Another year , another “anniversary....”
April is open us again...9 years ago our family was entering into the final stages of my husband’s life...we all knew it...time with him was becoming shorter and shorter...we were having our last
Easter, our last few days...time was becoming more and more precious...
I am sure there was some denial, some questioning in all of our hearts...why?...how could this be happening to us?...what can we do to make this time special?....what do we talk about?....where do we go from here?...what do we do?....tears at night and some in the days as well..
We only had a few more days and we took advantage of the times in remembering, story telling...just being together...it was hard and so meaningful all at once...
At night I would read the psalms out loud and hold his hand and cry...I wasn’t ready for this new chapter of life by any means...I still cry when I think of those last days...did I do it right? Was there something I could have done better? How do you prepare ????? Could we have changed our lifestyle in some way so that cancer wasn’t the winner?????
One person, a hospice friend, gave us some “guidelines” that I kept over the years that were so helpful just from an expectations point of view...they gave us a potential route that we faced in those final days...
Reading the Scriptures was and is comforting....reading through Old Testament again...”and he slept with his fathers” again and again...death has hit every family on earth...is it inevitable....but those who have Received and Believed Jesus , there is the resurrection...that life eternal with Him....thank YOU....
Salvation is found in no one else, for there is no other name under heaven given to mankind by which we must be saved.”
Acts 4:12
He then brought them out and asked, “Sirs, what must I do to be saved?” They replied, “Believe in the Lord Jesus, and you will be saved —you and your household.”
Acts 16:30-31
“God sent His Son, they called Him Jesus
He came to love, heal and forgive
He lived and died, to buy my pardon
An empty grave, is there to prove, my Savior lives
Because He lives,
I can face tomorrow
Because He lives,
all fear is gone
Because I know,
He holds the future
And life is worth,
the living just, because He lives
How sweet to hold, a newborn baby
And feel the pride, and joy He brings
But greater still, the calm assurance
This child can face, uncertain days, because He lives
And then one day, I’ll cross the river
I’ll fight life’s final, war with pain
And then as death, gives way to victory
I’ll see the lights, of glory and, I’ll know He lives”
By Bill and Gloria Gaither
Caring for a loved one through the final stage of life is never easy. Whether you carry all the responsibility or just want to be there for them, you probably wonder what to expect.
Getting familiar with end-of-life symptoms in older adults can help you understand what your loved one may be experiencing, and promote a smooth transition for everyone.
End-of-life symptoms timeline
Everyone is different, so you shouldn’t expect to see all these end-of-life signs. Also, your loved one will progress at their own pace, which could be significantly fast or slow.
Weeks before end of life
Some of the earliest signs have to do with a sense of resignation. That may involve low mood, lack of motivation, and withdrawal. The person may spend more time reminiscing about their childhood and earlier life experiences.
Loss of appetite, general weakness, and increasing fatigue become noticeable.
Days before end of life
Your loved one will likely sleep more than they’re awake. They’ll move and talk less and may not respond to conversation or commotion. Their sense of hearing is most likely unchanged, but vision may be impaired.
Other signs in the final days may include:
• drop in blood pressure, heart rate, and body temperature
• labored breathing
• difficulty swallowing
• refusing food
• no more bowel movements or urination
• hallucinations, illusions, or delusions
Some people experience a certain amount of restlessness or have a burst of energy.
Hours before end of life
Signs that the body is actively shutting down are:
• abnormal breathing and longer space between breaths (Cheyne-Stokes breathing)
• noisy breathing
• glassy eyes
• cold extremities
• purple, gray, pale, or blotchy skin on knees, feet, and hands
• weak pulse
• changes in consciousness, sudden outbursts, unresponsiveness
It’s thought that hearing is the last sense to fade. Even when unconscious, your loved one can probably still hear you.
At death
At the moment of death, breathing stops and there’s no pulse or measurable blood pressure. If the eyes remain open, pupils will be dilated.
As the muscles of the body relax, the bowels and bladder empty. As blood settles, the skin starts to look pale and waxy.
