Routine for sleep and rest

Lack of sleep may be caused by many reasons, such as visitors, discomfort, fear of not waking up, restlessness, or day and night confusion. Keep a night light on, a bell or intercom in the person’s room, or both. This will help the person if they are awakened and confused. A clock is also helpful.

Nutritional issues

Nutritional issues may be hard to address. Nausea, vomiting, diarrhea, constipation, and eating less often go along with the effects of treatment and the progression of the disease. Loss of appetite and weight loss are often a normal and natural part of the dying process. Offer small amounts of food if they enjoy it. If the person has trouble swallowing, don't give them solid food. You can try sips of liquid if they're interested. But don't force fluids.

Changes in bowel or bladder control

A seriously ill or dying person may have diarrhea, constipation, or incontinence. Care should be given to provide the person with a clean environment. It's also important not to embarrass or humiliate a person that has recently lost bowel or bladder control. Put a disposable pad underneath the patient. Give them a sponge bath or use wipes to clean soiled areas of their body.

Skin care

Various things can cause skin breakdown, pain, or both. Infection may occur in this case. The healthcare provider may talk with you about giving the person antibiotics. To prevent skin breakdown, help the person change positions every 1 to 2 hours.

Respiratory changes

Respiratory changes may happen from pneumonia, the effects of opioid medicines, or the disease getting worse. Often people will feel they can't catch their breath. This is often called air hunger, and it can be scary. Less oxygen in the bloodstream may also cause a seizure. The person may need oxygen given through the nose or by a mask for comfort. A simple fan aimed at the person may help ease the feeling of breathlessness. Or help position the person in any way that helps their breathing. Sometimes medicines can also ease anxiety related to breathing problems.

Managing discharge

Discharge from the nose, mouth, and throat may be hard to manage with a terminally ill person. Suction devices are available. It may also help to put the person in a different position to help drain the extra discharge. Medicines can also help lessen the amount of discharge. Clean the teeth and mouth with a soft toothbrush or foam swabs.

Managing pain

Every step should be taken to eliminate pain from the dying process. Pain control and management plans should be discussed before the person has a lot of pain. It's important to understand that the ultimate goal is comfort. Pain management is an important topic to discuss with the healthcare provider.

Changes in circulation and temperature

A person's arms and legs may become cooler during the dying process. Their skin may look blue and blotchy. This is called mottling. Keep the person warm with blankets. Don't use electric blanket or heating pads. They could cause burns.

When death occurs

The person's breathing and heart will stop. Their muscles will relax. They may lose control of their bladder or bowels. Their eyes will stop moving and may stay open. You may want to simply sit with the person. Some people find it helpful to pray, talk quietly, or hold their hand. If the person has home care or hospice staff, notify them that the person has died. Also notify the person's healthcare provider and funeral home.