Professional Geriatric Care Manager, Eldercare Services, Jean Tokarek, MPA, CMC

Realizing that your loved one’s end of life is upon you is not an easy event to face or admit.  Telltale signs can include refusing to eat or take medications, taking to their bed, sleeping all day and having more difficulty with ambulation.

When this occurs, their primary care doctor should be contacted who may order some lab tests to rule out any vitamin deficiencies, dehydration, assess for depression or other things medical going on with the body.  If the doctor clearly feels that Mom or Dad is at the end of their life, hospice services can be ordered and brought into the home to make their last months most comfortable and a reflective time to be had with family members and friends.

The hospice team can be a godsend when Mom or Dad’s household and health are in a state of flux.  The RN case manager will assess the patient for pain and symptoms, recommend comfort medication and order medical equipment such as a hospital bed to relieve pain and suffering, and educate family members and other caregivers on what to expect when your loved one declines in function.  The social worker will help out with any practical financial issues like Powers of Attorney, burial plans and hiring additional in home care if needed.  A home health aide will come to the house 2 to 3 times a week to give patient a bath or shower and change the bed linens.

Volunteers are available to be with the patient and give family members a break for a few hours a week.  The chaplain will make home visits to attend to Mom or Dad’s spiritual care and a bereavement counselor will work with patient and family members with any anticipatory grief concerns.  The hospice team will work very closely with the family and or care manager with any medical or psychosocial concerns of the patient.

One of the hardest things for both family members and caregivers to watch is when your loved one stops eating.  When this happens, they can lose weight very quickly and rarely relieve their bowel or bladder.  It is best to encourage Mom or Dad to eat but not force feed.  At this point, the patient knows when they have had enough and gradually their body will begin to shut down.

When the eating process slows down, it is not painful to them but important to know that the patient needs to be kept comfortable.  An extra blanket, some soft music that they enjoy, ice chips for thirst, a cold cloth on the forehead and a gentle touch of the arm can mean so much.  It is also during this time that meaningful conversations can be conducted with family members and friends to reminisce about happy, earlier times and to let your loved one know how much he/she means to you.

Hospice RN’s are also available to the patient and family 24-hours per day.  If there is a drastic change in medical condition with your loved one, it will provide comfort to the family to know that an RN on the other end of the line and his/her expertise is only a phone call away.

End of life situations can be a very difficult thing to plan for and discuss with family members.  Knowing that there are resources available and having the discussion on how to proceed sooner rather than later will make the last chapter of a loved one’s life less chaotic and will be spent comfortably and surrounded by people who are very important to them every step of the way.