Care Goals at the End of Life

End-of-life care is the term used to describe the support and medical care given during the time
surrounding death. This type of care does not happen only in the moments before breathing ceases
and the heart stops beating. Older people often live with one or more chronic illness and need
significant care for days, weeks, and even months before death.
The end of life may look different depending on the person’s preferences, needs, or choices. Some
people may want to be at home when they die, while others may prefer to seek treatment in a hospital
or facility until the very end. Many want to be surrounded by family and friends, but it’s common for
some to slip away while their loved ones aren’t in the room. When possible, there are steps you can
take to increase the likelihood of a peaceful death for your loved one, follow their end-of-life wishes,
and treat them with respect while they are dying.
Not everyone who is dying experiences pain. For those who do, experts believe that care should
focus on relieving pain without worrying about possible long-term problems of drug dependence or
abuse. Struggling with severe pain can be draining and make the dying person understandably angry
or short-tempered. This can make it even harder for families and other loved ones to communicate
with the person in a meaningful way

What about morphine and other painkillers?
Morphine is an opiate, a strong drug used to treat serious pain. Sometimes, morphine is also given to
ease the feeling of shortness of breath. You might have heard that giving morphine leads to a quicker
death. Research shows that morphine given in clinical settings at the end of life does not hasten death
when it is prescribed appropriately. Successfully reducing pain and addressing concerns about
breathing can provide needed comfort to someone who is close to dying. End-of-life care can also
include helping the dying person manage mental and emotional distress. Someone who is alert near
the end of life might understandably feel depressed or anxious. It is important to treat emotional pain
and suffering. You might want to contact a counselor, possibly one familiar with end-of-life issues, to
encourage conversations about feelings. Medicine may help if the depression or anxiety is severe.
The dying person may also have some specific fears and concerns. He or she may fear the unknown,
or worry about those left behind. Some people are afraid of being alone at the very end. These
feelings can be made worse by the reactions of family, friends, and even the medical team. For
example, family and friends may not know how to help or what to say, so they stop visiting, or they
may withdraw because they are already grieving. Doctors may feel helpless and avoid dying patients
because they cannot help them further and some people may experience mental confusion and may have strange or unusual behavior,
making it harder to connect with their loved ones. This can add to a dying person’s sense of isolation.
Here are a few tips that may help manage mental and emotional needs:
● Provide physical contact. Try holding hands or a gentle massage.
● Set a comforting mood. Some people prefer quiet moments with less people. Use soft lighting
in the room.
● Play music at a low volume. This can help with relaxation and lessen pain.
● Involve the dying person. If the person can still communicate, ask them what they need.
● Be present. Visit with the person. Talk or read to them, even if they can’t talk back. If they
can talk, listen attentively to what they have to say without worrying about what you will say
next. Your presence can be the greatest gift you can give to a dying person.

Q&A

1. What is end of life care?
2. What is a caregiver’s role during the end of life for a client?
3. Older people often live with one or more chronic illness and need significant care for days,
   weeks, and even months before death. True or false
4. What is morphine?
5. The end of life May bring about depressive feelings. True or false
6. List two ways to manage mental and emotional needs during end of life
7. Music played at a low volume can help with relaxation and lessen pain at the end of life. True
   or false
8. Morphine leads to quicker death. True or false
9. Not everyone who is dying experiences pain. True or false
10. How can isolation affect a person at the end of life?