Resources for coping with cancer during the COVID-19 pandemic.

Resources for coping with cancer during the COVID-19 pandemic.

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Signs that death is near

Most of us don’t know what to expect when someone nears death. The unknown is often very scary, so understanding what may be going on can help alleviate the fear and anxiety of the dying person, their family, and their caregivers.

Usually, when a person nears death, their bodily functions begin to slow down. But it’s important to understand that every situation is different. Showing one or more of the following signs doesn’t necessarily mean the end is near.

Withdrawal

The person can become more or less indifferent to his surroundings. She loses interest in activities she used to enjoy, and doesn’t feel like talking or being social. She may also become irritable or restless.

It is normal to feel sorry when a loved one seems to pull away from us, but we should not feel personally targeted.

Drowsiness

As they approach death, a person may sleep more, be drowsy, or be difficult to wake up. She can fall asleep even while talking. She may also slowly lose consciousness in the days or hours before her death.

When visiting someone with advanced cancer, it is good to remember that visits can be tiring and difficult for someone who is dying. Visits should be short and there should be only a few people at the same time.

The person can hear you even if they are unconscious and unable to answer you. Talk to him directly. You can also touch her gently when talking to her. If you must talk about matters that might disturb her, leave the room to prevent her from overhearing you.

Reduced food and fluid intake

When the end approaches, the body slows down. The person does not need as much food and fluids as before, so they are neither hungry nor thirsty. Don’t trust your instincts, but try to let her decide when and what she wants to eat or drink.


Guide created by Natera

The person approaching death may have difficulty swallowing. If so, do not force her to eat or drink, as she may suffocate or be at greater risk of contracting a lung infection.

You can often offer him liquids in the form of sips of water, pieces of ice or juice, for example. Using a moisturizing tampon or spray will help relieve his dry mouth. Apply a balm or lubricant to her lips to moisturize them.

Changes in breathing

Breathing changes as you approach death. It can slow down or be fast and shallow. Sometimes the person stops breathing for several seconds at a time. A pattern of irregular breathing called Cheyne-Stokes breathing is commonly seen in people who are dying: the breathing is very deep and rapid, then short, and then the person does not breathe for a while.

Secretions can build up in the back of a person’s throat, causing a grumbling or gurgling sound when they breathe. These noises can worry family members and visitors, but the person is usually not aware that they are occurring.

Breathing can sometimes be made easier if the person is lying on their side or if pillows are placed under their head and behind their back. Using a humidifier can also improve comfort.

If necessary, the healthcare team can reduce the amount of secretions by sucking or using medication; oxygen therapy is also a possible option in some cases.

Loss of bladder or bowel control

Some people lose control of their bladder or bowel because the muscles in the pelvis are relaxed. This is called incontinence.

To keep your loved one comfortable, always make sure they are clean and dry. Use a liner to protect the bedding and change it when it gets dirty.

Sometimes a tube (catheter) is used to drain urine, which may be darker and less frequent.

The healthcare team may use a tube called a catheter to collect urine in a bag. This urine may be darker than normal. If the person does not eat or drink a lot, the amount of urine and stool will be reduced.

Skin changes

When the end approaches, the skin can change. It may appear pale, mottled, or bluish. It can become thin, dry and flaky. Redness may appear on the joints of the hands and legs. The hands or feet may feel cool to the touch, but the person is not cold.

To keep your loved one comfortable, you can use lightweight blankets or sheets. Avoid electric blankets or heating pads as they can cause burns.

Wash the person with lukewarm water, using a non-drying cleanser. Blot off all traces of water and then apply a light, unscented moisturizer, gently massaging the skin. Avoid rubbing red areas or areas with thinning skin.

Delirium

Sometimes a person who is dying becomes agitated, anxious or confused. This state of confusion and disorientation is sometimes called delirium.

The delirious person may not recognize relatives or friends, know what day or what time it is, or where they are. She may also see things that others cannot see or speak to them (hallucinations). She may try to get out of bed or move more when lying down. She can completely change her sleep cycle so she can sleep during the day and stay awake at night. A delirious person may make jerky movements of the arms and legs that they cannot control.

Temporary improvement

Sometimes the condition of a person approaching death improves briefly and unexpectedly. She is more alert and can interact with those around her. For family members, this improvement may give hope that the person will be better and that the prognosis was not good.

Cancer