What is Death? 

 Death and dying are the steps that happen as we stop living. People call death many things, such as "passed on," "left this world," "gone to a better place," or "moved on." Death happens to everyone. It happens to friends, people we love, and to us. Most people do not like to think about death because it makes us sad to have those that we love go away. But, thinking about death before it happens gives you a chance to get ready for it.

Causes: Sometimes people die because of an illness, such as cancer, kidney or heart failure. An accident or an injury may cause death. Other people die because they are very old.

Signs and Symptoms:

*Following are some of the signs and symptoms you may have during the dying process. You may not have them all. In a sudden death like a car accident, you may not have any of them. You may see many of them over a long period of time if you have cancer or another terminal illness. A terminal illness is one that will cause you to die within the near future.

*Easily confused. This can be caused by not getting enough oxygen. But, it is also common with many illnesses.

*Feeling restless, such as pulling at the bedclothes.

*Hands and feet feeling very cool and even turning blue.

*Hearing and vision changes.

*It may seem like there is liquid or "spit" in the back of your throat that you cannot get rid of. When you breathe it may sound like you are "gurgling" or "rattling." Long ago, they called this the "death rattle." It is usually not uncomfortable, but is sometimes hard for loved ones to hear.

*No hunger or thirst. You may stop eating or drinking completely.

*Not breathing normally. It may sometimes seem like you are holding your breath for 20 to 30 seconds or more. Other times you may breathe really fast like 30 to 40 times a minute or more. It may sometimes sound like a moan. But, this is usually just air passing over your vocal chords which are very relaxed.

*Seeing or hearing things that the rest of the family cannot.

*Sleeping a lot more during the day, often as much as 23 hours in a day. At times, you may have trouble waking up at all.

*Trouble talking or making yourself understood.

*Trouble controlling your bowels and bladder.

*The signs of death are the same for everyone.

*Breathing stops.

*Bowels or bladder may empty as the body relaxes.

*Eyes may be wide open like you are staring.

*Heart stops beating.

*Mouth may be in many positions from closed to wide open.

*Unable to awaken even with shaking or shouting.

Care:

*At first, you will probably be seen in a clinic or caregiver’s office. But, at times, you may need to go into the hospital for tests and treatment. You may need blood tests, x-rays, an EKG, or a CT scan to help caregivers plan your care. You may also need medicine to control symptoms, such as pain or nausea (upset stomach). You may need to see your caregiver 1 to 4 times a month.

*Caregivers may suggest having hospice come to the hospital, a nursing home, or your own home. Hospice (hah-spiss) is a group of specially trained people who can help you during the dying process. Ask caregivers for the CareNotes^TM handout about Hospice.

Coping: Accepting death and the dying process is hard. Dying is something that both you and your family go through together. You and those close to you may feel angry, sad, or frightened. You may blame yourself and think you have done something wrong. These feelings are common.

*Following are the 5 stages in the dying process. You may not go through them all. You may have several at the same time or skip around out of order.

*Denial: You do not want to believe that this is happening to you and your family.

*Anger: There are many reasons that you feel angry. Often you are angry because you do not have control over what is happening to you.

*Bargaining: This is a way you try to avoid death. You make a secret deal with yourself or sometimes with God. You promise that you will do things right or better if you can just have a little more time.

*Depression: This is when you really begin to understand that you are going to die. You start to feel the losses that are happening to you and your family. You begin mourning these losses and feeling the pain they bring. If you think about hurting yourself or someone else, call your caregiver right away.

*Acceptance: This can happen if you are open to all the feelings, frustrations, and issues that happen when you face death. It is a feeling of peace and calm. It is accepting what is happening in your life. Acceptance doesnot mean giving up.

*It is OK to go through these stages and your family can help you by offering support and understanding. Remember that this is very normal. Talk to your family or friends about your feelings and theirs. Each of you may feel very differently. It is also very important to talk to caregivers.

*There is also a process called "Life Review" that may happen over time. It is remembering your life step-by-step over the years. This way of looking at your life helps you see how you are special and important. You may or may not choose not to do this because of difficult or painful memories. But, it is something both you and your family can do together to build closeness during this hard time. It is also a time to say "good-bye" slowly. Your caregiver is always available to help in this process.

*There are many other questions to think about when you are dealing with death and the dying process.

*Can I care for my loved one or myself at home when dying?

*How will I cope with my death or theirs?

*Is there any thing else I can do to be comfortable or to make my loved one comfortable as they die?

*How much will this cost my family and me?

*How can I find help with the bills?

*Call or write one of the following organizations for help with these problems

*National Hospice Organization 1901 North Moore Street, Suite 901 Arlington, VA 22209 Phone: 1-703-243-5900 Phone: 1-800-658-8898 Web Address: http://www.nho.org

*US Department of Health & Human Services - Administration on Aging Eldercare Locator US Department of Health & Human Services - Administration on Aging 927 15th Street NW, Sixth Floor Washington, DC 20005 Phone: 1-800-677-1116 Web Address: http://www.aoa.dhhs.gov/elderpage/locator.html

*National Health Information Center P.O. Box 1133 Washington, DC 20013-1133 Phone: 1-301-565-4167 Phone: 1-800-336-4797 Web Address: http://www.health.gov/NHIC

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about death and the dying process. You can then discuss treatment options with your caregivers. Work with them to decide what care will be used to treat you. You always have the right to refuse treatment.

Record Number: A128107620

SOURCE:
CareNotes.  Sept 1, 2004 pNA.

Full Text: COPYRIGHT 2004 A Thomson Healthcare Company