This article provides a compassionate guide to recognising and understanding the common signs of the end-of-life stage during palliative care. It aims to help carers and loved ones navigate these changes and offer the best possible support and comfort to those nearing the end of their life.
Limbs Are Substantially Colder
When it comes to palliative care it's crucial to understand and interpret various bodily changes linked to the end-of-life stage of care. As this phase unfolds, the body undergoes several changes; one noticeable change is when a person's limbs become colder, such as the hands and feet.
This significant drop in temperature is a common symptom found in end-of-life situations; this happens mainly because of a gradual decrease in the body's blood circulation. Additionally, as the body strives to keep the vital organs working, more blood gets redirected to these areas - this leaves less blood to flow in the limbs; thereby causing the hands and feet to become unusually cold to touch.
During this stage, there may also be noticeable changes in the person's skin colour, which can turn to a mottled pattern or adopt a bluish-grey hue. Acknowledging these physical indicators as part of the end-of-life journey can be incredibly important as it helps in establishing a sense of peace and acceptance. In these moments, the palliative care team's role becomes crucial - their guidance, expertise and support are invaluable and can provide comfort to both the caregivers and the patient. With their help, the final moments can be made as peaceful and comfortable as possible.
A Change In Fluid And Food Intake
When individuals move into the final stages of an illness, it's common for them to gradually lose their appetite. This can be for a variety of reasons, such as experiencing pain, feeling nauseous, or struggling to breathe; sometimes, an overwhelming sense of fatigue can also impact a person's desire to eat.
Alternatively, their body might simply reduce the need to consume food as frequently as before - as the body starts to prepare itself for the end of life, it's normal for the digestive system to start shutting down, which can make even small amounts of food hard to digest. This can leave individuals feeling uncomfortably full and nauseous or could lead to stomach ache and diarrhoea.
Even though it may look like their mouth is dry, it doesn't always mean that a person is dehydrated. Similarly, while they may lose interest in food and drink, it isn't the same as starvation or dehydration. In the approach to death, the body slowly begins to shut down and feelings of hunger and thirst disappear; therefore, a loved one in this stage will likely consume less food and eventually prefer liquids and softer foods before their appetite vanishes entirely.
Medical research has shown that during the end of life, the loss of thirst may even make the person more comfortable; their lack of drinking may end up reducing symptoms like vomiting or diarrhoea. Furthermore, patients can also experience reduced pain if they have tumours, and any swelling due to fluid retention may decrease by drinking less.
A Change In Breathing
As a person approaches the end of their life, changes in their breathing patterns become more noticeable. This might be quite alarming to observe, however, it's essential to understand that these changes in breathing are normal and generally not an indication of pain or distress.
Further changes you may find include shallow breaths, periods where no breathing occurs, or apparent gasping for air - on occasion, a distinct rattling or gurgling sound might also be heard. This is often caused by the accumulation of fluids in the throat or chest area.
During this phase, you can make sure your loved one is comfortable by providing reassurance, gentle physical contact, and maintaining a calm environment. It's important to note that the goal of palliative care is not just to deliver physical support but also to provide emotional guidance to the individual nearing the end of life and their loved ones. Using palliative care services not only helps the patient navigate the end of their life, but it also helps the family deal with the aftermath. This knowledge is significant in appreciating the critical role played by different aspects of palliative care during the patient's final days.
Changes In Bowel And Bladder Movements
As a person approaches the end of their life, there are often changes in their bowel movements - this can be a direct result of their body's muscles naturally weakening, which can result in the individual losing control over these basic bodily functions.
When this happens, incontinence pads or a catheter may be suggested as ways to manage and control this change. It's also important to note that the body's output, including bowel movements, may decrease as the person's food and water consumption diminishes over time. This could result in urine appearing darker and more concentrated than usual - however, this change is generally considered a normal part of the end-of-life stage of an illness or disease.
As a person nears the end of their life, it's not uncommon for them to lose control over their bladder either. This is because the muscles responsible for controlling these functions naturally start to loosen and relax; consequently, they might not function as efficiently as they previously did.
Palliative care teams strive to keep patients as clean as possible to avoid stress, and more importantly, to prevent the risk of their skin breaking down as well. Therefore, any changes in bowel or bladder movements must be treated immediately so that preventative measures and extra care can be put in place.
They Are No Longer Active
As individuals approach the end of their lives, a common sight is a decrease in physical and mental activity - this can mean that most of their time is spent resting or asleep. One reason for this is the body prioritising its remaining energy to help keep the vital organs alive and pumping.
However, an energy reduction can be one of the most apparent signs that a person is nearing their final days or hours. This period can be challenging for the people close to the patient since they may find it harder to communicate or interact with them. Despite this, it's crucial to stay emotionally close to the person - this could be through touch if they're comfortable with it, and speaking gently to them as hearing is usually the last sense to fade. Expressing love and reassurance to a loved one can provide them with the emotional reassurance they need.
Palliative care and hospices play a vital role in end-of-life care. Their focus extends beyond physical comfort to include maintaining dignity, and respect and providing emotional support to the dying individual and their family. It's important to remember that each death, like each life, is unique. Not every person will necessarily experience all these signs; it's about understanding and recognising the signs that a patient is near the end of their life and taking the necessary steps to make that end as comfortable as possible.
Our compassionate specialist caregivers provide palliative care in the comfort of your home. Companions Home Care offers personalised assistance and support for your loved ones with diverse care requirements. Get in touch with us today to explore our palliative home care services available in London.