When a parent or senior receives a terminal diagnosis, everything changes for both the senior and for the caregivers. The first reaction is for everyone to go into a state of shock and denial. The goal for a caregiver is to ease a senior's pain and assist in making their journey to the next phase as easy as possible. Understanding the phases of dying is an important part of caregiving.
One to Thee Months Before Dying
As a senior acknowledges that their life is ending, typically the person begins to withdraw for their surrounding. Even the most social person can start turning down invitations for social events. As a senior starts to turn inward to think about their life, the outside world becomes less important. Some seniors may still have a "bucket list" of things that need closure but often senior don't really have the energy at this point to worry about extra activities. Spending time with friends and family is usually the most rewarding activity. It is very common for seniors to sleep late and eat less. Most senior see a gradual decrease in their appetite starting with meats and followed by vegetables and then other hard to digest foods. As the body slows down, it is natural for the desire for food to slow down too.
One of Two Weeks Prior Before Dying
Sleep may be the highest priority at this point. For many seniors, they have one foot in this world and another foot in their new world. As the lines of reality become blurry, they may become easily confused or disoriented. They may be easily agitated and may start unusual behaviors like picking at their cloths or licking their lips excessively. They may start to converse with dead friends and relatives. It is also typical for them to become absorbed in aimless activities like rooming around the room with no place special to go.
During this period, you may also notice physical changes. Typically the senior's blood pressure lowers and their body temperature fluctuates. It may be hard to get comfortable, as they have increased perspiration and clamminess. Another change is in their skin tone. Nail beds, hands and feet become pale and bluish with cold due to decrease circulation. Some seniors may become yellowish as their condition progresses. The process of breathing becomes more erratic. Their breath may go from the normal 16 to 20 breaths per minute to highs in the 50 breaths per minute and lows of 9 breaths per minute.
The Final Few Days
The final few days may be marked by a surge in energy. A senior may go in and out of awareness with some short periods of clarity. Try to make the most of these brief moments of clarity to tell that you love them. They might ask for a favorite meal or want to visit with friends.
During the final hours, expect to see open or semi-open eyes that are glassy and often tearing. The tearing is not from sadness. The hands and feet may become purplish due to lack of blood circulation and parts of the body may become blotchy.
The ease at which most people die is based on the amount of unfinished business and fear left in our lives. The last few breaths may be very slow with a long time between them. At this point, they have gone on to a better place and nothing is left but their body.
Summary
The process of dying can be more difficult on the caregivers than on the terminal patient. As a caregiver, you must also take care of yourself. In the end, their struggle is over but you must still move forward.
