The last few days of life

You will usually need help looking after yourself. Your family, friends or a partner may want and be able to look after you at this time. But you may need the help of professional carers as well, especially if you do not have people around you to help.

Your GP, district nurse or palliative care team can arrange professional care if needed. Carers can visit you at home. They can:

• support your family and friends in providing care for you
• show your family and friends how to provide some aspects of your care – this could include learning how to move you safely and helping keep your mouth and lips clean and comfortable
• provide some aspects of personal care, if you would prefer them to do this.

You will probably want to wear comfortable, loose-fitting clothing. Your family, friends or partner may be comfortable washing you and changing your clothes. But if not, the district nursing team or palliative care team can show them the best way to do this. You are not likely to want to eat or drink very much, so your mouth may get dry. Lip balm can help moisten your lips.

It is important that your carers moisturise your skin and help you change your position regularly. This helps to stop your skin getting sore. Your nurses can advise your carers on how to make sure you are in a comfortable position. They may be able to arrange pressure care aids to help keep you comfortable. These include:

• cushions for chairs
• mattresses for beds
• special beds with pressure-relieving mattresses.

Some people lose control of their bladder and bowel as they approach the end of life. This is normal but can be embarrassing for you and those around you. Your nurse can show you and your carers the best way to manage this so you are comfortable. You may need a tube (catheter) put into your bladder to drain urine (pee).

It may feel strange to need so much help. But you may get very close to the people who are looking after you at this time.

When you are not needing any care, you can sit or lie quietly. You may want to have your family, friends or a partner sitting with you. This can be a very intimate and special time. You may want to talk, or you may want to be quiet, watch the television or listen to music.

You may want to have someone with you all the time. Or you may prefer to have some time on your own. Tell people around you what you would like, as it will help them in planning your care.

If you are at home, your carers can contact your district nurse, community palliative care nurse or GP at any time, day or night, if they are concerned. They can discuss your care and visit to give you medicines to control your symptoms if needed.

Your GP, district nurse or the palliative care team may suggest leaving a small case or box of medicines in your home, in case you need them. These are sometimes called just-in-case medicines or anticipatory medicines. They usually include injections to help with pain, sickness, restlessness and fluid in your airways.

Getting medicines quickly can be difficult, especially at night or weekends. If you have ‘just-in-case’ medicines at home, a nurse or doctor can give them to you straight away if you need them.

Although death is a natural process, it is normal to worry about what will happen. You may feel anxious or frightened. Or you may feel calm and peaceful.

Usually, you slip into a deep sleep where you are unconscious. You cannot be woken, but you may still be able to hear and be aware of the people around you. There might be times when you are awake and can talk, and then you slip back into unconsciousness.

The final moments of life are usually very peaceful. Your breathing may gradually become even slower and more irregular, with very long pauses between each breath. Eventually, you will stop breathing altogether.