Responsibilities of a family caregiver when their loved one reaches the end of life largely depend on where the person with cancer is receiving care. For instance, having constant care from nurses at an inpatient hospice would mean that the family caregiver can have fewer responsibilities as compared to a home setting. Nevertheless, if your loved one is under the care of hospice services, the hospice care team will ensure his or her comfort as much as possible, no matter where he or she is cared for. Read more about palliative care and hospice services
People reaching the end of life usually become weaker and more tired. It is not always possible to predict exactly how long more a person will live, but there are some common signs and symptoms that can indicate that the end is nearing. Knowing what to expect and what you can do allows you to plan better and feel less anxious. The following are some common symptoms that your loved one may experience, and suggestions on what you can do. Remember that
symptoms vary across individuals and not everyone will experience them.
This change is normal and is partly due to chemical changes in the body and brain.
Decreased interest in food & drinks
This is part of the normal dying process. Your loved one does not require many calories at this stage.
Unable to control urine & bowels
This is an expected part of the dying process.
Coolness of Limbs
Limbs may be increasingly cool to touch as blood flows to the vital organs. The face may be pale and the soles of the feet and legs may turn a purple-blue mottled colour.
Confusion or restlessness
Confusion about people and surrounding things may occur. Some may appear restless, displaying repetitive movements such as pulling at the bed linen or their clothing. This may be due to many reasons (e.g. chemical changes in the body).
Changes in breathing pattern
Your loved one may breathe with his/her mouth open as muscles become more relaxed. Breathing may be irregular, shallow or may stop for periods of 10 to 30 seconds. This usually does not disturb the dying person.
Gurgling throat secretions
Loud gurgling sounds from the throat are usually due to the inability to swallow saliva. This normally does not cause discomfort.
Help with caregiving
Caring for a loved one at the end of life can be challenging, especially if you prefer to provide care at home. Aside from hospice homecare services, some people choose to engage additional assistance so that they are able to cope better at home. This can come in the form of
private nursing, or other
home help services. Speak to your loved one’s healthcare or hospice care team if you need more information on help with caregiving at home. If your loved one is a patient with NCCS, you may call +65 6436 8417 or +65 64368088 to book an appointment to speak to an NCCS medical social worker if necessary.
When death occurs
When death occurs, the person will be unresponsive, breathing will stop, the heart will stop beating and the eyes will be fixed in one direction. Muscles will relax as well.
It is normal for family and caregivers to feel a sense of shock and unpreparedness, even when death is expected to occur. There is often no immediate rush to notify the doctor or nurse. Many people find comfort and peace in having a quiet moment with their loved one, after they passed on. If you feel that you are unable to cope with the loss of your loved one, individual counselling and bereavement support groups are available in NCCS. You may call
+65 6436 8417 or +65 64368088 to book an appointment with an NCCS medical social worker, to find out more about how they can help you.
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The above contents are made available as part of TEMASEK FOUNDATION-ACCESS (Accessible Cancer Care to Enable Support for Survivors) PROGRAMME, a holistic care programme to support cancer patients during their care and recovery journey.
The contents have been approved by the Cancer Education Information Service, National Cancer Centre Singapore (NCCS), for people with cancer and their families and caregivers. However, this information serves only as a guide and should not be used as a substitute for medical diagnosis, treatment or advice. For specific medical conditions, please seek expert medical advice from your healthcare team.
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