It was Haruki Murakami who said; DEATH IS NOT THE OPPOSITE OF LIFE, BUT A PART OF IT. It is not easy losing loved ones to the cold hands of death, even when they are aged. However, the understanding and acceptance of Haruki’s statement would greatly help us through this inevitable process of life.
My focus in this post is to help you understand what you can do, as you watch your elderly or aged ones go through this stage of life.
SIGNS OF FINAL STAGE OF LIFE AND REQUIRED INTERVENTION / CARE.
I. LACK OF INTEREST IN ACTIVITIES : As death approaches, the elderly people at this stage of life become withdrawn, nothing seems to attract them at this point . Their attention span at this point would have greatly nosedived. Most times, they just want to be left alone.
INTERVENTION/CARE
• Do not force them into any activities.
• You can talk to them about activities they are normally interested in.
• Let them know how they have touched your life, or that of some else through such activities.
• If you have a video record or pictures of such activities you can show it to them.
• Let them know it is absolutely alright if they no longer have the strength to do these things. It gives them a sense of satisfaction and fulfilment.
II. ANXIETY : The fear of unknown would be so palpable at this point. The religious ones would probably be thinking about heaven or hell, they have not been there, but they have heard about it. Others might be thinking about their past lives, companies and families they are going to leave behind. They wish they could have a glimpsed of what would happen and not knowing this, is what actually breed the fear of unknown.
INTERVENTION/CARE
• Be quick and don’t be tired of reassuring them
• Be hopeful around them.
• Let your speech and thoughts be positive around them.
• Allow them to express how they feel, it makes them feel better and it will help you to understand how you can be of help.
• Don’t be judgemental in addressing any concerns raised by them.
• Respect their spirituality and grant their desire to see their clergymen or perform their spiritual rituals. It leads to a peaceful death.
III. POOR HYGIENE : During the final stage of life, the loss of personal and environmental hygiene are mostly common. Personal hygiene such as , brushing the mouth, toilet hygiene and even bathing would be affected. Some senior citizens might not be able to control their stool ( faecal incontinence). Similarly, they need help with environmental hygiene.
INTERVENTION/CARE
• Ensure their oral care by brushing for them with toothbrush or cotton wool depending on the situation if they already lack the ability to do so.
• Check and clean their anus at intervals when soiled with faeces.
• Attend to their hair by combing it.
• If they are not ambulant, carry out bed bath by cleaning the body with soap, water and a small bath towel.
• Make sure their surroundings are clean and free from objects that can injure them and cause further harm.
IV. DIFFICULTY IN BREATHING : Grunting or laboured respiration is not uncommon at the final stage of life. At this point, oxygen or suctioning would probably not do any good . It is mostly not necessary.
INTERVENTION/CARE
• Put them in a more comfortable position.
• Invite a home health professional for review.
V. IMMOBILITY : Often, final stage of life can occur in combination with some ailments, which can render patient immobile or bed ridden.
INTERVENTION/CARE
• Turn elderly from side to side every 2hours to prevent pressure sore.
VI. LOSS OF APPETITE:
A dying elderly person would probably not be able to eat.
INTERVENTION/CARE
• Perform mouth care at least twice daily to increase appetite.
• Offer water with straw if they are able to sip.
• Do not force feed them.
VII. EXCESSIVE SLEEP AND COLD: This is very common at a dying stage.
INTERVENTION/CARE
• Do not startle them.
• Do not raise your voice at them.
• You can tap or speak to them gently , they might be sleeping but most times they still hear.
• You can play their favourite music.
• You can sit beside them and gently touch them and hold their hands, they might not be able to talk sometimes but they can feel.
SEVEN (7) GOLDEN RULES OF FAREWELL
When it is time to bid someone who is at the final stage of life farewell, there are seven rules you must follow:
1. Be physically present. This is priceless, the worth cannot be quantified. The satisfaction is enormous!
2. It is not a one time thing. It is what you do every time as the person goes through the stage of dying.
3. There are several ways of saying it. Sometimes, it is by putting a flower beside them, at other times, it might be by placing their head on your laps, and another way is by saying it. Also, you can bring their grand children to bid them farewell.
4. Let them know they are forgiven if they have ever hurt you. Nothing is more important at the final stage of life than reconciliation and making peace.
5. Let them know their last words would be cherished.
6. Ask or write it in a paper, asking them if there is anything they would want you to do for them. That is if they can still comprehend.
7. Let them know it is normal to die, this brings about acceptance on the part of the dying person and the person saying farewell.
AUTHOR
My name is Adesuyi Adesina, the founder and CEO of Ganat Healthcare Initiative. I am passionate about the care and health of older persons in our society. Senior citizens deserve good elderly care homes and better healthcare services.
