How Can You Help Someone In The Active Dying Phase
There are many ways that you can help someone who is in the active dying phase, even if they do not seem aware of your presence. Talking to them reassuringly and remaining calm is always advisable, and you can touch the patient gently if they normally like being touched.
If the patient is restless, medication may help. Keep in mind that patients who appear unresponsive may still be able to hear you, so it is important to speak respectfully and positively at all times.
If the patient is experiencing incontinence, you may supply them with underbody pads or diapers. Be sure to change their pads or diapers when they become soiled.
When a patients breathing becomes irregular, consider elevating the head of their bed to place them in a more comfortable position. If that is not possible, use pillows to elevate their head. Some patients may need to be turned onto their side.
What Happens If Someone Stops Dialysis
For many people with kidney failure, dialysis or a kidney transplant enables them to live longer and enjoy their quality of life. However, this may not be the case for everyone and each person has the right to choose howor ifthey want to receive treatment for chronic kidney disease. Without life-sustaining dialysis or a kidney transplant, once a person with kidney disease reaches stage 5 , toxins build up in the body and death usually comes within a few weeks.
The decision to stop treatment should be an informed and voluntary choice. Experts recommend patients talk with their physicians and a social worker or therapist to understand their choices and know what to expect.
Talking to family members about stopping dialysis
Its the patients right to make the decision to stop dialysis. Sometimes, knowing that death can be pain-free and peaceful for the person with ESRD helps ease family members fears.
There are many reasons why someone with ESRD may not want to continue or start dialysis. Some people feel theyve lived a full life and dont want to bother with additional surgery and treatments.
Studies have shown that people most likely to withdraw from dialysis are older and living in nursing homes. They often have health problems in addition to kidney disease, and suffer more severe pain. They usually have physical limitations that restrict normal daily activities.
Preparing for stopping dialysisadvance directives and hospice
What to expect once dialysis is stopped
How Is Kidney Failure Managed
Sometimes kidney failure can be managed with renal replacement therapy. This is either dialysis or a kidney transplant.
If someone is not fit enough to have a kidney transplant they can usually consider dialysis.
But for some people, dialysis may not be the right approach either. This includes people who:
- arent well enough to have dialysis
- are well enough to have dialysis but choose not to
- have started dialysis but due to a decline in their health are no longer well enough to have it
- have started dialysis but it didnt improve their quality of life, or their symptoms continued to get worse despite dialysis, so they choose to stop.
Sometimes people deteriorate quickly in these situations, so they should all be offered palliative care to help manage their symptoms and prepare them for the end of their lives. People on dialysis can also have symptoms that are hard to manage and may benefit from palliative care alongside dialysis.
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Acute Kidney Failure Symptoms
Signs that your kidneys have stopped working effectively are caused by the buildup of fluid and toxins in the body. The most obvious sign is a decrease in the amount of urine that is put out, although this isnt always the case. Some people do continue to produce urine, but lab tests will show that the urine is not normal.
Someone with acute kidney injury usually also looks swollen, as the fluid accumulates in the bodys tissues. This swelling is called edema and can come on very quickly.
Other symptoms of acute kidney failure can include:
- Shortness of breath
Urine and blood tests tell doctors how well your kidneys are functioning, so many samples are taken during diagnosis and treatment. For example, the doctors test for creatinine, which is created when muscle begins to break down. A BUN test tells you if a substance called urea is building up in the blood, an indicator that the kidneys are not filtering waste properly.
Be Guided By The Bodys Gradual Decline
A dying patients needs for food and water are far different from those of a healthy, active person. As the end of life nears, the body gradually loses its ability to digest and process foods and liquids. As organs and bodily functions shut down, minimal amounts of nutrition or hydration/liquids might be needed, if at all.
Continuing to offer food and water, or opting for artificial nutrition or hydration such as nasal or stomach feeding tubes or IV fluids for hydrationcan actually complicate the dying process and lead to other health problems.
VITAS Healthcare always works with patients and families to develop individualized care plans that support the patients wishes and values, and those plans include a discussion about the role of artificial nutrition and hydration.
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What Organ Is The Last To Shut Down When You Die
In most cases, dying is a gradual process and the organs begin to fail and eventually shut down. Physiological death happens when the vital organs no longer function. The affected organs/systems are:
- The digestive system is the first to be affected. When the dying process begins there is a loss of appetite and thirst.
- The brain will also lose function and shut down. This is due to a lack of oxygen attributed to labored breathing and the eventual cessation of breathing.
- The kidneys aren’t able to process fluids as before and will also shut down during the dying process.
- The heart and lungs are generally the last organs to shut down when you die. The heartbeat and breathing patterns become irregular as they progressively slow down and fade away.
