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End-Of-Life Stages Explained

During end of life care our goal as care providers is to treat the person, not the illness, and our focus is on providing the best care possible for them to ensure they are comfortable and able to enjoy excellent quality of life for as long as they can. The care professionals within our Future Care Group homes achieve this by meticulous end-of-life care planning and by ensuring the individual is both physically and mentally at ease. Once a resident transitions into the final stage of their palliative care, it often helps the individual and their loved ones to understand the timelines, stages and symptoms of the end-of-life stages that lay ahead of them. It helps them to assess where they are in their journey and what to expect.  

If you notice your loved one losing their appetite, sleeping more, withdrawing from others, or feeling restless, don’t panic. These changes are all part of the natural process as someone approaches the end-of-life. Each person’s journey is unique, so the pace and intensity at which they experience these symptoms may vary. While the timeline provided here might not align precisely with your or your loved one’s experience, it serves as a helpful guide to understand what to expect. Remember, you’re not alone in this journey, our professional and experienced care team will guide you through every step of the way with the dignity, compassion, and empathy you deserve.

How Do You Know When A Person Is Transitioning And Actively Dying?

Transitioning from palliative to end-of-life care involves recognising the tell-tale signs and symptoms that indicate the individual is entering the final stages of life. Whilst the experience is unique to everyone, there are many shared common indicators that a person is transitioning and actively dying. These include:

  • Decline in functional status: The person may experience a significant decline in their ability to perform activities of daily living, such as eating, bathing, and mobility. 
  • Increased weakness and fatigue: The individual may become increasingly weak and fatigued, with limited energy reserves. 
  • Changes in appetite and hydration: There may be a decrease in appetite and thirst, leading to reduced intake of food and fluids. The person may refuse food and fluids altogether. 
  • Changes in consciousness: The person may experience alterations in consciousness, such as confusion, drowsiness, or periods of unconsciousness. 
  • Changes in breathing: Breathing patterns may change, becoming irregular, shallow, or laboured. There may be periods of apnoea (pauses in breathing) followed by gasping or irregular breathing. 
  • Changes in vital signs: Vital signs such as heart rate, blood pressure, and body temperature may fluctuate or decrease as the body’s systems begin to shut down. 
  • Changes in skin colour and temperature: Skin may become pale, mottled, or cyanotic (bluish discoloration), particularly in the extremities. The hands, feet, and other extremities may also feel cool to the touch. 
  • Decreased urine output: Urinary output may decrease significantly or cease altogether as the body conserves energy. 
  • Increased restlessness or agitation: The person may exhibit signs of restlessness, agitation, or discomfort, which may be indicative of distress or impending death. 
  • Expressions of readiness for death: The individual may express a sense of readiness for death or a desire to be at peace. 

It’s important to note that not all individuals will experience all these signs, and the progression of symptoms can vary from person to person. Additionally, the timing and duration of the transition phase can vary, so it’s essential to provide individualised care and support based on the person’s needs and preferences. Collaborating closely with the entire healthcare team, including those within our home, as well as those in the community such as local hospices, can help ensure that the individual receives appropriate care and support during this challenging time. 

End-Of-Life Care Timeline Stages

As a person approaches the end of life, their symptoms may change and become more pronounced. Here’s a general outline of what symptoms someone might experience during each of the stages

One to two months before the end of life:

  • Decreased appetite and weight loss. 
  • Fatigue and weakness. 
  • Increased need for sleep or periods of sleeping more. 
  • Withdrawal from social interactions. 
  • Difficulty with concentration. 
  • Decline in physical functioning. 
  • Changes in breathing patterns, such as shallow breathing or shortness of breath.

One to two weeks before the end of life:

  • Further decline in appetite, possibly leading to refusal of food and fluids. 
  • Increased difficulty with mobility and performing activities of daily living. 
  • Changes in consciousness, such as confusion or disorientation. 
  • Restlessness or agitation. 
  • Changes in skin colour, including pallor or mottling. 
  • Increased fatigue and sleeping for longer periods. 
  • Decreased urinary output. 
  • Changes in breathing, such as irregular breathing patterns or periods of apnoea.

 

Days or hours before the end of life:

  • Profound weakness and fatigue. 
  • Inability to eat or drink. 
  • Minimal or no responsiveness. The person may become unresponsive or less responsive to external stimuli. They may not react to touch or verbal stimuli. 
  • Changes in breathing, such as noisy breathing, gurgling, or gasping. 
  • Decreased urine output or complete cessation of urine output. 
  • Cooling of extremities. 
  • Changes in heart rate and blood pressure. 
  • Decreased consciousness leading to coma. 
  • In some cases, individuals may experience visions or hallucinations.

Minutes before the end-of-life:

  • Irregular, very shallow, or laboured breathing. There may be periods of apnoea followed by gasping or irregular breathing patterns. 
  • Changes in skin colour: Skin may become pale, mottled, or cyanotic (bluish discoloration), particularly in the extremities. 
  • Blood pressure and heart rate decrease significantly as the body’s systems shut down. 
  • The person may slip into unconsciousness and become unresponsive. 
  • The hands, feet, and other extremities may become cool to the touch as circulation rapidly decreases. 
  • In some cases, there may be moments of clarity or lucidity followed by periods of decreased responsiveness. 

During this time, it’s important for loved ones and caregivers to provide comfort and reassurance, as well as to ensure that the individual is as comfortable as possible. Palliative care measures can be continued to manage any distressing symptoms and provide support to both the individual and their loved ones. 

It’s important to note that not all individuals will experience all these symptoms, and the progression of symptoms can vary widely from person to person. Additionally, these symptoms can be managed and alleviated to some extent through palliative care and symptom management interventions. 

As you near the end of your life, you can choose where you want to receive care—whether it’s in a hospice, hospital, or our care homes. No matter your choice, our main goal is to ensure you and your family feel supported and comfortable. If you stay with us, we’re fully committed to providing caring end-of-life support. This includes help with managing pain, controlling symptoms, and offering emotional support, as well as involving your family in the process. 

We understand that planning ahead while you’re with us can make things smoother, easing any worries and keeping your needs front and centre.

What Happens After I Pass Away At The Future Care Group?

Even after you’ve passed away, we continue to honour your wishes. For example, if you prefer not to be left alone until you leave our care, we’ll make sure a member of our team stays with your body. This practice is actually quite common in our homes, whether you’ve asked for it or not. Our caregivers often form close bonds with the residents they look after, and they frequently spend time with them after they’ve passed away. They reminisce, offer comfort, and pay their last respects to their friend. 

Our support doesn’t stop with you. We’re here for your family, friends, and caregivers after you pass away. Even if we can’t be there in person, we’ll give them the tools and information they need to cope with their grief. Everyone grieves differently, so we tailor our support to fit each person’s needs. 

Our team talks privately about the care you received and if it met your needs and our goals. If not, we figure out upon what we can improve. It’s important to support our staff too – they spend a lot of time caring for you and building strong relationships. By reflecting on their experiences and learning from them, we can improve how we provide care. 

If you would like to book a visit and see our expert team in action and get a feel for our warm and welcoming home-from-home environment, we would be delighted to meet you and show you around. For more information on our end-of-life care provision please click here.

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