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When your condition deteriorates and it looks like you are in the last weeks of life, this is the time to review what’s happening to you and assess your needs.  This is called a holistic needs assessment.  It may have been done before but it is useful to do it again now that your condition is changing to check that your needs are still being met. Your carers should also have a holistic needs assessment.  They are on this emotional journey with you so it’s important to check that they have what they need to support them as they care for you. This assessment isRead More →

As your body shuts down you will become much less active and spend more and more time in bed.  Your body will require less and less oxygen and changes in your breathing pattern are likely to occur. Even people who have been very breathless during their illness may find that breathlessness is less of a problem in the last days and hours of life.  This can be very comforting to know as many people fear that they will die gasping for breath. Breathing often becomes slower and shallower breaths are taken.  Carers may notice that your breathing rhythm becomes irregular with sometimes long pauses betweenRead More →

Serious bleeding can be very frightening for you and your carers.  It can happen with certain types of cancer that invade blood vessels making them bleed. It usually means that death is very close often occurring within minutes. Often you may be so close to death that you are not aware of what is happening.  If you are aware, it can be hard to overcome feelings of panic and extreme anxiety.  Fast acting medication can be given by injection to help you feel calm and to reduce anxiety.   Seeing you bleeding heavily is absolutely awful for carers and they may panic and feel helpless.Read More →

As your health deteriorates the risk of your heart or breathing suddenly stopping (cardiac or respiratory arrest) increases. If this happens in the presence of health care professionals (doctors, nurses, ambulance crew, paramedics), they will usually attempt to resuscitate you by giving an electric shock to the heart and starting artificial breathing (mouth to mouth or via a tube into the lungs). This is not always successful and is often an undignified way to die. You may choose not to have any attempt at resuscitation if your heart or breathing stops. If this is your choice, you must inform the health care professionals looking afterRead More →

Your brain and nerves stop working normally as the end of life approaches.  This can result in a range of symptoms: Uncontrollable twitching and jumping or arms and legs Feeling restless – can’t keep still Feeling agitated – shaking, involuntary movements of limbs and head, moaning even if not in pain Anxiety Hallucinations – often seeing visions of loved ones who have died Fever – the part of your brain that controls your temperature does not work properly so you may develop a high temperature Confusion Itchy skin Sweating and flushing often worse at night   Your health care professional will advise on how toRead More →

  Effective holistic assessment processes are key to meeting the complex, wide-ranging and changing needs of people approaching the end of life. Meeting the complex, wide-ranging and changing needs of people approaching the end of life requires: effective care co-ordination across boundaries strong communication a sound understanding of the individual’s needs, preferences and priorities for care. Effective holistic assessment processes are key to this. The National End of Life Care Programme have produced the Holistic common assessment of supportive and palliative care needs for adults requiring end of life care .   This document provides guidance for holistic common assessment of the supportive and palliative care needs ofRead More →

For many reasons, we know that it can be difficult for people to talk about their concerns with health care professionals. It’s often tempting for health care professionals to concentrate on physical symptoms and avoid talking about feelings and emotions. A useful way of finding out about the concerns of people is to use a questionnaire called a Distress Thermometer. This has three parts. Part 1 asks you to circle the number on the thermometer that best represents how much distress you’ve been in today and during the last week.   The second part is a list of problems divided into 5 sections – practical,Read More →

  Life limiting illness Living with your illness Planning for your future care Support for you and your family What happens in the last weeks of life What happens in the last days of life What happens after someone has died Bereavement Care ‘Dying Matters’      Read More →

In the last days of life parts of your body will stop functioning properly as organs and tissues shut down. You may not be aware of what is happening – this in itself can be part of the dying process – but your carers and loved ones will be aware. Seeing the changes occurring in you can be very distressing for carers and loved ones and they may need extra support to get through this difficult and often exhausting time. Changes carers may notice include: Click on any of these changes for more information Unless your doctors and nurses have diagnosed that you are inRead More →

Unfortunately it is very difficult to predict exactly what will happen – your experience is unique to you.  The condition you are dying from and any other health problems you have will affect the kind of symptoms you will develop as your condition deteriorates. For some people there is a sudden, massive deterioration suggesting the last weeks or days of life are here.  For others there is a steady almost unnoticeable decline over many months.  Sometimes something else happens that can speed up the dying process – for example picking up a chest infection or having a bad fall. Trying to pin point exactly whenRead More →