Providing Comfort Care to a Loved One at the End of Life

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Whether you have opted to take care of your loved one at home, or are doing an around-the-clock vigil at the hospital, there are things you can do to give comfort and relief to a beloved family member or friend who is dying. Their hospice team can take steps to manage pain, anxiety, and nausea with medications and other treatments. But there are also plenty of ways you can make their passing more peaceful, and strengthen the connection between the two of you during their last days of life. Here’s how to offer comfort care if your loved one is experiencing any of the following:

Pain

Pain is easier to prevent than to relieve, so make sure you are following their medication schedule to the letter, and if they seem uncomfortable, tell their doctor or nurse right away. Drugs can be changed and doses adjusted. Don’t worry if they need more opioids, or an emergency “rescue” dose. Addiction is highly unlikely at this stage, and the medication will provide much needed pain relief. There are other medications that can treat end-of-life nausea, vomiting, and constipation, as well.

Trouble breathing

This condition, known as dyspnea, is very common at the end of life. But it can frighten your loved one, and make it harder for them to have a conversation. You can help make it easier for them to breathe by turning their head to the side, elevating their bed, opening a window or turning on a fan to allow fresh air to circulate, and using a cool-mist humidifier. You can also talk to the medical team about increasing medications such as morphine, which can help reduce feelings of breathlessness.

Dry skin, mouth, lips, and eyes

Lip balm can relieve dry lips, while a damp cloth can soothe dry eyes. If their mouth seems dry, give them ice chips or wipe the inside of their mouth with a damp cloth or cotton swab. You can also massage their skin with a soothing alcohol-free lotion.

Bedsores

If your loved one is lying down for long periods at a time, make sure you turn them from their side to back and to the other side frequently (ideally, every few hours) to help prevent bedsores. You can also put foam pads under heels and elbows, which are common areas where irritation can occur.

Overheating or shivering

They may not be able to communicate this to you, so watch for subtle clues like your loved one becoming agitated and trying to kick off a blanket. If they seem too hot, remove extra covers and place a cool washcloth on their head and neck. If they appear chilled, or their feet and hands are cold to the touch, turn up the heat and add on more blankets. Avoid electric blankets, which can heat up too quickly and burn fragile skin.

Fatigue

This is very common at the end of life. If they are still mobile, encouraging them to walk around the block outside can give them a boost of energy. If they are not, and find it difficult to even get out of bed, make everyday activities as easy for them as possible so they can focus their efforts on conversation and interactions with close family and friends. For example, if it has become laborious for them to make repeat trips to the bathroom, put a commode by their bed. If showering, even with assistance, wipes them out, switch to a sponge bath in bed.

Loss of appetite

As your loved one approaches the end of life, their desire to eat and drink will ebb and may vanish entirely. While this may alarm you, it’s completely natural, as their body has started to shut down. If they seem hungry but don’t have more energy to eat, offer small, frequent high-calorie meals or supplements. Ice chips are also good for relieving dehydration and dry mouth.

Agitation and confusion

More than half of patients experience cognitive issues like delirium and distress at the end of life. You can help calm them down simply by talking to them in a soothing voice and holding their hand, or stroking their arm or back. Playing soft music and dimming the lights may also help relax them. It’s important that they hear your voice, and know that someone close to them is with them. Sometimes, they may seem to be seeing or talking to someone that’s not there. Let them interact with the imaginary person and don’t interrupt them or question what they are doing.

Loss of consciousness

Don’t assume that just because your loved one isn’t responding to you, they can’t hear you and aren’t aware of your presence. Now is a good time to let them know how much they’ve meant to you and the impact they have had on your life. You can also offer reassurance, such as promising to watch over another family member or take care of their beloved dog. This can also bring them comfort.

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