Who will help me, my family and my carers?

Information for relatives and carers in Last Days of Life Care (Recognise changes and know what to do)

Experience impaired hearing and vision and may develop a fixed stare
Never assume the person cannot hear you. Speak as if your words can be heard.

Become restless, pull at the bed linen and have visions of persons or things, not present
Provide reassurance and avoid physical restrictions when possible.

Lose control of urine or bowels. The amount of urine will decrease or stop as death approaches
Health care staff will help in suggesting appropriate padding or recommend a catheter for urine.

Breathe irregularly and may stop breathing for 10-30 second periods. Occasionally after death there may be a “last sigh” or gurgling sound. The pulse may become faster and irregular
There is no need to become alarmed about this as it is the normal pattern.

Collect secretions at the back of the throat that sound like a rattle. This is because the person cannot swallow saliva, but this does not mean they are uncomfortable
Turn the person on their side or raise the head of the bed.

Have cool arms and legs as the circulation slows down. Their face may become pale, their feet and legs a purple-blue mottled appearance
Use just enough coverings to keep the person comfortable.

When death occurs you may notice

  • The person is entirely unresponsive.
  • Breathing stops.
  • Heartbeat and pulse stops.
  • The eyes will be fixed in one direction and may be open or closed.
  • Loss of control of urine or bowels may occur.

Health care professionals realise that this particular time is a very difficult one for the family, friends and caregivers. We have found that people tend to cope better when they have an understanding of what is happening. Fear of the unknown is sometimes much worse than the reality. Our approach in matters affecting you is to be as honest and as straightforward as possible. We want to establish open communication with you and your family members.

The following information is offered to help you understand symptoms and signs, which may indicate approaching death. Not all of these symptoms may be present in someone who is dying, however you should be aware of them. Below are the possible symptoms of how the body may prepare for the final stages of life.

Signs of approaching death and helpful ways you can respond

  • Sleeping more and at times be difficult to waken
    Plan conversation times for when the person seems more alert.
  • Lose his/her appetite and may “forget” to swallow
    Offer small servings of favourite food or drink without “forcing”.
  • Become confused about time or may not recognise familiar persons
    Speak calmly so as not to startle or frighten. Remind the person of the day, the time and who is in the room. Leave a soft light on in the room.

What to do if you think death has occurred in the home

If the person is in their own home or a loved ones home, do not call 999, the police or the ambulance. These calls are not necessary when death is expected.

Call your District Nurse/GP so that he/she can come and verify the death

District Nurses 8.30am – 4.30pm: 01226 433211

District Nurses – out of hours 4.30pm – 8.30am: 01226 730000

(Barnsley Hospital NHS Foundation Trust) and ask for the Rapid Response Service.

Call those people important to the person, such as family members, friends and spiritual advisor that you would like to be present with you.

After the death has been verified call the funeral home when you are ready. There is not a rush to call the funeral home if you wish to take extra time with the person who has died.

Although this information may be difficult, please know that the aim is to help prepare you for what to expect. Your physical and emotional well-being is as important as the dying person.

It is important not to expect that all the symptoms of approaching death will occur. The focus of this information is to help you to be prepared for the signs that may occur. Please ask health care professionals if you have any concerns or fears about the death or expected death.

If you are looking after a family member or friend because they can’t manage on their own, you can ask for an assessment of your situation.

Please visit the link below for further information:

www.barnsley.gov.uk/social-care-wellbeing-and-community-information/carers/carer-assessment