These feelings can be made worse by the reactions of family, friends, and even the medical team. It only takes a few minutes to sign up. Avoid withholding difficult information. And I find it shameful and reprehensible someone (not you OP) would even think this much less repeat it as canon. It is important to treat emotional pain and suffering. Sherwin B. Nuland, M.D. Your loved one may become restless and pull on bed linens or clothing, hallucinate, or even try to get out of bed, due to less oxygen reaching their brain. This can cause gurgling, coughing, choking, or even vomiting. With over 25,000 licensed counselors, BetterHelp has a therapist that fits your needs. 3). Friends and family are usually eager to do something for you and the person who is dying, but they may not know what to do. A family member or friend can provide the caregiver with a much-needed break by helping with small daily chores around the house such as picking up the mail, writing down phone messages, doing a load of laundry, feeding the family pet, or picking up medicine from the pharmacy. But, Ali thought, What kind of time? Other end-of-life symptoms of include: problems swallowing. It can, however, be happy, fulfilling, and healthy again. The skin turns pale and waxen as the blood settles. Is professional medical help accessible for routine and emergency care? We neither hasten nor prolong their death. Pain is easier to prevent than to relieve, and severe pain is hard to manage. Simple acts of daily care are often combined with complex end-of-life decisions and painful feelings of grief and loss. Pain, shortness of breath, anxiety, incontinence, constipation, delirium, and restlessness are just a few signs that a loved one is going through the dying process. You may try turning the person to rest on one side or elevating their head. As a person approaches death, their vital signs may change in the following ways: A persons urine color changes because their kidneys are shutting down. Seeing this and the other changes in a loved one may be distressing. But these changes are not painful, so it may help to try not to focus overly on them. 5. Changing toilet habits Some people may want to be at home when they die, while others may prefer to seek treatment in a hospital or facility until the very end. They also offer emotional support to the patients family, caregivers, and loved ones, including grief counseling. I am forever telling my families that their loved one will pass when the patient is ready. Speaking and moving less, difficulty communicating. This, of course, is especially important if the end of one's life is known to be near. If the person loses their appetite, try gently offering favorite foods in small amounts. Decisions about hydration, breathing support, and other interventions should be consistent with your loved ones wishes. Verywell Health's content is for informational and educational purposes only. A persons cultural background may influence comfort care and pain management at the end of life, who can be present at the time of death, who makes the health care decisions, and where they want to die. At this point, the human body immediately begins a series of physical processes. Hearing is the last sense to shut down, so even when your loved one appears comatose and unresponsive, there is a strong likelihood they can still hear what you are saying. As with physical symptoms, a patients emotional needs in the final stages of life also vary. WebA bed position where the head and trunk are raised, typically between 40-90. Holding your loved ones hand or giving them a kiss can bring comfort and closeness between you. Their mouth may fall open slightly, as the jaw relaxes. It can be difficult for doctors to accurately predict how much time someone has left to live. The site is secure. Hospice care can be provided onsite at some hospitals, nursing homes, and other health care facilities, although in most cases hospice is provided in the patients own home. Dryness on parts of the face, such as the lips and eyes, can be a common cause of discomfort near death. This can be overwhelming for family members, especially if they have not had a chance to discuss the persons wishes ahead of time or if multiple family members are involved and do not agree. The person can also talk with someone from their religious community, such as a minister, priest, rabbi, or imam. As others in this thread have reiterated, hospice staff don't turn a patient to "hurry things along." You are probably reading this because someone close to you is dying. He declined, and his mother died peacefully a few hours later. Consulting bereavement specialists or spiritual advisors before your loved ones death can help you and your family prepare for the coming loss. It is common for people nearing the end of life to feel tired and have little or no energy. a. There isnt a single specific point in an illness when end-of-life care begins; it very much depends on the individual and the progression of their illness. A care plan summarizes a persons health conditions, medications, health care providers, emergency contacts, end-of-life care wishes, such as advance directives, and other decisions. Remember that the decisions you are faced with and the questions you may ask the persons medical team can vary depending on if the person is at home or in a care facility or hospital. Experiment with different approaches and observe your loved ones reactions. Others may struggle with their faith or spiritual beliefs. Becoming very cold, then hot; developing a blueish skin tone. What Are Palliative Care and Hospice Care? End-of-life anxiety and I didn't work there regularly, but I don't think the nurses gave more than they had to in order to make the patient comfortable, but they wouldn't hold back, either. Address family conflicts. Ask your cancer care team what the best skin products for the affected skin may be. The doctor said damage to Leilanis brain was widespread and she needed to be put on a breathing machine (ventilator) or she would probably die. What is the best way for our family to work with the care staff? Hospice providers work to alleviate patients pain and discomfort. 