FAQ
Learn More About Hospice Care In The Arkansas Valley
Arkansas Valley Hospice is a 501C3 non-profit organization. Since we were established in 1985, we have stuck true to our mission statement:
Arkansas Valley Hospice team members support people in the final phases of life, comfort the grieving and educate the community about end of life care.
Hospice: The Myths vs. the Facts
Here are some common questions and concerns people have about hospice care:
- A person on hospice can keep their referring physician involved while receiving hospice care.
- Hospice serves anyone with a life-limiting illness regardless of age or type of illness.
- Hospice is not a place. It is a high-quality form of care that focuses on comfort on quality of life.
- Hospice is paid for by Medicare, Medicaid, and most insurance plans. Fear of cost should never prevent a person from accessing hospice care.
- Hospice provides expert medical care as well as spiritual and emotional support to patients and families.
- Research has shown that most Americans would prefer to be at home at the end of life. Hospice makes this possible for most people.
- Hospice serves people living in nursing homes and assisted living facilities.
End of life symptoms
The following describes the physical symptoms you may observe. Here are end-of-life signs and helpful tips:
1. Coolness.
Hands, arms, feet, and legs may be increasingly cool to the touch. The color of the skin may change and become mottled . How you can help: Keep the person warm with comfortable, soft blankets.
2. Confusion.
The patient may not know time or place and may not be able to identify people around them. How you can help: If this end-of-life sign is occurring, identify yourself by name before you speak. Speak normally, clearly, and truthfully. Explain things such as, “It’s time to take your medicine now.” Explain the reason for things, such as, “So you won’t start to hurt.”
3. Sleeping. An increasing amount of time may be spent sleeping. The person may become unresponsive, uncommunicative, and difficult to arouse. How you can help: Sleeping more frequently is normal. You can sit quietly with them. Speak in a normal voice. Hold their hand. Assume they can hear everything you say. They probably can.
4. Incontinence.
They may lose control of urinary/bowel functions. This is a common end-of-life change that can occur during the process of passing on. How you can help: Keep your loved one clean and comfortable. Ask your hospice nurse for advice.
5. Restlessness.
The person may make repetitive motions such as pulling at the bed linen or clothing. This is due in part to A decrease in oxygen. How you can help: Do not interfere with these movements or try to restrain them. Speak in a quiet, natural way. Lightly massage their forehead. Read to them. Play soothing music.
6. Congestion.
There may be gurgling sounds inside the chest. This is also sometimes referred to as a “Death Rattle” These may be loud. This end-of-life symptom does not indicate the onset of severe pain. How you can help: Gently turn their head to the side to drain secretions. Gently wipe their mouth with a moist cloth.
7. Urine decrease. Output may decrease and become tea colored. How you can help: Consult your hospice nurse.
8. Fluid and food decrease. Your loved one may want little or no food or fluid. The body will naturally conserve energy required for the task ahead. Food is no longer needed. How you can help: If this end-of-life symptom is present, do not force them to eat or drink if they don’t want to. It only makes them more uncomfortable. Small chips of ice or frozen juice chips might be refreshing. A cool, moist cloth on their forehead might help.
9. Change in breathing.
The person may take shallow breaths with periods of no breathing for a few seconds to a minute. They may experience periods of rapid, shallow panting. These patterns are common and indicate decrease in circulation. How you can help: Elevating their head or turning them on their side may bring comfort. Hold their hand. Speak gently.
10. Fever.
Increase in temperature is common. How you can help: Consult your hospice nurse. A cool, moist cloth on their forehead may bring comfort.
The best practice is to consult your hospice medical team if you have questions or concerns. Hospice professionals are highly skilled and trained to provide support, care and education to patients and their families. You can reach Arkansas Valley Hospice at (719) 384-8827 or visit our office at 531 Lewis Ave. La Junta, CO 81050
Terminal Restlessness
When an individual is nearing their final days, terminal restlessness is a common symptom. Terminal restlessness (sometimes called terminal agitation) includes anxiety, agitation, and confusion. These signs are more intense than simple mood changes and can be very troubling for family members.
While you can expect anyone with an illness to be depressed, irritable, or sullen, terminal restlessness is more difficult for family members to manage. Even mild-mannered individuals may suddenly become extremely agitated, making angry accusations. They may demand to get up or want to call the police or an ambulance. Their body may jerk or twitch or they may pull at their bedding or clothing.
Individuals experiencing terminal restlessness may experience agitated delirium, disorientation, and hallucinations.
Causes of Terminal Restlessness
When an individual is experiencing the symptoms of terminal restlessness, it is important to determine if it is being caused by something that can be treated to alleviate their distress.
Causes of terminal restlessness can include, but are not limited to:
• Medication – High or long-term use of opioids, steroids and anti-seizure medication can cause agitated delirium.
