What to Know About End-of-Life Concerns
Mary Moseley
When a loved one is dying, it can make family and caregivers feel helpless. However, your role as a caregiver is crucial in addressing end-of-life concerns, which are typically in the following categories: physical issues, mental and emotional conditions, and spiritual concerns.
People who are dying may also worry about their loved ones, pets, and homes after their death. They want reassurance that their affairs are in order, especially if they were the primary income source or responsible for other family members.
What are end-of-life concerns?
End-of-life concerns affect the patient, their family, and their caregivers. Those concerns include the physical, mental, emotional, and spiritual aspects of the loved one’s life. They may also include the daily activities and tasks we take for granted but which need to be done, such as housecleaning, laundry, cooking, picking up groceries and prescriptions, and paying bills.
Physical Concerns
By the time a person reaches the end-of-life stage, they typically cannot leave the bed on their own. This can lead to physical issues that need to be addressed by a care team. At this stage, you may work with home health or hospice if your loved one is not in a facility. These highly skilled nurses can monitor vital signs and notice subtle changes indicating that a person is dying, providing you with the confidence that your loved one is receiving the best possible care.
Breathing problems Some people develop pneumonia or bronchitis once bedridden, making breathing hard. Shortness of breath is expected as the body begins to transition. Loved ones may also have COPD or another breathing condition and rely on oxygen.
Pain Not everyone close to death is in pain. If your loved one is in the hospital, a skilled nursing facility, or hospice, pain medication will keep them comfortable if it is needed.
Skin issues and wounds While bedridden, loved ones can develop pressure wounds. These wounds can grow and deepen and require medical treatment to keep from getting infected and causing severe pain. A wound nurse or doctor can care for the wound and show the family and caregivers how to treat and turn the patient into different positions to relieve the pressure. Dry skin and intense itchiness can also make your loved one uncomfortable.
Fatigue and sleepiness Another end-of-life concern for family and caregivers is the constant fatigue and sleepiness that their loved one experiences closer to death. They may need to sleep more than they are awake. Carbon dioxide can make them sleepy more than usual. If carbon dioxide buildup is an issue, the care team may ask the caregiver to help the patient use a machine to increase oxygen and remove the CO2.
Some people opt to live their last remaining days, weeks, or months at home with family. Others choose a hospital or skilled nursing facility close to medical intervention. If your loved one is aware and talking, discuss their wants and remember that conditions can change quickly toward the end of life.
Mental and Emotional Concerns
Unless your loved one is unaware of their condition, most people faced with the knowledge of end-of-life will have some anxiety and other mental and emotional concerns. Even Christians who know that their spirit will rest with Jesus after physical death still feel a bit apprehensive and afraid toward the end, especially if they are facing physical conditions and pain.
Counselors can address these mental and emotional concerns. Sometimes, one can be fully aware of what is happening, but their bodies are too weak. Other times, their bodies are strong, but their cognitive ability has declined. There is help available in either case.
Depression and anxiety Being unable to care for oneself and faced with end-of-life concerns or chronic illness can perpetuate depression in a dying person. Although family and caregivers do their best to treat their loved ones with dignity and respect, there may be moments when the patient feels vulnerable. Medical conditions can also worsen anxiety, and the patient can become agitated.
Worry Worrying about the future of their loved ones may keep a dying person from feeling rested and at peace. They may worry about their future after death or the ending itself. Worry robs them of any coherent moments they have. A Christian counselor can help to allay these worries and subsequent fears.
Fear People fear many things, but death may be the most debilitating. Believers or not, fear can grip us in those final days and weeks. Your loved one may become depressed, sad, anxious, or agitated closer to the end. Encourage them to talk if they can. You may want to request the help of a counselor.
Odd behaviors Toward the end, your loved one may live in their own reality where dreams rule. They may not be able to separate the past from the present. Some people develop personality changes at the end-of-life stage, possibly due to carbon dioxide buildup or other conditions.
Try not to take it to heart if your loved one suddenly says mean things to you or seems hateful. These personality changes are expected, and your loved one is probably unaware of what they are saying or how they are acting. Report these symptoms to the doctor.
Other mental conditions can weigh heavily at the end of life. For example, a person with PTSD (Post-Traumatic Stress Disorder) may experience panic attacks and struggle to gain control of their mind and emotions, worsening anxiety and depression, while isolating themselves from people who care about them. These moments of isolation may not be physical. People may emotionally distance themselves from friends and family.
Spiritual Concerns
Fear and anxiety can heighten spiritual concerns. Christians may question their faith in their final moments. Unbelievers may question whether God exists and if it is too late to be saved. Ministering to the dying is a challenging task. If you feel unqualified, reach out to a chaplain at the hospital or hospice house, or contact the clergy at your loved one’s church or a local church.
Prayer can soothe our souls, and the Holy Spirit works as a Comforter when we need Him. We need only ask.
Faith Some people like hearing comforting words during this time. If you are a family member or caregiver to a dying person, reading Psalms and other peaceful and reassuring scriptures may give your loved one a sense of peace at this time.
Minister Not everyone feels equipped to lead their loved ones in prayer for peace or to say the right things at critical moments like this. Call on a minister or chaplain for help. They can lead your loved one to Christ or relieve their fears and anxieties by encouraging them in their faith.
Worship music Worship music can change the atmosphere by drawing us closer to the Holy Spirit. When we worship Jesus with music, our souls are free from burdens. Play worship music in the background for your loved one. Create a playlist of their favorite worship songs.
You may notice that once the spiritual concerns have been addressed, your loved one has a decrease in depression, anxiety, fear and more inner peace. Never underestimate the healing power of Christ on emotional health.
Family and Caregiver Support
Caring for a loved one dying and addressing end-of-life concerns is stressful and challenging for families and caregivers. That is why we offer counseling support not only to the patient faced with end-of-life concerns but also to the family and caregivers.
We understand what keeping vigil is like and how draining managing everyday tasks can be for the family and caregivers. We also recognize what an honor and blessing it is to care for someone as they transition from this life here on Earth to Jesus’ arms in Heaven.
Contact us today to schedule a session with a Christian counselor and see how we can help you and your family through this difficult time.
Photos:
“Couple Walking Across the Lawn”, Courtesy of Natalia Blauth, Unsplash.com, Unsplash+ License; “Playing with Grandma”, Courtesy of Rod Long, Unsplash.com, CC0 License