Also, it is thought that hearing is the last sense to go during the dying process. Don’t assume your loved one can’t hear you. It is strongly encouraged that you speak to your loved one even if they are unconscious.
Weeks Before Death Symptoms
Several weeks before death, your loved one may start exhibit a range of behavioral changes relating to their sleeping patterns, eating habits and sociability. They may begin to sleep more often and for longer periods. They will start to refuse foods that are difficult to eat or digest, but eventually they will refuse all solid foods. Do not try to force them to eat, as it will only bring discomfort to them. Your loved one may enjoy ice during this time, since it will keep them cool while also hydrating them.
Unfortunately, your loved one may become withdrawn, less active and less communicative. They may spend more time alone introspecting and may turn down company. Some also appear to become comatose and unresponsive, but this is a symptom of withdrawal. Your loved one can still hear you, so speak in a calm, reassuring voice while holding their hand. Children may become more talkative, even if they withdraw from other activities. Its important to let your loved one set their own pace during this time. Your loved one may also start to use metaphorical language, which could be a way of coping with death. It may also be used to allude to a task they feel they need to accomplish, such as seeking forgiveness.
Common symptoms in this period also include physical changes, such as:
- Chronic fatigue
- Swelling of the abdomen, such as edema or ascites
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Communicating With A Dying Person
Many people find it difficult to discuss death openly with a dying person, mistakenly believing that the dying person does not want to discuss death or will be hurt by such a discussion. However, people living with eventually fatal conditions usually do better when family members continue to speak with them and include them in decision making. The following suggestions can help people feel more comfortable when communicating with a dying person:
Listen to what the person is saying. Ask, for example, What are you thinking? rather than shutting down communication with such comments as Dont talk that way.
Talk about what the person would envision for surviving family members at a time long after death has occurred and work back toward events nearer to death. This allows for a gentle introduction to a discussion of more immediate concerns, such as the persons preferences regarding funeral arrangements and support for loved ones.
Reminisce with the dying person because this is a way of honoring the persons life.
Continue to speak with the dying person, even if the person is unable to speak. Other ways of communicating, such as holding the persons hand, giving the person a massage, or just being near the person, can be very comforting.
Talk With Hospice Care About The Stages Of Dying
If your loved one has a life-limiting illness, hospice care can help improve their quality of life during their final months. Get in touch with the compassionate team at Harbor Light Hospice to find out how they can help your family and your loved one physically, emotionally and spiritually each step of the way.
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Treating Acute Kidney Injury
Treatment of AKI depends on what’s causing your illness and how severe it is.
You may need:
- to increase your intake of water and other fluids if you’re dehydrated
- antibiotics if you have an infection
- to stop taking certain medicines
- a urinary catheter, a thin tube used to drain the bladder if there’s a blockage
You may need to go to hospital for some treatments.
Most people with AKI make a full recovery, but some people go on to develop chronic kidney disease or long-term kidney failure as a result.
In severe cases, dialysis, where a machine filters the blood to rid the body of harmful waste, extra salt and water, may be needed.
Importance Of Preparation For Signs Of Death
Not every person will exhibit each one of these signs, but most will show several. Since we don’t know when death will exactly occur, people often hold vigils by the bedside so that they will be present as the person passes on. Although many people do not want to talk about death, it is a part of life. Understanding and being prepared for the uncomfortable and sometimes scary signs of approaching death will give you the chance to help your loved one and be at peace with the situation yourself.
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How To Tell When Your Loved One Has Passed
Eventually, your loved one will pass away, but it can be difficult to tell at first if this has happened. Its not uncommon for a person to be unresponsive throughout the dying process, and it is easy to think that your loved one is simply asleep or unconscious when in fact they have died. If you suspect this is the case, call your hospice nurse, who can provide you with further instructions. Special procedures must be followed when removing our loved ones body from your home.
Here are a few tell-tale signs that indicate when your loved one has passed away:
- They begin to gasp, then slowly take several more breaths relatively far from one another
- Their eyes and mouth open
- They cannot be awakened
There Are Mental And Emotional
- Restlessness or agitation which may be a result of less oxygen to the brain, metabolic changes or physical pain.
- Occasional or constant confusion which may be related to separation from the normal routines of living. It may also be the result of a disease, or the dying process.
- Levels of consciousness which may vary.
- Sleepiness, but being able to be awakened and have awareness of the surroundings. The senses may be dulled and there may be little awareness of what is happening in the environment. Sleep may be so deep that the dying person cannot be awakened and is unresponsive.
- During the dying process, changes affecting a persons inner feelings and interpersonal relationships may take place. Looking back at ones life in search of meaning and contributions life review.
- Saying good-bye to people and places, forgiving and being forgiven, facing regrets life closure.
- Acceptance or coming to terms with ongoing losses and eventual death.
- Some individuals may not want or be able to do these things. Take cues from the dying person. Listen, share memories and find ways to say good-bye.
