What are the end of life symptoms in elderly?
Hospice and palliative care can help seniors live out their last days with dignity, relief from distress symptoms, and the comfort that comes with knowing you are not alone. The ultimate benefit of hospice is that it’s an end-of-life treatment plan designed to support both the physical and emotional well-being of patients as they live through their final days.
There are usually four basics goals for hospice:
1) To relieve pain or other distressing symptoms that are affecting the patient and in so doing better their quality of life.
2) To improve quality of life by maintaining good hygiene and feeding you well. You are also given a chance to make amends with relatives whom you might have wronged or those that wronged you.
3) To uphold spiritual beliefs—Depending on the religion that you ascribe to, the hospice facility will make all efforts to have you feeling close to your maker and giving you the relief that even after dying you are going to a happy place.
4) To maintain hope even when a cure cannot be found—hospice providers come with counselling skills where they are able to provide emotional and psychological support not only to the patient but also to their family members.
5) Have a serene hospice transitioning to death—as they die, most elderly people wish to have everything in order. The hospice workers will ensure this by calling in all the people that you would like to see before you breathe your last. This way, one is able to die peacefully and with hope.
End of life symptoms in elderly people
Hospice doctors, attendants, nurses and caregivers are all trained to pinpoint the end of life signs in their patients. You will for example see us call up the family members of a patient when we detect that they are almost passing on.
In the last six months of their life, here are typical symptoms that might be seen in elderly people:
-Weight loss despite good appetite
-Sleep problems including daytime sleepiness and trouble sleeping at night
-Confusion or changes in thinking, such as forgetting close family members or doing more than one thing at once. They will also have hallucinations at night.
-Loss of mobility and decreased endurance when walking
-Decreased sensitivity in fingers, hands, arms and feet
– A sense of pins and needles with no actual numbing. Extra sensitivity is sometimes a symptom.
-Changes in bladder function such as needing to go more often. This could also include difficulty emptying the urine from the bladder. At other times, some elderly pass very little stool and pee since they could be having trouble eating.
Although we know death to be inevitable especially for our hospice patients, there are times when we also see cases of elderly people giving up on their lives and this actually hastens death. Research shows that psychogenic death or giving up in life can actually hasten dying in elderly people.
So what are the tell-tales indicators that we know that someone is giving up in life and will soon die?
Signs of elderly giving up on life
- Refusing to eat—Elderly people who refuse to eat have simply refused to be sustained. They are at their end and nothing can be done to bring them back. Not unless they will themselves to continue getting sustenance.
- Refusing to take care of their hygiene—for someone who has psychogenic death, they are adamant to being taken care of. They will therefore refuse to be washed or have their diapers changed. They have given up on their dignity.
- Refusing to take their medications—patients who refuse to take their pain medications just want the pain to eat them away and die.
- Getting easily agitated and angry at everyone—patients who have given up in life will tend to be agitated at everyone and will call you all sorts of words without a care at who you are. They are frustrated and they cannot hide it.
- They do not want visitors—Even for the most social of patients, we sometimes see them shrugging off being seen by their relatives or friends. They do not want anything in the world. Even their friends or family members.
- Lack of motivation—at this stage of psychogenic death, the patient seems to lack motivation to do anything. Even things that used to interest them before seem not to make sense at all.
How to help elderly people who display signs of giving up on life
If we detect that a patient has already given up in their lives, we try our best to bring them back to track so that death can be a natural process and not something that they are hastening.
We provide lots of counseling to them telling them how important they are in life. We encourage them to take everything as it comes and that we are together with them as they battle with whatever is going on.
We invite the clergy, family members and friends to come and talk to the patient giving up so that they can find a reason to smile and live again.
We use reminiscence therapy where we remind the patient of all the life accomplishments they have made and show them that they are indeed important.
We try to get a motivating factor that will have the patient willing to live for longer.
For patients at home not receiving hospice care, the family members might not know that their loved one has actually given up on life and so they will die sooner than they were supposed to.
Does a person know when they are dying?
When they are dying, people tend to feel pain for a long time and they can tell that they are breathing their last. They might also will themselves to stay longer postponing their death until they have said some words to a certain relative or waited to see one of their family members.
Some hospice patients have also asked that their relatives move out of the room where they are in so that they can pass on. It seems that one is uncomfortable breathing their last with family members close by.
Can a dying person choose when to die?
From what we have noticed, patients do indeed choose when to die. There are those in great pain but will brave it for a long time until a birthday passes, a wedding of a loved one happens or a certain document gets signed. At the hospice, we have noticed that some elderly patient will wait till a favorite child comes to visit and when they do so, they feel relieved that they can now rest in peace.