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Questions of Death and Dying

Family Matters

Everyone facing the death of a loved one copes differently. Some family members will accept the news more easily and may find it difficult to be patient with others who are in denial.

The chaplain helps families understand that everyone takes in this information at different rates, and some people need more time.

In some families, old angers and hurts bubble to the surface when a death is near. The chaplain is someone removed from the family. So the chaplain can be a neutral, safe facilitator to help people talk out their issues.

Even if you and your family do not have a religious faith, a palliative care chaplain can be helpful.

 

As Death Approaches

People are often anxious about what to expect as death approaches, but a palliative care team, including the doctors, nurses, and social workers as well as the chaplain, can help you prepare for the stages of death and dying. These stages can vary depending on the type of illness and other factors, but they are still very common.

As the body's systems weaken in the months before death, people tend to become less active and begin to look inward. They start to withdraw from the world around them and often use this stepping back as a way of preparing.

People tend to become less interested in food as death approaches. This may feel strange. But even though one of our main ways to comfort people is to feed them, there comes a point when the body is simply not able to digest the food it's given.

A couple of weeks before death, people often become disoriented. Days and nights switch, and sometimes they can't keep their eyes open. Other times they can't fall asleep. This can be particularly hard on caregivers.

During the week or so immediately prior to death, you'll see physical changes: the pulse and breathing will slow, blood pressure will drop, and skin color will become duskier.

Within a few days or hours before death, there might be what palliative care professionals call "terminal agitation." It's a kind of energy or restlessness that might be expressed as "I need to get out of here." If your loved one is deeply confused and distressed, the palliative care team can offer a sedative that will ease this transitional symptom.

Most people with a terminal illness become unconscious in the last few hours or even days before death. But that doesn't necessarily mean they don't  know you are there. Many palliative care and hospice professionals will tell you that hearing is often the last sense to go at the end of life.

Well after your loved one can no longer speak, he or she can still hear you say, "I love you."

WebMD Medical Reference

Reviewed by Melinda Ratini, DO, MS on June 30, 2013
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