Understanding the dying process Te mārama ki te ara mate haere
It is difficult to know exactly what will happen when someone is dying. They may get worse very quickly, become unconscious and die within hours. Some people may be awake and alert right to the end, while others may be in and out of consciousness over a few days.
Caring at home can become too difficult
No matter how much you want to care for your loved one at home, their needs may become too great. This can make it too difficult for you to continue caring for them at home.
This may mean they will need to go to:
- hospital
- a hospice
- long-term care, for example, a care home or private hospital.
If this happens you can still support and care for them.
Make the most of the time you have
Make the most of any chance to share special moments, express your feelings, say goodbye and perhaps discuss any unresolved issues.
Tamariki and rangatahi need open and honest information from adults when someone they love is dying. It is important to include them in whānau discussions and in caring for the person. Encourage them to talk about how they are feeling and to ask questions.
Signs that someone could die soon
A dying person usually gets drowsy and spends more time sleeping. At times they may be difficult to wake. This is because their organs are slowing down and getting ready to stop.
- The best time to communicate with them is when they seem alert.
- Never assume your loved one cannot hear you. Keep talking to them.
Almost everyone will completely stop eating and drinking.
- Do not offer them food or drink if they cannot swallow. This may upset them. Instead, keep their mouth moist using swabs dipped in water or fruit juice (your nurse will provide swabs).
- Moisten their lips with petroleum jelly (Vaseline).
They may become confused about the time of day or night, where they are and who you are, including whānau and friends.
- Talk calmly and confidently to reassure them.
- Tell them your name.
- Use a night light and keep familiar objects in the room.
This may be because they are uncomfortable, afraid or want to resolve unfinished business.
- Try to find out what is worrying them and offer comfort and reassurance.
- Try changing their position, moistening their mouth or finding out if they need to go to the toilet.
- Contact your nurse or doctor for advice.
The person's arms and legs may feel cool, and their lips, fingers and toes may look blue. This is because their blood circulation is slowing down.
- Avoid too many blankets as this can make them overheat and become restless.
When they are very close to death, they may lose control of their bowel or bladder.
- Use incontinence pads and sheets to keep them comfortable and protect the bed.
- They may need a catheter to drain wee (urine).
They may have more saliva and mucus in the back of their throat as they become too weak to cough or swallow.
- Sit them up a little or turn them to one side. It may help to perform mouth care for them.
- Talk to your doctor or nurse as medication might help.
The person's breathing may become irregular, and they may stop breathing at times. Their breathing can be noisy due to air passing over saliva at the back of their throat.
This is a normal part of the dying process as their lungs slow down — it is not distressing for them. This is usually a late sign in the dying process.
- Contact whānau who want to be with them when they die.
Knowing when someone has died
The death process can be both sudden and gentle. You will probably know that the person is no longer alive. Some things to look for and be aware of are:
- they will be unresponsive and not breathing or moving
- their eyes and mouth may be slightly open
- the colour of their skin will become paler and cooler
- stiffness does not happen until several hours after death.
It is very helpful if you note the approximate time of death.
If you need help or advice, contact your healthcare provider.