After death, you may still see tears falling from the eyes or small movements of the arms, legs, or voice box.
End-of-life symptoms
1. Appetite and digestive changes
As one nears the end of life, metabolism and digestion gradually slow down. Fewer calories are needed, so loss of appetite and decreased thirst are normal.
Trouble swallowing, nausea, and constipation can also interfere with appetite. There might be weight loss and signs of dehydration.
2. Sleeping more
Generalized weakness and fatigue are common. Energy levels wane and time spent sleeping increases.
3. Withdrawal from the world
You might notice a sense of resignation and withdrawal from the larger world. The person may create a protective bubble of fewer people and less curiosity about events outside the bubble. They might spend more time talking about the past than the present.
4. Anxiety and depression
As the end of life becomes apparent, some people experience a growing fear or worry for themselves or for those who will be left behind. End-of-life anxiety and depression aren’t uncommon.
5. Urinary and bladder incontinence
As the kidneys begin to fail, urine can become more concentrated and darker in color. Both bladder and bowel functions get harder to control.
6. Changing vital signs
Heart rate, body temperature, and blood pressure begin dropping. With reduced circulation, the hands, arms, feet, and legs start to feel cool to the touch. The skin may turn dark blue, purple, or appear mottled.
7. Confusion
Your loved one may be periodically confused. Time, place, and even close loved ones may be difficult to identify. You might note a limited attention span or repetitive motions like pulling at sheets or tugging at clothing.
8. Sensory changes
Eyesight is weakening. Someone nearing death may see, hear, or feel things that you don’t, even speaking to others who have died. Sensory changes can also lead to illusions, hallucinations, and delusions.
9. Saying goodbye
If alert to what’s happening, some people want to participate in funeral planning, putting affairs in order, or distributing possessions. They may feel a sense of urgency in clearing up loose ends, expressing feelings, and saying goodbye.
10. Breathing changes
Breathing grows increasingly slow and shallow with periods of shortness of breath. Fluid can collect in the throat as throat muscles relax. The person may be too weak to clear it by coughing, which can lead to noisy breathing known as a “death rattle.”
11. Loss of consciousness
Waking your loved one can become difficult. Eventually, they’ll be uncommunicative and unresponsive, losing consciousness or falling into delirium. Eyes may develop a glassy appearance.
How to support your loved ones during end of life
Your doctor will advise you on how to provide physical comfort based on their medical conditions. This may include administering medications for such things as pain, digestive issues, or anxiety.
Providing physical comfort
Whether or not you have professional caregivers or hospice care, there are some basic ways you can provide physical comfort:
• Use a humidifier to aid breathing.
• Apply lip balm and alcohol-free lotion to soothe dry skin.
• Help them stay hydrated with ice chips or applying a wet washcloth to the lips.
• Change positioning every few hours to prevent bedsores.
• Provide comfy bedding and refresh as necessary.
• Prepare soft foods, but don’t force a person to eat.
• Use low lighting and block out loud or distracting sounds.
• Let them sleep when they want to.
Proving emotional comfort
To help provide emotional and spiritual support:
• Encourage conversation if they’re up for it. Let them lead, be a good listener, and avoid initiating potentially stressful topics.
• Even if they don’t respond, assume they hear you. Speak directly to them rather than about them. Identify yourself when you enter or leave the room.
• Provide light physical contact by holding their hand or placing a hand on their shoulder.
• Play their favorite music at low volume.
• Don’t ignore, interrupt, or dismiss their thought process. Remain calm if they’re confused. If they’re talking to or seeing someone who isn’t there, let them be.
• Express your love.
• Don’t deny reality. If they want to say goodbye, let them. It can provide you both with peace of mind.
Think about your loved one’s spiritual needs.
Takeaway
Letting go is not easy. Learning about elderly end-of-life symptoms can help you provide the physical and emotional support your loved one needs as they transition.
Once your loved one has passed, allow yourself time to grieve, take care of yourself, and reach out for help if you need it.
https://www.healthline.com/health/elderly-end-of-life-symptoms