• Pain – Uncontrolled pain can cause terminal restlessness. Patients at this stage in their illness may be unable to communicate their pain, so caregivers should speak to their hospice care team about this possibility.
• Fever – Fevers can be a sign of infections or sepsis.
• Metabolic disturbances – A chemical imbalance caused by vital organs beginning to shut down at end of life.
• Decreased oxygen to the brain, brain tumors, or brain swelling
• High calcium levels
• Constipation, fecal impaction, or urinary retention
• Emotional turmoil
How to Help Someone Experiencing Terminal Restlessness
If the patient is experiencing terminal restlessness due to pain or another treatable cause, the hospice team will first treat this. If there is no treatable symptom, the best course of action is to try to calm the individual and keep them safe. This may include adding side rails to the patient’s bed to prevent them from getting up.
Family caregivers can help their loved one by spending more time with them. Stay by their side to keep them from getting up or accidentally harming themselves. Offer reassurance and a calming presence by reading favorite stories or prayers. Play soothing music and do gentle massage. To maintain a calm environment, it may be helpful to decrease the number of visitors. Understanding what terminal restlessness is and learning about other end of life signs can help family members cope with the changes their loved one experiences. The sudden burst of terminal restless can be genuinely concerning for family members. Speak to your hospice team about any concerns you may have for your loved one’s safety or if you need additional emotional and spiritual support to help you cope.
Signs & Symptoms of Cancer
Cancer is one of the leading causes of death in the United States. Although mortality rates are dropping, cancer is common enough that most people in the United States know someone who has had cancer in their lifetime.
However, not as much is known about the end-of-life signs of cancer, and what one should expect at the end. Furthermore, many are unaware of the ways in which hospice can help patients in dealing with the stages of death from cancer.
What are the stages of death from cancer?
While the stages of death from cancer are different for every patient, and not everyone will experience the symptoms below, here is a general list of the stages and symptoms of death from cancer. Additionally, if you have questions you can contact us 24/7 at (719) 384-8827, visit our website at www.arkvalleyhospice.org, or come in to our office at 531 Lewis La Junta, CO 81050
During the Final Weeks:
• A Loss of Interest in Most Things/Inability to Concentrate: The patient may start to lose interest in things such as the news, entertainment, sports, etc., and may also be unable to concentrate or hold a conversation. Activities that used to interest the patient may now be of no interest. While this can be distressing to the family caregiver, it is not out of the ordinary in the final weeks of cancer.
• Exhaustion, Weakness, and Desire to Sleep: The cancer patient may become much weaker and more easily exhausted during these last weeks. They may want to sleep often because of this, as well as spend most of their day in bed.
• Loss of Appetite: They may lose much of their appetite or have difficulty eating and drinking.
During the Final Days:
• Skin Cools or Changes Color: The patient’s skin may start to feel cold to the touch and may start to turn colors. The process of the skin changing color is known as “mottling.”
• “Rattling Sounds”: You’ve likely heard of the phrase “Death Rattle.” This is something that occurs at the end of life and is caused by fluids in the person’s throat. This can affect his or her breathing. Breathing patterns may slow as well.
• Incontinence: An inability to control one’s bladder and bowels at the end of life is another common symptom and sign that the end is near.
• Confusion: The patient may be confused and delirious, including confusion regarding loved ones and close friends. If the patient is unable to recognize you, please understand that this is a symptom of the disease and nothing more.
• Restlessness: Cancer patients frequently suffer from restlessness, but this is not necessarily a reaction to pain. However, it is best to speak with the healthcare professionals regarding this restlessness to determine if pain is the cause.
Tips for managing cancer end-of-life signs.
Even if not medically trained, a family caregiver can provide comfort and care to their loved one as they begin to exhibit the signs of dying from cancer. For example, family caregivers can help cancer patients who are confused or delirious by answering their questions, listening to their concerns, and just by being present. If the patient shows no interest in doing anything, just sit with him or her. If the patient gets confused or angry, fight the natural instinct to become upset. The best thing you can do for your loved one is making this time easier in any way possible.
We also recommend speaking to the healthcare professionals, such as the patient’s primary care physician, regarding other ways in which loved ones can help. Palliative care, for example, is designed to treat the symptoms and side-effects of cancer, which can help with many of these issues. There is no reason that your loved one should suffer more than he or she has to, even before it may become time to consider hospice care. Palliative care can be administered separate from hospice care.
What else you can do for your loved one.
Besides providing relief throughout the cancer end-of-life stages, a family caregiver can provide both emotional and practical support at the end of life. This usually involves speaking to the patient about their financial plan but should also include things like speaking to the patient about how they would like to spend their final days. Perhaps there is something they wish they could have done or seen. And perhaps there is some way you can help them make this dream a reality. You can also help them with planning a funeral, as well as speak to them about when they feel it is time to begin hospice care.
Call today to have any other questions you have about hospice care answered.
(719) 384-8827
