![]() Most of us have heard this term. It is the noisy rattling sound that a dying person makes that can be very disturbing to hear. Death rattle happens when secretions gather in the throat because the person is too weak to swallow. The gurgling sound happens when air passes through the secretions upon exhale. This doesn’t necessarily mean the person is having trouble breathing.
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![]() As a person nears the end of life, there are some very basic similarities that may be seen which crosses the type of illness or ‘reason’ for dying. Below is a list of some of these behaviors. Usually, the closer to death the more pronounced the symptom. Simple to complicated, easy to difficult, know there is always something that can be done to relieve any suffering that may accompany any of the following:
![]() I belong to Hospice Community Forum and just had a discussion with an “11th hour volunteer.” An 11th hour volunteer is a person who sits at the bedside of the dying, usually when death is imminent or within 24 hours or so. They are very much akin to a death doula. Well, he brought up the issue of creating a peaceful environment, which can be especially challenging in a nursing home. To all the nursing homes out there, most of you do a great job … but, there are some situations that nobody should have to endure, especially when he is dying. Watch the clip below to get a better understanding of what Palliative Medicine is all about. ![]() Agitation can be one of the worst symptoms to encounter at the end of life. Most in the field refer to this kind of restlessness as terminal agitation or terminal restlessness. It can be extremely difficult to treat. Not only can this be very distressing for the person ill, it is very difficult for the family. When someone has this condition, some of the following is seen: picking in the air, at clothes or at *his skin, trying to get out of bed and then wanting to get back in within 5 minutes or less or constantly changing his mind about ![]() An article, “The TLC Model of Palliative Care in the Elderly: Preliminary Application in the Assisted Living Setting” in the Annals of Family Medicine, describes 5 barriers to palliative care with the elderly who live in assisted living facilities. We can definitely generalize this to most situations where the elderly would benefit from palliative care. Basically, the 5 barriers to palliative care for them are:
![]() There is a blog post with some interesting points and comments that I’d like you to read, The Danger of For-Profit Hospices. The title alone gave me chills, did it do it to you too? I guess in some people’s minds, only those working in non-profits have the hospice heart, or give the best service and of course that is not true. It totally depends on the company. Who owns the company is a good question and matters to a point. I’ve worked at 3 for-profit hospices and one nonprofit. One of the for-profits was ![]() I wanted to revisit a study that came out 2 years ago (in case any of you missed it). I remember I had been looking for quite awhile for a study that would validate what we know in hospice–that if you come into hospice sooner, you have a good chance of living longer. There was not one. The closest I came to was an article written by a doctor stating another doctor did a study that came to this conclusion, but I couldn’t find the study (there were no references in the article). I needed more than that. Then, the following article came on the scene in March 2007: “Comparing Hospice and Nonhospice Patient Survival Among Patients Who Die Within a Three-Year Window” ![]() When someone is dying a natural death, there is a breathing pattern that usually happens. It goes something like this: a deep breath or 2, then holding it, followed by a shallow breath or 2, and so on. It is an uneven pattern of inhales and exhales. It can be scary if you don’t know it is coming. Another thing that happens is as the person gets closer to death, the time between inhales widens. When breaths are towards 20-30 seconds apart, death may be happening very soon. I say “may” because there is always someone who may have this breathing pattern and live much longer. Overall, breaths will be getting more shallow and the time between inhales will space out. There are exceptions to everything, but generally this is what you will see. Of course right now I want to tell you all the ways it could be different and how many ways breathing can look even with the above very general guidelines. The best thing to do is when you are going through this time, ask you hospice doctor or nurse about it and ask them to show you ![]() When a person is dying, she is retreating from everything outside of her. She has little energy for anything outside of what is going on in her internal world. She cannot respond the same to conversation. It takes much effort to answer questions. To engage someone in the normal back and forth conversational style can be overwhelming for her. Instead, tell a story. |
AuthorIn fall 2014, I moved some old blog posts here that I had written years ago from 2007 to 2010. Hope they are helpful. Archives
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