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Care Giving

If your physician or hospice has not given you information regarding what takes place prior to the death of a loved one, know that the person’s sleep will increase, the need/desire for food and drink will decrease and likely cause discomfort, as might oxygen if they have difficulty breathing. As your loved one enters the stage of active dying their body will commence to shut down – sometimes over a period of 10-14 days or as little as 24 hours. If distressed breathing (air hunger) occurs medication, not oxygen, will ease the person’s anxiety (call your physician or hospice for prescription). It can also help to open a window or direct a fan away from the patient in order to circulate air. If the dying person can communicate, ask them regularly what they would like to increase their comfort.

During the final 48 hours:

  1. The person will become dehydrated and swallowing will become difficult (the mouth can be kept moist by putting small pieces of ice inside the cheek). 
  2. Changes in hearing and vision are common as is the mottling of the soles of their feet.
  3. Eliminate bright light but provide enough dim light for the person to see the faces of those in the room. 
  4. Near the end of life the tongue and mouth tissues soften increasing secretion and causing a loud gurgling sound. It can help to turn the person on their side or elevate the head a bit. 
  5. If the loved one feels cool to the touch, refrain from adding blankets as increased weight on the feet/extremities can be intolerable. It is best to leave sheets and blankets untucked.
  6. In the last hours the dying person might well talk about joining those who have preceded them in death. It is not a time to contradict or debate their comments, discuss regrets or plead that they not die. Rather allow the person to detach from their life, keeping physical contact via touch to let them know you are there for them.

Home HealthCare Programs – Relief for Primary Caregivers

As a primary caregiver you understandably subordinate your needs 24/7 for your loved one and often realize, too late, that the schedule you are keeping has lead to physical and emotional exhaustion. In truth, the person who is terminally ill often suffers less stress and has better mental health than you, the caregiver.

It is imperative that you find some time away from the world of schedules, monitoring and medicating.   Check your insurance policy, Medicare and other organizations in your area for sources of Home Healthcare Services to relieve you for a few hours a couple of times a week. Remember your role is not to be responsible for your loved one’s recovery.

Scope of Home Health Care

Care includes medical/nursing/rehab to help with dressings, medications as well limited physical therapy. Some organization offer homemaker services which help with cleaning and food preparation. Medicare Part A requires a physician’s statement that home care is appropriate and provides nursing care and physical, speech and occupational therapies.
 
Many hospices have instituted home health care programs independent of their hospice care.  Suggested Reading: Comfort of Home, 3rd Ed. (2007), Maria Meyer and Paula Derr.

Sibling Care Giving

No family, large or small, gets along all the time with everyone. However, when it comes time to share responsibility/care giving for an aging parent, a divide can create total chaos. If your family is in this situation, you might want to consider the resources below.
 
Make it known to your adult children that no one has to forgive another’s prior behavior, but everyone can profit from sharing responsibility and acting as a cohesive unit (yes, there is always something an out-of-town sibling can do). If discord is escalating, consider a mediator who specializes in elderly care www.mediate.com.
 
Other websites: www.GenerationsUnite.com and www.carecentral.com to help families communicate and find care giving. Suggested Reading: They’re Your Parents, Too! (2010), Francine Russo and Stuck in the Middle (2008), Barbara McVicker.
Copyright 2014 by Retired Brains