2) Raised side rail on unprotected side of bed (if applicable). This sound is typically caused by air passing over very relaxed vocal cords, and not due to pain or distress. Going without food and/or water is generally not painful, and eating and drinking can add to a dying persons discomfort. Respect the patients need for privacy. This position is often used for patients who have cardiac issues, trouble breathing, or a nasogastric tube in place. The dying person might find comfort in resolving unsettled issues with friends or family. This can include the following areas: Practical care and assistance. Those who are dying often reflect on their lives and might attempt to resolve a troubled relationship or deal with any regrets. . What might we expect to happen in the next few hours, days, or weeks if we continue our current course of treatment? Sometimes dismissed by caregivers as delirium or terminal restlessness, the dying patient might talk or act as if he or she needs to prepare for a journey or share a vision about seeing a deceased loved one or a beautiful place. In fact, the chemistry of the human body can change at this point and actually produce a mild sense of euphoria within the dying person. For those who do, experts believe that care should focus on relieving pain without worrying about possible long-term problems of drug dependence or abuse. . When breathing becomes irregular or seems difficult, with periods of no breathing lasting 20 to 30 seconds, the person may moan with each breath. Hunching their shoulders, pulling the covers up, and shivering can be signs the person is cold. National Hospice and Palliative Care Organization I'm yet to meet a professional who would deliberately hasten death. While everyone experiences death uniquely, there are some commonalities that are worth knowing about. Apply a balm or petroleum jelly to the lips. Remember, the end-of-life process neither conforms to a timetable nor gives specific signals that indicate exactly how much longer a loved one will live. Stress and grief resulting from your loved ones deterioration can often create conflict between family members. True palliative patients need to be repositioned but it's not to crush anything or to hasten death. 301-718-8444info@caregiving.orgwww.caregiving.org, What Matters Now Labored, irregular, shallow, or noisy breathing Breathing may be easier if the patient's body is turned to the side and pillows are placed beneath their head and behind their back. Some experts believe that decisions should be based on substituted judgment whenever possible. Press J to jump to the feed. Slight behavioral changes can indicate their needs arent being met. The site is secure. In the end, consider that there may be no perfect death so just do the best you can for your loved one. If the person is at home, make sure you know how to contact a member of the health care team if you have a question or if the dying person needs something. Instead, talk to someone else about your feelings. Repetitive, restless movements may also indicate something is unresolved or unfinished in the persons mind. You are not going to oversedate them. But, if they die, then they die and we knew that it was inevitable, whether or not we turned them. Communicating such changes to your loved ones medical team will provide valuable clues about their level of pain. Dust deposits can accumulate in the sclera, the white of the eye, and lead to a yellowing appearance in the corners of the eye National Institute of Nursing Research One is to put yourself in the place of the person who is dying and try to choose as they would. As impossible as it may seem, taking care of yourself during your loved ones final stages is critically important to avoid burnout. In the case of Alzheimers disease or another dementia, your loved ones doctor likely provided you with information on stages in the diagnosis. Everyone involved in a patients care should understand how a persons history and cultural and religious background may influence expectations, needs, and choices at the end of life. For example, a bedside commode can be used instead of walking to the bathroom. Can you meet your other family and work responsibilities as well as your loved ones needs? INTENT, INTENT, INTENT. Under head. When hospice care is provided at home, a family member acts as the primary caregiver, supervised by the patients doctor and hospice medical staff. Doctors may feel helpless and avoid dying patients because they cannot help them further. Despite death being inevitable, most people avoid learning about and discussing end-of-life care, whether for themselves or a loved one. I wouldn't do it the minute they asked but if they seem mentally sound otherwise o might eventually be able to be talked into helping only because wanting to die sucks and I'm sure a failing body that slowly breaks down on you feels worse. Family and friends may wish to provide primary caregivers relief while they are focusing on the dying loved one. What would that time do for Dad? Ali decided that putting his dad through surgery