![]() Patients generally find this experience quite comforting. Patients may talk about friends or family members who have died, or they may see people who have died. If they are distressed, listen for any underlying messages, ask them if you can help, or offer reassurance. They are preparing for their next journey. Patients may use traveling metaphors when they speak, referencing packing for a trip, waiting in lines, or boarding a ship. Maybe they will take ice chips that you gently place in their mouth or drink sips of water through a straw - if they still have the strength to use a straw. ![]() They likely will not have the strength to feed themselves. They will start eating and drinking less, perhaps only small bites of yogurt or ice cream that you have to offer them throughout the day. They may be able to verbally respond, but they probably do not want to engage in conversation. They may not be aware of the people entering or leaving in their room. They pay less attention to the TV or music. They turn inward and care less about external events. They rarely notice if they go to the bathroom in their brief, though they may become agitated or restless if this happens. They may have a more difficult time waking up. They may sluggishly rouse when you tap them on the shoulder. ![]() They are less responsive and sleeping most of the time. When a patient is transitioning, they are typically bedbound due to exhaustion, weakness, and fatigue. I have seen some patients completely skip the transitioning phase and some stay in it for weeks. Generally, when one is transitioning, they likely have days - or even weeks - to live. It describes a patient’s decline as they get closer to actively dying. Transitioning is the first stage of dying. The patient seems to acquiesce at the actively dying stage, to let go, and let the body do what it needs to do. The line is not always clear as to when transitioning ends and the active dying process begins, but there is often a shift that is visible and feels intentional. The two stages of decline before death are called transitioning and actively dying. I want to provide you with a list of the signs that we - hospice nurses - look for.Īlthough different for everyone, this is what death looks like for most patients. One of the hospice nurse's most pressing goals is to vigilantly monitor the hospice patient for signs of imminent death so that family and friends can be present at their last breath. Most of the time, family and close friends want to ensure that they are beside their loved one at the moment of death.
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