Living with the Dying
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Loss of appetite and reduced intake of fluids are normal parts of dying because the vital organs are shutting down and no longer need food or water to keep them functioning. In most cases, a dry mouth can be painful for the ill, so caregivers are recommended to keep ice chips for the dying to suck on, if they can. If their ability to swallow is impaired, smooth cool water or ice over the lips.
Caregivers could protect cracked or dry lips with a chapstick or a lip balm. Two key concerns during this process are constipation and incontinence.
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During this time, loved ones can keep watch for signs of constipation and be alert for signs of incontinence. Keeping the patient clean and dry helps to avoid rashes, bedsores, or other pains.
Just as common as difficulty in the bowels, overall physical changes like the shutting-down of organs, body color and temperature, and other concerns become important in keeping a patient calm and feeling cared-for. Try to keep the dying comfortable by keeping their body temperature at an average. Use a damp washcloth to cool a person who feels too hot and cover the person with a sheet or blanket if they feel too cold. Alert the healthcare team if any physiological changes are noticed. Other emotional changes like anger, anxiety, and restlessness may occur.
We think this happens due to the process of dying, but may also be caused by reduced oxygen to the brain, side effects of pain medications, and other metabolic changes. Sometimes, the dying fight death, wanting to hold on until they see a person, or until they feel the time is right. Agitated patients may pick at bandages or scars, pulling at IV lines, etc.
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This is due to medications, metabolic changes, or decreased oxygen to the brain. Its best to speak calmly and be comforting to the dying at these times.
Do not try to correct their perceptions. To protect the patient against this confusion, the caregivers and healthcare team ca work to always identify themselves by name, by using a gentle voice and responding with other senses like touch.
The caregiving team should feel free to ask the doctors for pain management or medications to relieve the agitation. In a hospice situation, pain is a real and constant process. Most physical pain can be controlled.
Caregiving and the Dying Process
No one should die in pain when the means to relieve it are available. All persons have the right to have their pain controlled. Pain is real. Always believe a terminal person who shows pain. Remember that each person is an individual and perceptions of pain differ. Nobody deserves to die in pain. A tough old lady from the streets named Sono, who was there to die, asked him about the book, and he explained the tradition of Japanese monks to write on the day of their death a poem expressing the essential truth discovered in their life.
He read her a few. She wrote:. We would also like to recognize George Cowan - for being the first to sponsor this series. For more information about donations and Seminar Sponsorship, please contact donate longnow. We are a public c 3 non-profit, and donations to us are always tax deductible.
Membership: Dashboard Membership Dashboard Members get a snapshot view of new Long Now content with easy access to all their member benefits. Membership Newsletters Published monthly, the member newsletter gives in-depth and behind the scenes updates on Long Now's projects. About Frank Ostaseski Introduction Summary twitter facebook. Frank Ostaseski's Homepage. It should be required reading for all healthcare professionals who provide end-of-life care.
How to Care for the Living During the Dying Process
From its use of personal narratives to its emphasis on the theoretical underpinnings of social work practice and research, this resource models excellence in teaching. It is authoritative, comprehensive, practical and readable. Although each of the chapters could stand alone, together they carefully weave the complex elements of what healthcare professionals need to know to be both competent and compassionate in providing end-of-life care.
This resource thoroughly addresses the educational challenges set forth in the three Institute of Medicine reports calling for the education of healthcare professionals to facilitate improved care to people with life-limiting illness. Kathleen M. Reverend Francis C. Zanger, American Journal of Hospice and Palliative Care This text offers a successful interdisciplinary approach to understanding suffering, the vital relationship of self to others and the importance of self-care , and the competencies needed to promote compassionate, professional palliative care Choice This text is an excellent resource.
Katherine Miller, Palliative Medicine It beautifully encapsulates the profession of social work and the care that social workers provide for the dying and bereaved.