One of the questions I hear most often is, "What do I do when my loved one no longer responds?" When a dying person no longer responds, families often wonder if they should change the care they provide. The answer is simple: the care doesn't change. We continue to provide the same comfort, dignity, and respect we always have.
In the days to hours before death, when the person no longer responds to their name or surroundings, continue to provide basic physical care.
Basic Physical Care Checklist:
- Change their position, and do so more frequently because skin can break down rapidly.
- Keep them dry, watch urine output, and consider inserting a Foley catheter, if appropriate.
- Check for bowel movements. Even as we are dying, our body continues to make poop.
- Moisten the lips and tongue, as they will probably be breathing with their mouth open.
- If pain is part of the disease history, continue giving pain medications, but other medications can generally be stopped.
- Bathe them and change the bedding daily.
- If breathing is a struggle, as it often is, consider oxygen as a comfort measure. Use a nasal cannula (the small tube that rests just inside the nose). Some healthcare professionals believe oxygen near the end of life offers little benefit. That may be so, but it may also ease the feeling of air hunger. There is no harm in trying oxygen and it will possibly bring comfort.
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Don’t worry about food or water intake. The body is beyond needing nourishment.
- They will probably be non-responsive, but continue talking with them as if they understand. Tell them who you are ("My name is Barbara. I'm your caregiver/daughter/friend") and explain what you are doing ("I'm going to help turn you onto your back") as you provide care.
Physical care in the final hours before death is really no different than the care you would give someone who is going to get better. The difference is that they can no longer respond. Continue caring for them with the same respect and dignity you always have.
Something more...
This checklist covers just one part of the dying process. If you're caring for someone you love, you don't have to figure the rest out alone.
The End of Life Family Support Bundle will help you understand what is happening, what to expect, and how to provide comfort throughout the dying process. Knowledge reduces fear.
