Approaching the End-of-Life
Just as life experiences are unique to the individual, it is important to recognize that the experience of physical decline, death, and dying is unique as well. Residents will decline in their own time and manner. Their signs and symptoms will vary. As a care provider it can be a challenge to adapt to these differences. In order to provide the best possible care to your residents it is essential to be aware of the consistent changes that take place during this critical time. These changes include:
One to Six Months Prior to Death
May withdraw from friends and family
Spends more time sleeping
Gradual decrease in eating and fluid intake
One to Two Weeks Prior to Death
Sleeps most of the time but can be aroused
Skin color may begin to change
Blood pressure may begin to decrease
Continued decrease in foods and fluids
Breathing changes occur
One to Two Days Prior to Death
Often has difficulty in, or inability to swallow
Blood pressure often decreases
Often see apnea (pauses in breathing)
Congestion or respiratory secretions can occur
May become restless
May sleep most of the time
May notice mottling (blotchiness to skin)
Sometimes has a surge of energy or alertness
Body temperature fluctuates
May or may not have pain
