When a person enters the final stage of the dying process, two different dynamics that are closely inter-related and inter-dependent are at work. On the physical plane, the body begins the final process of shutting down, which will end when all the physical systems cease to function. Usually this is an orderly and undramatic progressive series of physical changes that are not medical emergencies requiring invasive interventions. These physical changes are normal, natural way in which the body prepares itself to stop and the most appropriate kinds of responses are comfort-enhancing measures.
The other dynamic of the dying process is at work on the emotional-spiritual-mental plane and is a different kind of process. The ‘spirit’ of the dying person begins the final process of release from the body, its immediate environment, and all attachments. This release also tends to follow its own priorities, which may include the resolution of whatever is unfinished of a practical nature and reception of permission to ‘let go’ from family members. These ‘events’ are the normal, natural way in which the spirit prepares to move from this existence into the next dimension of life. The most appropriate kinds of responses to the emotion-spiritual-mental changes are those which support and encourage this release and transition.
When a person’s body is ready and wanting to stop, but the person is still unresolved or unreconciled over some important issue or with some significant relationship, they may tend to linger even though uncomfortable or debilitated in order to finish whatever needs finishing. On the other hand, when a person is emotionally-spiritually-mentally resolved and ready for this release but their body has not completed its final physical stages, the person will continue to live until the physical shutdown is completed.
The experience we call death occurs when the body completes its natural process of reconciling and finishing. These two processes need to happen in a way appropriate and unique to the values, beliefs, and life-style of the dying person.
As you seek to prepare yourself as this event approaches, the members of your Hospice care team want you to know what to expect and how to respond in ways that will help your loved one accomplish this transition with support, understanding and ease. This is the great gift of love you have to offer your loved one as this moment approaches.
The physical and emotional-spiritual-mental signs of symptoms of impending death that follow are offered to you to help you understand the natural kinds of things that may happen and how you can respond appropriately. Not all these signs and symptoms will occur with every person, nor will they occur in this particular sequence. Each person is unique and needs to do things in their own way. This is not the time to change your loved one, but the time to give full acceptance, support and comfort.
Dealing with grief
Grief is a natural response to loss. It is not a disease but a healthy process that mourners can pass through to adapt to change. Individuals grieve differently and there is no uniform way people cope with their feelings of loss. You may find it helpful to talk with friends. Naming our feelings aloud often helps us to adjust to our profound pain of loss. Family and friends are often a source of support during this time. Although no one will ever replace your loved one nor will any words lessen your pain, trusted family and friends are ready to listen and be there for you. If there are children in the home, you need not hide your sadness. Children understand when a person is sad and will learn that grief is part of life and is a natural experience when someone you love is dying. Dealing with grief takes time. It may last more than a year. Feelings of grief may be experienced at different times and in varying degrees of intensity. This work requires patience and the belief that you will survive. Hospice is ready to help you through this process.
Emotional, Spiritual, Mental Signs & Symptoms with Appropriate Responses
How do you know death has occurred?
Although you may be prepared for the death process, you may not be prepared for the actual death moment. It may be helpful for you and your family to think about and discuss what you would do if you were the one present at the death moment. The death of a hospice patient is not an emergency. Nothing must be done immediately. The signs of death include such things as: no breathing, no heartbeat, release of bowel and bladder, no response, eyelids slightly open, pupil enlarged, eyes fixed on a certain spot, no blinking, jaw relaxed, and mouth slightly open. Do not call 911. If you would like to sit with the person for some time before calling Hospice, please do. Call the Hospice nurse. The nurse will make a visit.
The body does not have to be moved until you are ready. If the family wants to assist in preparing the body by bathing or dressing, that may be done. The police do not need to be called. The hospice nurse will notify the physician and funeral home and will assist in getting equipment removed from the home.
Hospice del Valle makes spiritual and emotional support available to both patient and family members. Chaplains and counselors are available to meet with you to discuss funeral planning and issues relating to grief and loss, and to support you through this time of transition and transformation.