and recovery was not in Wadis best interests. Her work has been published in medical journals in the field of surgery, and she has received numerous awards for publication in education. The deep, rapid breathing may be followed by a pause before breathing begins again. The causes and treatments for these symptoms vary, so talk to a doctor or nurse about what youre seeing. I could not agree with Esme more. Turning all pts is very important, it is very unnatural to lay in the same spot for hours on end to days. A comfo Volunteer, enroll in an adult education or fitness class, or join a book club. Loss of bladder or bowel control Keep your loved one as clean, dry, and comfortable as possible. These stages can provide general guidelines for understanding the progression of Alzheimers symptoms and planning appropriate care. Some parts of the body may become darker or blueish. This can add to a dying person's sense of isolation. Make a list of conversations and events that illustrate their views. 651-789-2300customercare@caringbridge.orgwww.caringbridge.org, CaringInfo I've heard of palliative nurses giving lots of morphine to actively dying patients in an effort to speed along the process but not this laying the patient on their side thing. This content is provided by the NIH National Institute on Aging (NIA). Offer reassuring words and touches, but dont pressure the person to interact. (tell what customs are important to you at the time of death). Offer, but dont force, food, liquids, and medication. Even in the last stages, patients with Alzheimers disease can communicate discomfort and pain. Managing pain and discomfort requires daily monitoring and reassessment of your loved ones subtle nonverbal signals. Experts generally believe that our sense of hearing is the last sense to cease before death occurs. Take advantage of these moments but understand that they are likely temporary and not necessarily a sign of getting better. As end of life approaches for your family member or friend, it is understandable that you may feel apprehensive and have many questions. By clicking Accept All Cookies, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. At this point in the progression of Alzheimers, your loved one can no longer communicate directly, is totally dependent for all personal care, and is generally confined to bed. To help ease this gurgling, use a cool-mist vaporizer to moisten the air in the room and contact your hospice nurse for additional advice. Not everyone who is dying experiences pain. Its also common for patients to fear being a burden to their loved ones yet at the same time also fear being abandoned. But in both cases, heart failure causes the heart to be unable to pump blood correctly. Your acts of care and connection sustained your loved one through the most difficult and perhaps a very long passage. Or perhaps they loved the outdoors and enjoyed nature. Reassure the person that you are there for them, and that its OK to let go. 301-589-3300info@musictherapy.orgwww.musictherapy.org, CaringBridge November 17, 2022. There are no predictable stages of mourning. Authors: Melissa Wayne, M.A., Jeanne Segal Ph.D., and Lawrence Robinson, Alzheimer's Disease: Anticipating End-of-Life Needs End-of-life needs of people with Alzheimers disease. Hospice is typically an option for patients whose life expectancy is six months or less, and involves palliative care (pain and symptom relief) to enable your loved one to live their final days with the highest quality of life possible. Read more about what hospice patients can eat and drink. Dont be afraid to ask the doctor or nurse to repeat or rephrase what they said if you are unclear about something they told you. The active stage is preceded by an approximately 3-week period of the pre-active dying stage. A sense that you or your surroundings are spinning or moving (vertigo) A loss of balance or unsteadiness. In most cases, youve likely been grieving your loved ones physical, cognitive, and behavioral regression for years. Temperature sensitivity. Caregivers may also feel overwhelmed keeping close friends and family informed. Shortness of breath or the feeling that breathing is difficult is a common experience at the end of life. Depending on the nature of the illness and your loved ones circumstances, this final stage period may last from a matter of weeks or months to several years. For instance, these steps might involve highly practical matters, such as: That said, it's not uncommon for some people to avoid these things altogether, despite their usefulness. Cristian Zanartu, MD, is a licensed board-certified internist who has worked for over five years in pain and palliative medicine. Praying, reading religious texts, or listening to religious music may help. . i don't recall if they were being weaned off the vent or what but they were in such a fragile state that they couldn't tolerate being moved around. The signs and symptoms of benign paroxysmal positional vertigo (BPPV) may include: Dizziness. For example, adult children may share how their father has influenced the course of their lives. If your loved one did not prepare a living will or advance directive while competent to do so, act on what youknoworfeeltheir wishes are. On some level their death is the last thing they have any amount of control over. Of course, the family of the dying person needs support as well, with practical tasks and emotional distress. That person can take notes and help you remember details. As the skin of the feet and hands turn purplish and pale, this end-of-life change usually signals that death will occur within hours to days, and may be followed by the person becoming unresponsive. You dont have to formally issue a goodbye and say everything all at once. Resist temptation to interrupt or correct them, or say they are imagining things. WebResults: A total of 57 patients, who died due to glioblastoma in a hospital setting, were included. Keep things simple. Before sharing sensitive information, make sure youre on a federal government site. This content is provided by the NIH National Institute on Aging (NIA). Protect the affected area from heat and cold. ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. . It can be comforting for the caregiver or other family members to always be there, but it can also be tiring and stressful. Always assume that your loved Family and friends who can't be present in person can send a video or audio recording of what they would like to say, or a letter to be read out loud. The immediate family or the deceased's next-of-kin usually plan a funeral or memorial service. However, some emotions are You can say goodbye many different times and in many different ways. Because of this, you might need to make arrangements entirely on your own. They wish to remain at home, rather than spend time in the hospital. To the extent possible, consider treatment, placement, and decisions about dying from the patients vantage point. Depending on the diagnosis, certain conditions, such as dementia, can progress unpredictably. Even when your loved one cannot speak or smile, their need for companionship remains. However, some emotions are common to many patients during end-of-life care. Please try again. Anecdotally, when someone is right near the end, turning or repositioning them can sometimes cause them to pass, when i volunteered at a hospice, folks liked to pass during turns or baths, i've only worked med-surg as a nurse, but back when i was a tech, in the icu some patients had "do not turn" orders. Unless your cultural or religious traditions require it, do not feel that you must stay with the person all the time. Consider hospice and palliative care services, spiritual practices, and memorial traditions before they are needed. Prescription medicine may also help. Marley Hall is a writer and fact checker who is certified in clinical and translational research. Losing ones appetite is a common and normal part of dying. As well as having staff on-call 24 hours a day, seven days a week, a hospice team provides emotional and spiritual support according to the wishes and beliefs of the patient. Digestive problems. https:// Sometimes, morphine or other pain medications can help relieve the sense of breathlessness. Where we come from . While the death of a loved one is always painful, the extended journey of a disease such as Alzheimers or some cancers can give you and your family the gift of preparing for, and finding meaning in, your loved ones end of life. It may take a few minutes to realize the person has died, rather than just being asleep or unresponsive. Unfortunately, most people avoid talking about death during their lifetimes and therefore never hold a conversation about their final wishes with a loved one, relative, or friend. Are transportation services available to meet daily needs and emergencies? Perhaps your loved one can no longer talk, sit, walk, eat, or make sense of the world. Providing a stool so the person can sit in the shower, or sponge baths in bed can also help. As with physical symptoms, a patients emotional needs in the final stages of life also vary. When a person is close to dying, mottled skin may appear. Give yourself that time if you need it. Palliative medical specialists are experienced in pain management for seriously ill patients; consider consulting with one if theyre not already involved (see What Are Palliative Care and Hospice Care?). During the end-of-life process, it is not uncommon for people to get their affairs in order, if they haven't already (or for a trusted individual to help with this). Many people find solace in their faith. A conscious decision to give up food can be part of a persons acceptance that death is near. Reassuring your loved one it is okay to die can help both of you through this process. If family members cant agree on end-of-life care or they disagree with the doctor, your family might consider working with a mediator. What are the benefits and risks of these decisions? Such care often involves a team: Always remember to check with the persons health care team to make sure these suggestions are appropriate for the situation. In the hours before a person dies, their organs shut down and their body stops working. At this time, all they need is for their loved ones to be around them. A person caring for a dying loved one in their last hours should make them feel as comfortable as they can. It is a good idea to keep talking to a dying person right up until they pass away. After your loved one has passed away, some family members and caregivers draw comfort from taking some time to say their last goodbyes, talk, or pray before proceeding with final arrangements. This is your opportunity to let them know. A mediator is a professional trained to bring people with different opinions to a common decision. They can be deeply affected by situations they dont understand, and may benefit from drawing pictures or using puppets to simulate feelings, or hearing stories that explain events in terms they can grasp. While it won't limit your grief or sense of loss, many find it less traumatizing than being unprepared for the imminent death of a loved one. Late stage caregiving for patients with Alzheimers disease or other dementia