End of Life Care

As a caregiver, you can help clients transition through the dying process and ease them to a peaceful death by understanding their wishes and by seeing the beauty and privilege in providing end of life care.

The Dying Process

The process of dying is as unique and varied as the individual human being. No two bodies will respond the same. However, there are some events that all people will experience as they progress through the dying process. As the body’s metabolism slows:

Less oxygen is carried to the brain causing a chain reaction of events in the body.
Vision begins to blur, the sense of taste and smell become less acute, and there is a decreased perception of pain. Hearing is usually the last sense to disappear.
Skin becomes mottled (blotchy), cold and clammy.
There is a gradual decrease in urinary output. Loss of muscle control leads to incontinence.
First, the heart rate increases, followed by a slow, irregular heart rate and a decreased blood pressure.
There may be abdominal bloating, gas, and incontinence. A bowel movement may occur just before or at the exact time of death.
Breathing is first increased, then slows and becomes irregular. The inability to cough or clear the throat cause gurgling or “noisy” breathing. This sound is also known as the “Death Rattle.”
Death occurs when all the vital organs stop functioning.

How You Can Help

Above all else, the goal of end of life care is to keep the client as comfortable as possible. Report to the nurse any changes in the level of pain so that pain medications can be adjusted.
Always keep the client clean and dry. Offer small sips of fluids or ice chips upon request. Perform frequent mouth care for the unconscious client.
Continue to speak directly to the client. Remember, hearing is the last sense to go. So, chances are you will be heard!
Remember to tend to family members as well as the dying client. Be sure to ask spouses, adult children and other loved ones how they are doing. Offer to help in any way you can.