Palliative care’s core focus is on making the terminal patient as comfortable as possible. Relatives will also need to be assured that their loved ones are not suffering unduly. We look at what you can do to ease your loved one’s physical symptoms towards the end.
Pain Relief
Every effort should be made to reduce pain. The patient’s perception of pain should dictate the medication they receive. Their primary care doctor should be contacted to prescribe and manage end-stage pain.
The patient should be made as comfortable as possible. This requires frequent changes of position, providing a supportive room temperature (this may have to be alternated), gentle massage, relaxing music, and talking if the patient wants to.
Delirium
Delirium is common in patients approaching the end of their lives. The patient may present with confusion, an inability to concentrate, swapping day and night sleep patterns, and moving around constantly. Some patients will be more withdrawn, experience visual and auditory hallucinations, talk to the dead, and not know where they are or which year it is.
The cause should be determined and addressed. Infections occur frequently and need to be treated or symptoms eased. Pain must be managed adequately. Some medications can cause delirium; however, if they are helping with pain, the doctor may want the patient to continue with the prescribed dosage. Pain medications such as morphine can cause constipation and quantities must be balanced for maximum comfort.
Dyspnoea
Dyspnoea is difficulty breathing. It may occur in bouts interspersed with easier breathing. When patients experience breathlessness, place them in an upright position to improve the flow of air. Maintain a calm manner and reassure them if they are afraid or agitated. If necessary, the doctor can prescribe something to ease their discomfort.
Oral Symptoms
The dying person may be plagued by mouth ulcers, sensitivity, and dry mouth and tongue. Teeth or dentures may be broken or missing, the person may have bad breath, and tooth problems can cause facial swelling. A dry mouth could be a result of medication or the illness. Frozen slices of lemon can be helpful for dehydration, dry, mouth, and bad breath.
Teeth and tongue must be brushed gently twice a day and followed by a drink of water. Sips of water should be given often in between brushing.
Nutrition and Hydration
Most end-of-life patients lose their appetite. However, you should not refuse them anything they ask to eat and drink. At this stage, their needs are all that matter. You can make it easier for a loved one to consume soups and drinks by thickening these meals. You can learn how to thicken coffee so that patients with dysphagia can swallow it more easily. Dysphagia, difficulty in swallowing, is common in palliative patients.
Dehydration is likely to be a symptom. Use a suitable mouth barrier to prevent lips from cracking. Small pieces of pineapple encourage saliva flow. Offer sips of water often. Although a dying person does not need food and drink in the last few days, you should nevertheless make them as comfortable as possible.
Spend as much time as you can with loved ones in their final weeks. You will be grateful for this time after they have passed on.