Caring for a loved one.
If you are a caregiver, you may have had training in symptom relief for terminally ill patients. But, many family members now take care of their loved ones at home, and training may come through experience only. If you are one of those latter individuals, spend some time at the library, as many books about caregiving can be found on the book shelves. Also, calls to local hospice organizations or training programs offered by hospitals can help provide information as well.
Some basic information about symptom relief is listed below, and these solutions apply to any person at any age — even if they do not have a terminal illness. These problems may frighten a caregiver at first, but they are common problems, and solutions are available. Remember to rely on a trained hospice worker, a trusted nurse or a doctor for specific directions for your ‘patient’ before you take extreme measures.
Constipation: This is a common problem during the last stages of terminal illness, because the patient may not be physically active. Some solutions include increasing fiber in the diet with foods such as prune juice and bran cereal. Sufficient fluids also help to resolve the problem in many instances. Only give stool softeners or laxatives as a doctor may recommend. He or she may recommend them, as constipation can be a side effect of some medications. The warning sign for severe problems – one that warrants a call to the doctor – is constipation for more than three days or blood in the stool.
Eating and Drinking: Smaller and more frequent meals may resolve the eating problem. Some physical activity, if the patient can tolerate it, also helps stimulate appetite. Fluids are, sometimes, the most important issue. Dehydration can develop rapidly in people who do not drink enough fluids. Use a straw or offer ice chips to suck. Be aware that too many fluids also are dangerous and providing intravenous fluids to a person who is dying may result in respiratory distress. Follow a doctor’s instructions on how much food and fluid is ‘normal’ for your patient’s situation.
Breathing Problems: Breathing problems can occur during the final stage of any illness and may require oxygen. Another way to help open breathing passages is to elevate the head of the patient’s bed or to move the patient to a recliner. A doctor may prescribe small doses of liquid morphine or bronchodilator drugs. Follow orders for these prescriptions carefully. Opening a window on a mild day or running a fan in the patient’s room also can help improve air circulation.
Nausea and Vomiting: This problem may occur as a side effect of some medications or as a result of the disease. Do not force a nauseated person to eat. Use ice chips instead of drinking to help retain body fluids. Overt vomiting is an issue, however, as the patient may not be able to keep down medication. A doctor may order medication in suppository form if the patient continues to be nauseated.
Dry Mouth: A dry mouth can be caused by medication or by the disease or by a lack of fluids. Go by the doctor’s advice on the amount of fluids to provide, and if the patient continues to have dry mouth, contact the doctor. You may need to provide glycerin swabs or artificial saliva for the inside of the mouth and a lit coating of lip balm for dry or cracked lips.
Itching: Dry skin, a new reaction to a laundry product, medications or the disease may cause rashes, dry skin and discomfort. To stop the itching, you can apply a soothing skin cream (alcohol-free, as alcohol-based products can further dry the skin) or calamine lotion to itchy areas. Cornstarch, baking soda or baby powder may work, too. Use a humidifier during the fall and winter when heat is used to help moisten the air. You may need to experiment if none of this solutions work. Change laundry detergent or avoid dryer sheets to see if those solutions help.
