Understanding The Dying Process

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Every year, several of our long-term residents pass away over the holidays. Have you noticed this happening at your nursing home, too? I wondered why so many elderly people die during the Christmas season, so I did a bit of research.

Several studies indicate that the most common time for adults to die of natural causes is over the 2 weeks surrounding Christmas and New Year’s Day. A few theories exist as to the reason, but nobody knows for sure why this happens.

As a volunteer, you may be called upon to spend time with a resident who is in the dying process. If you’ve never before seen a person who is dying, the symptoms can be unsettling. You’ll provide better support for the resident when you understand what’s happening during these normal end-of-life changes.

At our nursing home, we have a program called Garden Angels that provides volunteers to sit with residents who are dying. Our goal is for nobody to die alone.

Garden Angels sit with dying residents in a variety of situations. Some residents simply don’t have any family or friends in the area who are available to spend time with them.

In other cases, a resident experiences a sudden decline, and their family lives far away. We stand in the gap, providing companionship for the resident until the family can get here.

Sometimes we provide a much-needed break for a family. After attending to their loved one for a long time they may need to get away for a shower, a nap, or a good meal.

You may see some or all of these signs as a person is dying:

• The resident often loses interest in eating, and they could develop difficulty swallowing. You might see nursing staff offer ice chips, popsicles, or lip balm for comfort.

• Respirations may become irregular or there may be pauses in breathing. Increased secretions can result in gurgling sounds. Administration of oxygen or medication is sometimes helpful. Staff also may elevate the head of the bed or help the resident change positions.

• Skin color often changes and takes on a bluish or purplish hue. Hands and feet may become cool to the touch. A light blanket is helpful, but be sure not to apply too many heavy covers.

• The resident often becomes sleepier and eventually may not respond at all. It’s important to remember that the resident probably is still able to hear, so always talk as if they’re aware of everything you say.

• They may or may not experience pain. If you see any signs that the resident is having discomfort, be sure to let the nurse know right away.

• The resident may lose bladder and/or bowel control. As the kidneys shut down, there’s often little or no urine output.

• Sometimes a dying person displays confusion and talks about seeing or hearing people who aren’t there. While this might be a bit unnerving to you, remember that your role is to simply listen and provide reassurance as needed.

Today my goal was to provide basic information about the dying process. I hope your facility provides additional training to help you know how to best support residents as they prepare to leave this life. If you’re interested in getting involved in this special ministry for residents at your nursing home, please contact your volunteer coordinator or chaplain.

Now that you’ve read this article, I believe you’ll also find helpful information in this post about hospice care in the nursing home.