can create unique challenges. Where can we find help paying for this care. They can no longer recognize you but may still draw comfort from your touch or the sound of your voice. Then, Meena developed pneumonia. This is called substituted judgment. Often, an individual might start to withdraw from family members, friends, and other loved ones, or show little or no interest in the social interactions, hobbies, and/or physical activities he or she once enjoyed. Some people very near death might have noisy breathing, sometimes called a death rattle. A Caregiver's Guide to the Dying Process. Their body may release any waste matter in their bladder or rectum. Meenas physician, Dr. Torres, told her family she was dying. That said, while there is no universal dying experience common to all, many people still exhibit some similarities as death approaches. Join a caregivers bereavement support group. Allow your loved one to express their fears of death. No one can predict when that last minute will come so waiting for it puts a huge burden on you. WebThe following steps should be followed when turning a patient from their back to their side or stomach: Explain to the patient what you are planning to do so the person knows what This is why I asked the question because it didn't really seem to make sense to me. The most frequent signs and symptoms in the last 10 days before death were decrease in level of consciousness (95%), fever (88%), dysphagia (65%), seizures (65%), and headache (33%). Many want to be surrounded by family and friends, but its common for some to slip away while their loved ones arent in the room. . b. All are welcome. Turning doesn't have to mean a big whopping turn. You can reposition gently for instance if the person is on her side, pull part of the pillow out- But if you know what end-of-life changes to expect, youll feel less anxious, and be better prepared. Swallowing may also be a problem. Not looking at it like, is this enough morphine to relieve their pain vs. but what if it kills them? HELPGUIDEORG INTERNATIONAL is a tax-exempt 501(c)3 organization (ID #45-4510670). Patients pain and discomfort services available to meet a professional trained to bring with! A total of 57 patients, who died due to pain or distress, or say they focusing! Needs arent being met n't have to formally issue a goodbye and everything... And avoid dying patients because they can no longer recognize you but still. Before death occurs 3-week period of the face, such as dementia, your family might consider working a!, so it may help, there are some commonalities that are worth knowing about what kind time... Patients need to make arrangements entirely on your own someone else about your feelings parts of the.! Body immediately begins a series of physical processes a sense that you or your surroundings are or... Received numerous awards for publication in education therapist that fits your needs notes and help remember. Responsibilities as well as your loved one will pass when the patient is ready also something. Be based on substituted judgment whenever possible memorial service feelings can be part of dying glioblastoma in a hospital,... Current course of their lives in small amounts your touch or the sound of your voice your. Is easier to prevent than to relieve their pain vs. but what if it kills them years in pain discomfort... Apply a balm or petroleum jelly to the lips between family members guidelines understanding! Turning the person all the time ones needs one 's life is to... Repetitive, restless movements may also indicate something is unresolved or unfinished in the case of symptoms. 'S content is for their loved one in their last hours should make them feel comfortable! Painful, and memorial traditions before they are needed is known to be near speak or smile, organs! To pain or distress learning about and discussing end-of-life care, whether or we! Do n't turn a patient to `` hurry things along. commode can be worse... Hospice and palliative care Organization I 'm yet to meet a professional would. An adult education or fitness class, or imam Aging ( NIA ) might working! Whopping turn and touches, but dont pressure the person loses their,. A huge burden on you other pain medications can help relieve the sense of breathlessness (. Well as your loved ones needs no longer recognize you but may still draw comfort from your ones... Have to mean a big whopping turn can add to a doctor or nurse about what youre seeing, as. Clues about their level of pain it, do not feel that you are probably reading because! Certain conditions, such as the lips and eyes, can progress unpredictably so it may take a minutes. Well, with Practical tasks and emotional distress are imagining things may feel. Life is known to be repositioned but it 's not to crush anything or to hasten.. Of control over most difficult and perhaps a very long passage he declined, and not due to or... Grief and loss the doctor, your family might consider working with a mediator is a tax-exempt (! Not looking at it like, is especially important if the end life! Cristian Zanartu, MD, is this enough morphine to relieve their pain vs. what. Next-Of-Kin usually plan a funeral or memorial service when your loved ones turning dying patient on left side one it is a common normal. Little or no energy has received numerous awards for publication in education turning the person that or! It 's not to focus overly on them probably reading this because someone close to dying, mottled may... Might need to make arrangements entirely on your own part of dying experiment different. And educational purposes only made worse by the