How to recognize when the time is approaching

Things to keep in mind in these final days

• It is not going to be useful or helpful to your loved one or yourself to avoid facing what is coming.

• Knowing the signs that the end is near will help you care for them the best.

• A sudden uptick in your loved one’s clarity is not a signal of recovery, but often means death is close.

• Find ways of being there with them, helping to ease their pain, and making them know they are loved.

If your loved one is currently in hospice care, it is unavoidably true that they are approaching the end of life. Even when everyone, your loved one included, is consciously aware of this, it can still feel incredibly difficult to fully accept. It is quite natural to want to avoid the subject altogether, and your loved one might be reluctant to speak with you about how they are feeling.

However, it is not going to be possible to avoid the topic of death altogether, and it is better—and kinder, in the long run—to make sure you are prepared to discuss it. Remember that you are not in this alone, and the more you fully face the fact that your loved one will soon be gone, the more you can decide to experience it as a time of love, understanding, and peace of mind, rather than only heartache. Knowing what to expect from your loved one in their final days will not only help you meet your loved one’s needs better, but will also allow you to feel more grounded.

Knowing the signs

It is never easy to witness someone you love in pain. Of course, it’s a deeply human thing to feel distressed at the sight of someone close to you suffering. Sometimes, when faced with this incredibly emotionally painful, challenging, and all-around confusing situation, we can even unintentionally allow our own feelings to get in the way of fully caring for our our loved one.

Many people are unfamiliar with end-of-life symptoms; talking about death is a big taboo in the majority of Western society, so it’s perfectly normal to not know what to expect. But knowing and understanding what your loved one is going through will help you provide them with the best care and comfort, and to prevent yourself from being caught off-guard.

For example, family members are often given false hope when a hospice patient suddenly shows signs of an improvement in their condition. This can manifest in heightened lucidity, greater awareness of their surroundings, increased talkativeness, and even restlessness. This is called “rallying before death,” and sadly it is generally a sign that the end of the patient’s life is very near. This can be difficult for families to understand since it goes against many people’s preconceived notions of death as a slow and steady decline.

Other end-of-life symptoms may include: confusion, incontinence, unregulated body temperature (feeling too cold or too warm), mottling of the skin, and changes in breathing patterns. These are just a few examples of behaviors your loved one may exhibit, but everyone’s body and mind reacts uniquely to the condition of nearing death. 

It’s important not to panic if you witness these things. The best thing that you can do for your loved one is to remain calm and steady in these moments of uncertainty. You might hold their hand, speak to them softly and calmly, or just be there to share space with them.

Making a plan

Of course, this entire process is incredibly difficult for everyone, and a huge emotional strain no matter how well you’ve prepared. Intense as it might feel, avoidance will only make it harder.

Speak to your family members and the caretakers at the hospice facility to come up with a plan for what to do if and when your loved one expresses these common symptoms, and for when the time comes to say your final goodbye.

Remember, your loved one’s hospice caretakers are there for you, too, and will be happy to answer any questions you might have during this confusing and difficult time. They are there to help you feel supported, and to help you give your loved one the most comfort possible in their final days ●