What is End-of-Life Care?
End-of-Life care is meant to provide physical, emotional, and spiritual care and comfort for someone suffering from a terminal illness. This can be an emotional time for all parties involved, but there are ways to prepare yourself.
Learning the difference between palliative and hospice care, documents needed to make medical decisions, and the best practices for end-of-life care can give you valuable guidance during this process.
Palliative vs. Hospice Care
What is Palliative Care?
The purpose of palliative care is to alleviate pain and discomfort for patients fighting serious illnesses such as cancer. In addition, palliative care is meant to improve the quality of life. It may begin early on in treatment or continue as an aftercare measure once the patient has already started the process of recovery.
What is Hospice Care?
Hospice care is provided for patients who no longer receive treatment for their illness and are preparing to pass away. Hospice services are administered when all other options have been exhausted, and the primary goal is to provide comfort and support for the patient.
How Do You Know When Someone is About to Pass Away?
There is no definitive way of telling when someone is about to pass away, but there are some signs that they require End-of-Life care.
- Shortness of breath
- Agitation, confusion, and restlessness
- Loss of appetite
- Cold hands and feet
- A bluish tinge to the skin caused by a lack of oxygen
- Unusually long periods of sleep
- Gurgling or rattling sounds when breathing
What Decisions Need to Be Made?
Making these decisions can be agonizing but necessary when a loved one is nearing the end of their life. But the goal of these decisions is to fulfill the wishes of your loved ones and provide comfort and support for them and the family.
Some decisions that you may be confronted with include:
- Whether or not to continue treatment
- Where to receive hospice care ( Hospice care can be provided at home, an assisted living facility, or hospital )
- Whether or not to institute a DNR – Life support measures include CPR (Cardiopulmonary Resuscitation), feeding tubes, and breathing machines. These are measures meant to prolong life when vital parts of the body are not functioning. One of the decisions you may have to make is whether or not to institute a DNR ( Do Not Resuscitate ), which is a refusal to have life-saving measures performed for your loved one.
- What types of support a family will need to care for their loved one
Experts at the Mayo Clinic recommend planning ahead to ensure that the proper medical care is provided and to prevent relatives from having to make significant decisions during a time of grief and stress.
Advance Directives
A medical power of attorney is someone that you can appoint to make decisions for someone who is otherwise incapacitated. Some other terms for a medical power of attorney include health care power of attorney, a health care proxy, or a durable power of attorney for health care.
Living Wills
A living will is a type of advance directive that indicates the type of medical care that is or is not permitted to be implemented during end-of-life support. Some of these preferences include:
- Pain Management
- Organ Donation
- Cardiopulmonary Rescuscitation
- Mechanical Ventilation
- Tube Feeding
- Dialysis
- Antibiotics and Antiviral Medications
- Donating your body to science
End-of-Life Support
Hospice care requires the assistance and expertise of medical professionals who specialize in end-of-life care. These professionals include doctors, nurses, in-home caregivers, social workers or counselors, and spiritual advisors.
There are even people who specialize in providing emotional support and guidance for the families of people who are dying. These specialists are known as “death doulas,” or end-of-life doulas.
End-of-life doulas are similar to midwives who assist in the birthing process. In addition, end-of-life doulas can be hired to help ease the end-of-life process.
For more information on end-of-life doulas, please visit inelda.org.
Emotional and Spiritual Needs
Someone who is nearing end-of-life may experience intense feelings of anxiety and conflict. Listening to them and being at their side, in addition to holding their hands, can provide a sense of comfort and safety.
The best locations for hospice care are quiet environments with low lighting and soft music. Music therapy is a technique used in hospice care, which can inspire joy, peace and bring back calming memories.
Some other types of complementary therapy used for hospice patients include:
- Pet therapy
- Art therapy
- Massage therapy
- Aromatherapy
- Meditation
It is common for religious advisors to provide emotional and spiritual support during hospice. Hospice centers and hospitals sometimes have chaplains on-site to give this type of support for patients nearing end-of-life.
In addition, priests, rabbis, imams, nuns, and Buddhist monks may be requested to provide final rites and spiritual support for the dying person and their family. Having a religious advisor attending your loved one can provide comfort during this difficult time.
How to Comfort a Loved One Who is Nearing End-of-Life
You can take steps to help alleviate the discomfort that someone is experiencing during this period.
- Hand-feeding them small spoonfuls of food or using ice chips and damp sponges to keep their mouth moist
- Use a damp cloth or lotion to relieve dryness of the skin and applying balm or petroleum jelly to their lips
- Gently adjust the position of their head using pillows to help them breathe. Misting humidifiers are also helpful
- Apply lotion to their skin and adjust the position of their body to prevent bedsores
- Learn how to change bedpans, incontinence pads, and catheters
- Hold their hand and speak calmly, remind them of who is there and where they are
- Administer pain medication as directed
- Provide blankets, socks, and warm articles of clothing if they feel cold or adjust the room’s temperature so that they are comfortable
Please note: The information in this article is provided as an educational resource and should not be used as a substitute for professional expertise, diagnosis, and treatment regarding a specific medical condition. Please consult your healthcare provider before making any decisions regarding dietary or lifestyle changes, or doing any physical exercises. If you’re feeling overwhelmed by grief or depression, contact a mental health professional.
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