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Care at the End of Life - The Dying Process
If you are dying or are caring for a dying loved one, you may have questions and concerns about what will happen physically and emotionally as death approaches. The following information may help answer some of these questions.
Signs of approaching death
The dying process is as variable as the birthing process. The exact time of death cannot be predicted, nor can the exact manner in which a person will die. But people in advanced stages of a terminal illness experience many similar symptoms as they approach the end of life, regardless of their illness.
Several physical and emotional changes occur as death approaches, including:
- Excessive sleepiness and weakness as periods of wakefulness become shorter and overall energy declines.
- Breathing changes, such as periods of rapid breathing alternating with short episodes when breathing stops.
- Visual and hearing changes, such as seeing people or scenes that others do not (hallucinations).
- Decreased appetite as your metabolism slows and you no longer have the same interest in food.
- Urinary and bowel changes, such as dark or red urine and hard stools that are difficult to pass (constipation).
- Temperature changes, such as running a high temperature or feeling very cold.
- Emotional changes, such as becoming less interested in the outside world and being less socially involved with others.
Dying people may also experience symptoms specific to their illness. Talk to your doctor about what to expect. Also, if you have chosen to receive hospice care, the hospice team is available to answer any questions you may have about the dying process. The more you and your loved ones know, the better prepared you will be to cope with what is happening.
Pain
Palliative care can help you to feel relief from physical symptoms related to your illness, such as nausea or difficulty breathing. Pain control and symptom control are important parts of managing your illness and improving the quality of your life.
Whether a person suffers from physical pain in the days before death often depends on the illness. Some terminal illnesses, such as bone or pancreatic cancer, are more likely to be accompanied by physical pain than others.
Pain and other symptoms can be so feared that a person considers physician-assisted death. But pain associated with the dying process can be managed effectively. Any pain should be reported to your family and your doctor. Many medicines and alternative methods (such as massage) are available to treat the pain associated with dying. Do not hesitate to ask for help. Have a loved one report your pain if your illness prevents you from communicating with your doctor.
You may want to protect your family from your suffering. But it is important to tell them if your pain level is not tolerable so they can tell your doctor right away.
Spirituality
WebMD Medical Reference from Healthwise
Care at the End of Life Topics
VIVELLE-DOT (estradiol transdermal system) IS AVAILABLE BY PRESCRPTION ONLY.
INDICATION
Vivelle-Dot is used after menopause to: reduce moderate to severe hot flashes; treat moderate to severe dryness, itching and burning in or around the vagina; help reduce your chances of getting osteoporosis (thin weak bones); and treat certain conditions in which a young woman's ovaries do not produce enough estrogens naturally. Vivelle-Dot 0.025 mg/day is only used to prevent osteoporosis from menopause. If you use Vivelle-Dot only to treat your dryness, itching, and burning in and around your vagina or if you use Vivelle-Dot only to prevent osteoporosis from menopause, talk with your healthcare professional about whether a different treatment or medicine without estrogens might be better for you.
IMPORTANT SAFETY INFORMATION
Estrogens increase the chances of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are taking estrogens. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb).
Do not use estrogens with or without progestins to prevent heart disease, heart attacks, or strokes. Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens with progestins may increase your risk of dementia (decline in memory and thinking skills).
Vivelle-Dot should not be used if you have unusual vaginal bleeding; currently have or have had certain cancers, including cancer of the breast or uterus; had a stroke or heart attack in the recent past (for example, in the past year); currently have or have had blood clots; currently have or have had liver problems; or think you may be, or know that you are, pregnant.
The most common side effects that may occur with Vivelle-Dot are headache, breast tenderness, and back pain.
You and your healthcare professional should talk regularly about whether you still need treatment with Vivelle-Dot.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please see Full Prescribing Information for Vivelle-Dot.
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