When a loved one is diagnosed with a terminal illness, it’s important to prepare yourself for the practicalities of their death, as well as the inevitable emotional upheaval. In these instances, it’s common to begin grieving before the person actually dies. Death becomes something to wait for, marked in days, weeks or months. Death from a terminal illness is often a slow process; a gradual shutting down of the faculties. All we can do is prepare to say goodbye for the last time.
Know their wishes
According to Sunlife, only 1% of the UK know what their loved one’s last wishes are, and 22% of people don’t know any of their wishes. If you can, find out what they want for the funeral, and ask if they have any arrangements already in place, such as a funeral plan. It might seem morbid to bring up funeral arrangements, but it shows a desire to consider their wishes and means the funeral will ultimately be more personal to them. It’s important to ask these questions in a delicate manner, by explaining that you’re concerned about what will happen after they die, and want to make it as simple as possible for everyone involved.
This is also a good time to ask if there is a will in place, and if so where it is kept. If they don’t have a will and are still in good health, now might be a sensible time to write one. It may not be practical to do this, and in this instance there is a protocol for what to do when someone dies without a will. You need to respect the choices they make, and accept there may be differences of opinion.
Spend time with your loved one
Spend time in their presence. As their condition deteriorates, this is one of the most important things you can do. Talk to them if they have the energy. Otherwise, be there, so they’re not alone, and be honest. Don’t hide your emotions from them or try to be strong, it’s OK to let them know you’re scared, confused or sad. The situation may feel uncomfortable, but don’t let this stop you from saying, ‘I love you’, and, ‘I will miss you when you’re gone’. Say what you need to, or else you may always regret it. This is time you will cherish in the future, and will help you in difficult times of grief.
Take care of yourself
When you’re dealing with sorrow, take care of yourself – eat well, sleep well, do activities that help you relax. Beyond this, it’s important to care for your emotional health. You may feel overwhelmed by emotion. You’ll just be recovering from one wave of grief, when you’re struck by another. Find someone unaffected by the circumstances who can offer you support. Don’t feel guilty for practicing self-care; you can’t help others until you’ve helped yourself.
Contact anyone who might wish to see them
Get in touch with family and friends. The person may wish to do this themselves, or may need your assistance. Do this in good time so everyone can say their goodbyes and spend time with them. You should talk to children in the family and explain to them what is going to happen. Be clear, and do not gloss over the reality of the situation. If you’re unsure whether or not your loved one wants to see someone, ask your loved one before contacting them.
Research the condition
This may be as simple as talking to the carers or nurses if they are at a hospital or hospice. You may wish to research the illness on the internet. Speak to the person directly, and ask, ‘How can I make things easier for you?’. Your aim should be to provide the best care and best possible quality of life for that person.
As death approaches
The person will appear quite changed to their normal self. Signs they are nearing the end include:
- Discolouration of the skin
- Less fluid and food intake
- Restlessness
- Disorientation
- Spending a lot of time sleeping
- Becoming socially withdrawn
- Incontinence
- Urine decrease
- Change in breathing pattern
This is a natural part of the body preparing to shut down and you should be alert to this, so that you can contact family in time. Alongside the natural closing down of the body, there is often a concluding of all affairs in that person’s life. People on the verge of death may feel compelled to hold on to life, feeling a duty to the living to be present. It’s important that you give the person permission to go, as holding on will only prolong their pain. This desire to stay can be caused by unresolved conflict, for example if two family members have fallen out, or if one person in the family is still travelling to say their goodbyes. Show your love on a united front, put aside old wounds, and let their last image be the faces of all their loved ones sat around.
As death nears, many of their senses will deteriorate. Hearing, however, is often unimpaired right up until the last few moments, so even if they are not responding physically it is not to say they cannot hear you. Don’t be deterred to speak from the heart and say all you need to. Equally, don’t say anything in front of them that would be better said in private.
Once death has occurred, there’s no need to ring 999 if the death was expected and has resulted from an illness. Get in touch with the family doctor if at home, or if at a hospice or hospital inform the staff.