After settling Mrs. G in her room, her nurse sits and talks with her daughter and son.
The nurse explains to Mrs. G’s daughter and son what to expect as death nears:
- People become weaker, spend all their time in bed, and withdraw from interactions.
- Hunger and thirst diminish and food intake declines.
- Although patients often do not experience thirst, mouth and lips may be dry and family can moisten them with a swab or ice or apply lubricant.
- Urine output declines and patient may lose control of her urine or bowels. If this happens, staff will keep patient clean and dry.
- Secretions may accumulate in the throat or chest causing breathing to become noisy, gurgling or rattling. While not uncomfortable for the patient, this may be disturbing to the family and can be treated with change in position or medication.
- The arms and legs may be cool and pale or bluish as circulation slows down.
- Closer to death, breathing changes, becoming irregular with periods of rapid breathing followed by very shallow or absent breathing until the breath stops.
- Agitation or restlessness can occur which can be treated with medication.
Daughter: “What can I do now?”
Nurse: “She can hear, but may not be able to respond. Tell her how much you love her, reminisce, read to her passages she likes from the Bible.”
Invite family to participate in physical care, if the are interested. Many families feel helpless, doing oral care or combing mom’s hair can give them a sense they are helping and provide a valuable sense of connection.