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Complete Kidney Failure Stage
Kidney has some important roles to the body function, which include filtering blood, regulating hormones, balancing body fluids, keeping bones healthy, and helping make red blood cells. Thus, a complete kidney failure will likely to affect your body functions significantly. Commonly, kidney disease stages are divided into 5 main stages based on the degree of severity. In the earlier stages, mild symptoms of kidney failure problems can be improved through proper treatment plans and dieting. However, the latest stage, which is stage 5 may require a kidney transplant in order to keep the patient alive.
How Does Cancer Cause Death
Every patient is different, and the way cancer causes death varies. The process can depend on the type of cancer, where it is in the body, and how fast its growing.
For some people, the cancer cant be controlled anymore and spreads to healthy tissues and organs. Cancer cells take up the needed space and nutrients that the healthy organs would use. As a result, the healthy organs can no longer function. For other people, complications from treatment can cause death.
During the final stages of cancer, problems may occur in several parts of the body.
In some cases, the exact cause cant be pinpointed and patients simply decline slowly, becoming weaker and weaker until they succumb to the cancer.
Again, every patient is different and all processes have different stages and rates in which they advance. And some conditions have treatments that can help slow the process or make the patient more comfortable. Its very important to keep having conversations with the patients health care team.
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The Last Few Days: What To Expect
Many people have never been present when a person dies. The movies certainly do not give us a realistic picture of what to expect. Of course, much of the process depends on what is causing the person to die. However, there are some generally common elements.
Emergency Room?Some family members are tempted to call an ambulance, especially as the breathing becomes labored or irregular. They want to go to the Emergency Room. Of course that is an option if staying at home is too traumatic for the family. However, for the person who is dying, the commotion surrounding a transport to the hospital can be very distressing and uncomfortable. What awaits are machines and protocols and unfamiliar surroundings. Many people die on the way in the ambulance.
Your loved ones wishesIts wise to talk with your relative weeks ahead of time to determine where it is that he or she prefers to die. Most people prefer to stay at home with family present. Make plans about what you will do as death approaches.
Below are some articles that describe what to expect.
Investigating The Underlying Cause
Urine can be tested for protein, blood cells, sugar and waste products, which may give clues to the underlying cause.
Doctors also need to know about:
- any other symptoms, such as signs of sepsis or signs of heart failure
- any other medical conditions
- any medication that’s been taken in the past week, as some medicines can cause AKI
An ultrasound scan should reveal if the cause is a blockage in the urinary system, such as an enlarged prostate or bladder tumour.
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Who’s At Risk Of Acute Kidney Injury
You’re more likely to get AKI if:
- you’re aged 65 or over
- you already have a kidney problem, such as chronic kidney disease
- you have a long-term disease, such as heart failure, liver disease or diabetes
- you’re dehydrated or unable to maintain your fluid intake independently
- you have a blockage in your urinary tract
- you have a severe infection or
- you’re taking certain medicines, including non-steroidal anti-inflammatory drugs or blood pressure drugs, such as ACE inhibitors or diuretics diuretics are usually beneficial to the kidneys, but may become less helpful when a person is dehydrated or suffering from a severe illness
- you’re given aminoglycosides a type of antibiotic again, this is only an issue if the person is dehydrated or ill, and these are usually only given in a hospital setting
What Are The Signs That The Person Has Died
- The person is no longer breathing and doesnt have a pulse.
- Their eyes dont move or blink, and the pupils are dilated . The eyelids may be slightly open.
- The jaw is relaxed and the mouth is slightly open.
- The body releases the bowel and bladder contents.
- The person doesnt respond to being touched or spoken to.
- The persons skin is very pale and cool to the touch.
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What To Expect In The Final Hours
In a persons final hours and minutes, their body is slowly shutting down. The organs stop working entirely.
The only thing you can do in these last minutes is help them be comfortable and feel loved. Surround yourself and your loved one with the friends and family they most care about.
Dont stop talking with your loved one. Many dying people can still hear and understand whats happening. Help them feel comfortable by letting them know theyre surrounded by people who care for them. For some individuals, knowing they have people around them who care helps them let go.
If youre using a heart rate monitor, you can see visibly when the heart stops working. This is a clear indication your loved one has died.
If youre not, look for other signs that death has occurred. These include:
- no pulse
- a bowel or bladder release
- partially shut eyelids
When your loved one has passed away, take your time. Spend a few minutes with the people who surround you. A persons natural death isnt an emergency, so you dont have to call anyone right away. When youre ready, call the funeral home that youve selected. They will remove the body and begin the burial process.
If your loved one is in a hospice facility or hospital, the staff will handle the final logistics for you. When youve said your final goodbyes, they will arrange for your loved one to be moved to the funeral home.