Programs at Hospice & Palliative Care of Iredell County

Monday, October 27, 2014

Understanding The Emotional Changes of Life's Final Stages

The final stages of life for a terminally ill person can feel overwhelming for so many different reasons. It's a time when both the caregiver and his or her loved one are embracing life and all it has to offer, but it's also a time of deep sadness and reflection for everyone involved. Understanding the emotional changes your loved one is going through in these final stages of his or her life is imperative to providing your loved one with the best care possible. 

There isn't one specific point in an illness when end-of-life care begins. The process very much depends on the individual. For instance, in the case of Alzheimer’s disease, according to The Alzheimer's Association, the patient’s doctor has likely provided you with information on stages in the diagnosis. These stages provide general guidelines for understanding the Alzheimer’s symptoms and planning appropriate care. For other terminal illnesses, the following are signs you may want to talk to your loved one about proper end-of-life care:

  • The patient has made multiple trips to the emergency room and their condition has been stabilized, but the illness continues to progress significantly, affecting their quality of life.
  • They’ve been admitted to the hospital several times within the last year with the same or worsening symptoms.
  • They wish to remain at home, rather than spend time in the hospital.
  • They have decided to stop receiving treatments for their disease.

When a person's final stages of life start to become more apparent to the caregiver, there are specific emotional changes with which the caregiver must familiarize him or herself. These changes have the potential to drastically change the relationship you have with your loved one, but once you're aware of the changes, you can adjust your care efforts appropriately.

The first emotional change your loved one will express is the need to give away personal belongings and make funeral plans. For example, he or she may ask to solidify their will or call local funeral homes for the best price packages available. Some people need to maintain control of their lives, even in preparation for their own death. It's no secret that this is emotionally difficult for the person's family and friends, but it's important you let your loved one do these things if they so choose. Everyone appreciates having their choices honored, especially those facing death and what it brings for their family and friends.

Another common emotional change your loved one might experience is withdrawal, which either replaces the first change mentioned above or comes shortly after. He or she might seem unresponsive, in a comatose-like state, for instance, when you ask them a question that makes them reflect on life. This might seem like depression, but what you're actually witnessing is your loved one detaching. When you start to notice these signs, all you need to do is continue being yourself. Speak in a normal voice, identify yourself if your loved one is suffering from a mental illness, hold their hand, and say what you need to say. This helps them more than you'll ever realize.

Restlessness, while a physical response to an emotional change, is common for those facing death. This kind of behavior might indicate they have something unresolved or unfinished, and it's preventing your loved one from fully letting go. In this stage, it's best to talk with them if they're mentally stable to have conversation. Ask them what's on their mind. It's also good to read to them, play soothing music and give them your blessing to let go.

Last but not least, it's possible your loved one is feeling depressed and alone, even if family and friends surround them. Death brings so many unanswered questions about life and what may come afterward, so it's common for someone so close to death to feel like they're going to miss out on so much when they're gone. This is especially common in those who lead an active and involved life, both in their career and otherwise. The best thing to do when your loved one is feeling depressed about death is to reminisce with them about their glory days and ask them for their wisdom. The more they can share their life lessons with you paired with all the great experiences they've had, the better they'll feel about passing on.

Remember, all these signs and symptoms are common in a person's final stages of life. Your loved one may be as unique during this time as they have always been, so they may show some of these signs and not others. Or, they may act differently altogether. These signs of emotional change are simply guides to help you understand what is common and how you can best respond to your loved one’s emotional needs. 

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