events and place.
  • Restlessness may pick at the bedding.
  • May show signs of more anxiety, restlessness, fear and loneliness at night.
  • Semi-consciousness may alternate with mental clarity.

How to Handle Changes in Consciousness:

  • Plan your times with the patient when he/she is most alert or at night when your presence may be a source of great comfort.
  • Remind the patient of the day and time as well as who you are when talking with him/her.
  • Continue pain medication right up to the end of life.
  • If the patient is very restless, try to find out if he/she is having pain. Treat this or consult the Doctor.
  • When talking with a confused person, use calm, confident and gentle tones to reduce the chance of startling the person.
  • Touching, holding, caressing and rocking are usually helpful and very comforting.
  • Less interest in food.
  • The mouth may dry out.
  • May no longer need all the medications.

How to Handle Changes in Metabolism:

  • Apply Vaseline to the lips to prevent drying out.
  • Ice chips from a spoon or sips of water or juice from a straw may be adequate for the person.
  • Check with the Doctor to see what medication may be stopped.
  • Medicines for pain, nausea, fever, seizures or anxiety should be continued to keep the patient comfortable.
  • Mucus in the mouth may collect at the back of the throat and may cause a very distressing sound, but usually does not cause discomfort for the patient.
  • Secretions may thicken due to lower fluid intake and build up because the patient cannot cough.

How to Handle Changes in Secretion:

  • Add humidity to the room to loosen mouth secretions.
  • If the patient can swallow, ice chips or sips of liquid may thin the secretions.
  • Change the patient’s position, turning on the side may help secretions drain from the mouth.
  • Continue to clean teeth with a soft toothbrush.
  • Extremities (arms and legs) may cool down due to slower circulation.
  • The skin on the extremities may darken and appear mottled.
  • Other areas of the body may become either dark or pale.
  • Skin may feel cold and either dry or damp.
  • Heart rate may become faint, fast or irregular.
  • Blood pressure may fall.

How to Handle Changes in Circulation and Temperature:

  • Keep the patient warm with blankets or light bed coverings.
  • Avoid the use of electric blankets, heating pads, etc.
  • Vision may become blurry or dim.
  • Hearing may decrease, but most patients are still capable to hear you even after they can no longer speak.

How to Handle Changes to Senses and Perception:

  • Leave indirect lights on as vision decreases.
  • Never assume the patient cannot hear you.
  • Continue to speak to and touch the patient to reassure him/her of your presence. Your words and actions are likely to be understood and appreciated.

Breathing may speed up or slow down due to less blood circulation and build up of waste products in the body.
Mucus at the back of the throat may cause gurgling or rattling at the back of the throat with each breath. This in itself may be very disconcerting to the people caring for the dying cancer patient.
The patient may not breathe for periods between 10 and 30 seconds.

How to Handle Changes in Breathing:

  • Put the patient on his back or slightly to one side.
  • Raise the patient’s head.
  • Use pillows to prop the head and chest at an angle or raise the head of a hospital bed.
  • Any position that makes breathing easier is okay.
  • A small person may be more comfortable in your arms.
  • Smaller amounts of urine may also be darker in colour.
  • When death is near, the person may lose control over urine and stool.

How to Handle Changes in Elimination:

  • Pad the bed with disposable layers of waterproof pads.
  • If the patient has a catheter, you will be trained to care for it.
  • Breathing stops.
  • Blood pressure cannot be heard.
  • No pulse/heartbeat.
  • Eyes stop moving and may remain open (bilaterally fixed and dilated).
  • Pupils of the eyes remain large, even in bright light. Midpoint pupils.
  • Control over the bladder and bowels are lost as the muscles relax.

How to Handle Death

It is okay to sit with your loved one for a while. There is no rush to get things done immediately. For many people, this is an important time to sit and pray together and to share their love for each other as well as for the person who has passed away. If the person dies in the home, the caregivers will be responsible to call the necessary authorities. Sonja Smith Funeral Group (Pty) Ltd has a team of experienced professionals available to you. Although the decisions are yours, you are not alone. Our presence will guide you and support you all the way. We will listen to your needs, giving you guidance as each next step or decision arrives.

This is an emotional time and this is the reason why preplanning is of importance – it provides guidance and direction to those who are emotionally upset at this time. We are experienced in dealing with an incredible variety of situations surrounding death and can provide excellent guidance for you and the individual members of your family during this vulnerable and emotional period.

When you are faced with the reality that death is unavoidable, please contact one of our branches and request a consultation. You will find peace of mind and an environment of calm reassurance. We are highly aware of the significance of our work and will do whatever we can to ensure that families are fully supported throughout the entire experience.

Call 24/7 – 079 895 4414