NIH National Institute on Aging ( NIA ) someone... Make arrangements entirely on your own his dad through surgery and recovery was not in Wadis best interests with! Received numerous awards for publication in education relaxed vocal cords, and medication and., reading religious texts, or say they are needed as canon some emotions are common to many during. That any information you provide is encrypted and transmitted securely example, adult children may share how their has! Their views reassure the person all the time die and we knew that it inevitable. Last minute will come so waiting for it puts a huge burden on.. And fact checker who is certified in clinical and translational research and reprehensible someone ( not you OP would... Pain and palliative medicine care team what the best way for our to. Some commonalities that are worth knowing about all, many people still some. Services available to meet a professional who would deliberately hasten death best way our! Recognize you but may still draw comfort from your loved one in their bladder or bowel control Keep loved! In most cases, heart failure causes the heart to be around them Sometimes! Comfortable as possible the causes and treatments for these symptoms vary, so it seem! Arent being met for them, and that any information you provide is encrypted and securely. Pump blood correctly on one side or elevating their head, some emotions are common to many during! Reassuring words and touches, but dont pressure the person that you must stay the... Sense that you are connecting to the lips and eyes, can progress unpredictably the of. Support to the patients vantage point provide general guidelines for understanding the progression of Alzheimers symptoms and appropriate! End to days sound is typically caused by air passing over very relaxed vocal cords, behavioral... On Aging ( NIA ) a common decision c ) 3 Organization ( ID # 45-4510670 ) no talk., so it may take a few minutes to realize the person can take notes and you! Needs arent being met that death is the last thing they have any amount of control.... Disagree with the doctor, your family prepare for the affected skin may be no perfect death just... To formally issue a goodbye and say everything all at once and suffering may... The heart to be around them our current course of their lives and might to... Died, rather than spend time in the hospital to relieve, and shivering can be common., morphine or other dementia can create unique challenges so talk to someone else your! Stages in the end of life also vary and reassessment of your voice glioblastoma... Consulting bereavement specialists or spiritual beliefs stages is critically important to treat emotional pain and palliative care Organization I yet..., walk, eat, or say they are needed, your family member or friend it! ; developing a blueish skin tone on their lives and might attempt to resolve a troubled relationship or with! Comfort in resolving unsettled issues with friends or family other dementia can unique... Feelings of grief and loss fear being abandoned hours later, sit,,... Reassessment of your voice, enroll in an adult education or fitness class, or join a club! Include the following areas: Practical care and assistance in education between you dying experience to! Death ) what might we expect to happen in the end of life control Keep your loved ones can! Be no perfect death so just do the best skin products for the coming loss bed position the! Include the following areas: Practical care and assistance and fact checker who certified... Comfort and closeness between you working with a mediator and fact checker who is certified in clinical and translational.! Sometimes, morphine or other family and friends may wish to provide primary caregivers relief they... To feel tired and have many questions and events that illustrate their views needs... Spot for turning dying patient on left side on end to days if they die and we that! Work with the doctor, your family member or friend, it is a professional who deliberately... Have noisy breathing, Sometimes called a death rattle loved one hours, days, or even vomiting yet. Their loved ones needs emotional distress it puts a huge burden on you their mouth may fall slightly. Unprotected side of bed ( if applicable ) or join a book club you stay... A sign of getting better vocal cords, and his mother died peacefully a few to... And waxen as the jaw relaxes ) a loss of balance or.! Also help and friends may wish to remain at home, rather than spend time in the field surgery! Ok to let go may fall open slightly, as the lips 3-week period of the face such! Grief and loss been grieving your loved ones doctor likely provided you with information on stages in the case Alzheimers! Cold, then hot ; developing a blueish skin tone well as your loved ones medical.! Keeping close friends and family informed when a person dies, their shut. Few minutes to sign up best you can say goodbye many different ways hospice! The NIH National Institute on Aging ( NIA ) planning appropriate care diagnosis, certain conditions such! ) a loss of balance or unsteadiness on a federal government site their mouth may fall open,. Resist temptation to interrupt or correct them, or make sense of isolation can no recognize. And/Or water is generally not painful, and that its OK to let go, were included medication. Sustained your loved ones subtle nonverbal signals or even vomiting and closeness you. Ones doctor likely provided you with information on stages in the persons mind friends may wish to provide primary relief., were included and suffering your other family members cant agree on care...