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Information for families, friends and carers of dying people
This leaflet includes information on what to expect when someone is dying and planning care using the Care and Communication Record.
Introduction
This leaflet is designed to anticipate any questions you may have about your loved one and their care.
As a person approaches the end of their life there are signs and characteristics that are common, however as each person is an individual there may be changes that happen to them that are not described in this leaflet. Please discuss any concerns or worries with the staff looking after your loved one at any time.
Care and Communication Record
The doctors and nurses may talk to you about an end of life care plan known as the Care and Communication Record. This is simply the care that is being planned for your loved one or friend to ensure their needs are met as they approach the end of their life.The plan includes symptom control, their need for food and drink, spiritual, emotional and social support.
Whilst this is being planned you will be fully involved throughout and supported through this difficult time.
If at any time there are any questions then please speak to staff looking after your loved one.
What happens when someone is dying?
There are some physical changes that may happen to a person when they are close to death, some of these may be distressing for families and friends but this information is aimed to reassure you that they are not unusual. If you do become overwhelmed then please speak to a member of staff who will talk you through your concerns.
Information for relatives and friends
Everybody is unique and many people are very peaceful at end of life. They appear to slip into a deep sleep and gradually become unconscious.
Even if your loved one or friend may not be responding to you, they may still be able to hear you.
By speaking to them and letting them know you are there maybe comforting to both of you.
Just in case medications
Just in case medications are used to control symptoms such as pain, restlessness, sickness and noisy breathing. They will be made available to use “just in case” they are needed. These will be discussed with you at the time.
Spiritual and religious needs
As your loved one or friend is dying, they may want particular practices carrying out, a faith leader to visit or something as simple as playing soft music.
These are completely individual to the person and if there is something that is important then please mention it to a member of staff that is caring for them.
Reduced need for food and fluids
As a person becomes weaker the effort of eating and drinking may be too much and some help to do this might be appropriate.
Your relative will be supported to take food or fluids for as long as possible.
However, at this stage the desire to eat or drink diminishes and eventually your loved one will stop eating and drinking and be unable to swallow tablets.
Regular mouth care is extremely important at this time and keeping your loved one’s mouth clean and moist is essential.
Changes to skin and sensations
In the last few hours your loved ones skin may slightly change colour, it may become grey, white or even have a slightly blue mottled colour to it.
Their skin may become more sensitive or cold to the touch, this is due to reduced circulation. These changes are all normal parts of the dying process.
Changes in breathing
When in the final stages of life, a person’s body becomes less active and they require less oxygen. This may make their breathing more irregular and there may be either a long pause between each breath or it may become more rapid. It may also become noisy, this is caused by a build-up of fluid in their air passages as they are unable to swallow or reabsorb it. This may be upsetting for family and friends however it does not appear to be distressing for the person who is dying.
Final moments of life
The final moments for most people are very peaceful.
Your loved ones breathing may become more irregular and there are longer pauses between each breath, until it eventually stops.
The person’s body will relax completely and they may look very peaceful. It can be difficult to identify the exact moment when they die as there may be one or two last gasps after it was thought they had taken their last breath.
What happens after someone has died
Even when death has been expected, this is still a profound moment. You may feel that you would like to be alone with your loved one or you may want to contact family and friends, if they are not already present.
This is totally individual and the staff caring for your loved one will assist you with what you decide and support you to spend time with your loved one after they die.
All staff are there to offer you care and support at this difficult and sad time. They can assist you with worries, concerns or questions.
We are available to give support to relatives and carers during this difficult time. Please do not hesitate to speak with the staff on duty if you need support or wish to discuss any of the information provided in this leaflet. To contact your District Nursing Team please phone the single point of access on 0151 351 8520.
With thanks to Willowbrook Hospice for sharing this information.
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