Elderly care

Frail Care

Post-operative care

Respite Care

Palliative Care

Short/long term illnesses
Music:  For those who appreciate music, playing the radio or playing the persons choice of music can be very calming and soothing.  The days are long when confined to a bed or a chair and "music therapy" can be most beneficial for many patients.                                                                                                                        

Quiet time: Some of us prefer silence and if this is the case, a quiet and peaceful atmosphere should be maintained.  A lot of us have had experiences in hospital where staff is chatting loudly in the passages at all times of the day and night.  This is very disturbing, especially when a person is actively dying.  Some families are very inconsiderate and even argue loudly in front of the patient, which most definitely adds to their tension and pain.                                                                                                                                       

Massage: Some patients may find that massage is helpful.  Lying in bed or sitting for prolonged periods can cause extreme discomfort.  Gently massage the persons back, buttocks, shoulders and extremities with aqueous cream, Arnica oil or gel as often as possible.  This is extremely soothing and at the same time increases and promotes circulation to the pressure areas.  There is also nothing like gentle touch to show you care.  Some may simply wish to be held. The simple presence of someone who loves the patient can be extremely soothing and helpful. You can be creative to find what helps and supports your loved one's comfort.

Practical Tasks
There are many practical jobs that need to be done at the end of life-both to relieve the dying person and to support the primary caregiver. Everyday tasks can be a source of worry for someone who is dying, and they can be overwhelming. It is important not to forget the importance of hygiene, mouth care, doing regular pressure care and maintaining the overall dignity of the person.  I often hear a loved one say to a caregiver, please don't worry to bath or turn my husband today as he needs his rest or don't worry to put lipstick on my mother as she is dying.  

Being clean, dry, nicely dressed and comfortable is of utmost importance right until the end.  If the person had a daily facial routine and liked make-up and lipstick, yet can no longer request it, they will still appreciate it being done!  For other family members who may not be helping with the physical side of nursing, taking over small daily chores around the house such as answering the door, collecting the mail, writing down phone messages, setting and managing visitors appointments, doing a load of laundry, feeding the family pet, picking medicine up from the pharmacy, doing some shopping, sitting with the person whilst the caregiver has a much needed break - can all be VERY helpful!

If you are the primary caregiver, try to ask for help when you need it. Don't hesitate to suggest a specific task to someone who offers to help. Friends and family are probably anxious to do something for you to ease your load.

Preparing for Approaching Death
It is important that you understand the last stage of the dying process as these natural kinds of things which may happen are interrelated. Not all these signs and symptoms will be the same with every person.  Besides from the physical signs and symptoms of near death, there is also an emotional-spiritual-mental side. Each person is unique and needs to do things in his or her own way. To allow them to complete their journey, you will need to have an understanding of these dynamics in order to give continuous acceptance and support.

On the physical side the body begins the final process of shutting down, which will end when all the physical systems cease to function. Usually these physical changes occur slowly and in quite an orderly way and can be easily dealt with.  These changes do not require emergency interventions as this is a normal, natural way in which the body prepares itself to stop, and the most appropriate kinds of responses are comfort enhancing measures.

The other part of the dying process at work is on the emotional-spiritual-mental plane, and is a different kind of process. The spirit of the dying person begins the final process of release from the body and all attachments. This release also tends to follow its own priorities, which may include the resolution of whatever is unfinished of a practical nature and reception of permission to "let go" from family members. These events are the normal, natural way in which the spirit prepares to move from now into the next dimension of life. The most appropriate kinds of responses to the emotional-spiritual-mental changes are those which support and encourage this release and transition.

When a person's body is ready and wanting to stop, but the person is still unreconciled over some important issue, he or she may tend to linger in order to finish whatever needs finishing even though he or she may be uncomfortable or debilitated. On the other hand, when a person is emotionally-spiritually-mentally resolved and ready for this release, but his or her body has not completed its final physical shut down, the person will continue to live until that shut down process ceases.

The experience we call death finally happens when the body completes its natural process of shutting down, and when the spirit completes its natural process of reconciling and finishing. A dying person might be worried about who will take care of things when he or she is gone. Offering reassurance-"Dad, we want Mom to live with us from now on," "Debbie has promised to take care of Cheeky", "we have sorted out your bank account so that Mom can sign cheques"-might provide a measure of peace and resolution.

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