Coping with your journey's end

• Hospice care focuses on terminally ill patient’s pain and symptoms as well as their spiritual and emotional needs.
• It is available either at a patient’s home or inpatient facility for patients whose doctors believe they have less than 6 months to live.
• Hospice is covered by Medicare, Medicaid and most private insurance plans with minimum if any out-of-pocket expenses. It includes pharmaceuticals, medical equipment, supplies such as depends, wipes and pads, and 24 hour/7 days a week access to care. Some have volunteers who will come help sit with you or your loved one so you can run an errand, as well as support for loved ones following the death.
• Check with your doctor and social workers at the hospital to find hospices in your area.
• Research hospice groups early, you want to make sure you understand exactly what will be covered, how often the staff will be there, etc. This is best done when you or your loved one has more strength to be a part of the decision making.
• Call our toll free Helpline for assistance at 877-422-2030

The US Government (National Cancer Institute) advises that the presence of some of the following may indicate that death is approaching:

• Drowsiness, increased sleep, and/or unresponsiveness (caused by changes in the patient’s metabolism).
• Confusion about time, place, and/or identity of loved ones; restlessness; visions of people and places that are not present; pulling at bed linens or clothing (caused in part by changes in the patient’s metabolism).
• Decreased socialization and withdrawal (caused by decreased oxygen to the brain, decreased blood flow, and mental preparation for dying).
• Decreased need for food and fluids, and loss of appetite (caused by the body’s need to conserve energy and its decreasing ability to use food and fluids properly).
• Loss of bladder or bowel control (caused by the relaxing muscles in the pelvic area).
• Darkened urine or decreased amount of urine (caused by slowing of kidney function and/or decreased fluid intake).
• Skin becoming cool to the touch, particularly the hands and feet; skin may become bluish in color, especially on the underside of the body (caused by decreased circulation to the extremities).
• Rattling or gurgling sounds while breathing, which may be loud (death rattle); breathing that is irregular and shallow; decreased number of breaths per minute; breathing that alternates between rapid and slow (caused by congestion from decreased fluid consumption, a buildup of waste products in the body, and/or a decrease in circulation to the organs).
• Turning of the head towards a light source (caused by decreasing vision).
• Increased difficulty controlling pain (caused by progression of disease).
• Involuntary movements (myoclonus), increased heart rate, hypertension followed by hypotension, and loss of reflexes in the legs and arms are additional signs that the end of life is near.