withdrawal from family and friends

• People often focus inward during the last months of life. This does not mean that your loved one is angry or depressed or that they do not love you.

• They may lose interest in favorite TV shows, friends, even their pets.

• When they feel like talking, they may want to reminisce, about both joys and sorrows. Or they may want to tie up loose ends, talk about where important documents or mementos are kept. Use this time to listen to what is important to them.

Sleep

• Your loved one may sleep a lot more, or sleep for a few hours at a time, day and night.

• They may seem drowsy and be confused at times when they first wake up.

• Worries or concerns may keep them up at night. Staying in their room as they fall asleep might help them or they might prefer to be alone; be sure to ask.

weakness

• Weakness and fatigue will increase over time. You can expect your loved one to have good and bad days, and increased help with daily personal care and getting around will probably be needed.

• As much as possible, help them save their energy for things that are most important to them.

appetite

• As the body naturally shuts down, your loved one will need and want less food. Offer small amounts of the food they enjoy. Since chewing takes energy, they may prefer milkshakes, ice cream or pudding.

• Offer sips of fluids as long as they can comfortably swallow. Use a flexible straw if they have difficulty sitting up. When a person can no longer swallow, offer bits of ice chips. Keep lips moist with lip balm and their mouth clean and moist with a soft damp cloth.

near death awareness

• Near the end of life, people often have episodes of confusion, or waking dreams.

• Sometimes they may report seeing or speaking with loved ones who have died. They may talk about going on a trip, seeing lights, butterflies or other symbols of a reality we can not see.

• As long as these things are not disturbing to your loved one, respond by asking them to tell you more. Let them share these visions and dreams with you and try not to talk them out of what they believe they see.

THE DYING PROCESS

• Your loved may sleep more and over time seem unable to respond at all. Continue to talk to your loved one, even if unconscious, as they may hear you. Talk to them, share your favorite memories, pray or play favorite music.

• You will notice a decrease in urination, it may be dark and smell strong and your loved one might have bowel changes. You can continue to provide clean dry bedding and provide gentle personal care; your care team will help you manage this care.

• Touch lets your loved one know you are there, as long as it doesn’t cause pain.

• Breathing patterns often change — becoming slower or faster, in cycles. In most cases this is unnoticed by the person who is dying, but let your care team know if you are worried about these changes.

• As blood flow slows, some parts of the body may discolor and feel cool. This is not painful or uncomfortable; simply keep your loved one covered with a light blanket.