February 12, 2026 | End of Life Care

Please read the in-service topic & complete the quiz questions below:

In our society, most deaths do not occur at home. As a result, death can feel distant and frightening for many people. However, with the increasing availability of hospice care, this trend is shifting. More individuals and families are choosing to experience death at home as an alternative to hospitals. One of the primary goals of hospice care is to provide a comfortable death in the home, surrounded by family in a comforting environment.

Preparation for one’s death can take anywhere from a few days to several months. As a person becomes aware of their impending death, they often begin to distance themselves from family and the outside world. They may spend more time alone, sleep more, and communicate less with others. There is often a natural review of one’s life during this time. While it’s important to allow for rest, it’s equally essential to maintain communication with the person. Caregivers should explain their actions during personal care and encourage family members to continue engaging with the patient.

As a person prepares for death, they will typically eat and drink less. This decrease in intake is natural as the body begins to shut down. Accepting this can be challenging for family members and caregivers, as food is often associated with nurturing and love, and is central to many celebrations and social gatherings. It’s essential to recognize that if a patient refuses food, it does not necessarily mean they are starving; decreased food intake is a natural part of the dying process. The person may experience dysphagia, or an inability to swallow. Forcing food and fluids is not advisable, as the body can no longer properly process them. However, it’s acceptable to offer food occasionally, as the patient may still be hungry. Options like ice chips, frozen juices, and ice pops can help soothe a dry mouth.

Family members may feel frightened and experience guilt as their loved one approaches death. It’s crucial not to point out issues like dehydration or a lack of urination. Instead, caregivers should focus on interventions that provide comfort, such as mouth care for a dry mouth and changing positions for comfort. If the patient is in pain, ensure that someone is administering pain medication. For any questions or concerns, caregivers can contact Alliance Care to speak with a nurse or consult the hospice nurse. It’s essential not to alarm the family with the typical signs and symptoms of the dying process; instead, provide support and reassurance that everything possible is being done to keep their loved one comfortable and pain-free.

Typical Signs and Symptoms of Impending Death and Appropriate Care

Increased Sleeping/Lethargy: The patient may spend an increasing amount of time asleep, becoming more detached from others and occasionally failing to recognize loved ones. This is natural, and caregivers should continue to whisper to the patient, explaining procedures and care. Encourage family members to speak with the patient and express their needs. Providing privacy is essential. Permitting loved ones to let go is crucial; family members should reassure them that it’s okay to go and that they will be fine. It’s natural to say goodbye, and tears should not be hidden from the dying person, as they express love and the sadness of loss. Sometimes, the patient may suddenly become alert after a prolonged period of lethargy. Family members should be present during these moments and respond to any requests from the patient—a common occurrence in the final hours of life.

Incontinence: The patient may lose control of urination and bowel movements, making the use of adult briefs advisable. A Foley catheter may be considered, but it isn’t always necessary due to low urine output and the risk of infection. Caregivers should aim to keep the patient clean and dry. Use gentle soap and water for washing, dry the skin thoroughly, and apply lotion to prevent skin breakdown. If the patient is in pain, ask the family to administer medication before bathing or changing them. Take care not to rub the skin vigorously, as it may become fragile due to poor nutrition and hydration. Keep the patient covered, except for the area being washed, to prevent them from becoming chilled.

Urinary Output: Urine output may decrease or stop altogether during the dying process due to reduced kidney function. Urine may appear very dark and foul-smelling, and sediment or mucus may be present. Again, do not alarm the family; no intervention is needed other than keeping the client clean and dry. For any questions, refer them to the hospice nurse or contact the office to speak with a nurse.

Restlessness/Disorientation: It is common for patients to become restless or confused as they near death. They may pick at bed linens or grasp at things that aren’t there, often seeming to communicate with people who have passed away. Provide support to the family and continue to speak to the patient calmly and reassuringly. Do not contradict or argue with the patient about what they are experiencing; it is genuine to them. This is a natural part of the transition from life to death. Encourage family members to express their love and feelings.