Finals days

As deterioration occurs and death approaches, you may experience a range of emotions including anger, fear, sadness, frustration, worry, loneliness, grief and perhaps some relief that the situation and suffering will soon be over. This can be a very difficult time for you and people close to you. It is helpful to acknowledge your feelings and your place in this process – this is a very difficult experience and you may need some support during this time.

Often during the final days of life, people may:

• • Sleep more than they are awake, meaning they may only wake for minutes at a time, and then they will return to sleeping. Their sleep also becomes heavier and it is normal for them to become difficult to wake at all when spoken to, or touched.

• • Become confused due to reduced blood flow or chemical imbalances in their brains that can cause them to be disorientated and confused about simple things such as where they are, or the year they are in – they may even forget names, or not recognise people close to them.
• • Have visions or hallucinations of unexpected things or people. They may see items, or pets, or loved ones who are not actually in the room, or even people who have perhaps died many years before. Though it may feel distressing for you, these visions can be comforting to them, especially if they are seeing loved ones.
• • Refuse, or be unable to take any food or fluids at all as their bodies simply no longer want or require food. Their sense of taste and smell may alter, so they no longer wish to take anything orally. It can also become dangerous to place anything in the mouth if they are too sleepy or physically unable to swallow.
• • Feel hot or cold to touch due to the slowing of their circulation. Body temperature can fluctuate, so a person can be cool to the touch at one point and then hot later on.
• • Breathe differently – they may breathe faster or slower, have noisy breathing or very soft and shallow breathing.
• • General appearance may change. In the days leading up to the death, some people start to look a little different – they may appear to lose weight, so their cheek bones may appear more prominent, or their eyes may appear to be deeper or larger. If present, their dentures may no longer seem to be a comfortable fit within their mouth.

Saying goodbye

Caring for someone with a life-limiting illness allows time to say goodbye in ways that feel most meaningful to you. This may take the form of an intimate conversation with them, telling them how important they are to you, letting them know their impact on your life…saying all of the things that you may not usually say to someone.

Saying goodbye is an intensely personal experience so do what feels most appropriate for you – it may be talking, sharing music together, looking at photos together to re-live happy memories, or even playing a game. It can be very difficult talking about death and dying, especially when there is so much emotion involved, however saying words and sharing feelings and experiences may provide comfort and remove or decrease regret after the death.

There is no right or wrong time to have these conversations or experiences – they should be done when it feels right.