Managing emotional and physical pain is the most difficult aspect of care during the last moments of life. You can learn to face the worst, when it comes, with dignity and elegance. Make the necessary arrangements early and make the most of the life you have left.
Note: this article addresses aspects and treatments in the terminal phase of a disease. If you are struggling with suicidal thoughts, read this article or call the suicide prevention toll-free number or helpline.
Steps
Part 1 of 3: Managing the Pain
Step 1. Talk to your doctor about different options for managing pain
It is important to prioritize your physical well-being during the later stages of life. Depending on your specific condition, you may be taking different medications or undergoing a number of different procedures, so it's important to discuss all possible solutions with your healthcare provider and ensure maximum comfort in addition to these treatments.
- Morphine is typically prescribed to terminally ill patients and sometimes has to be given on a constant basis. Although there is some debate as to whether or not this drug can shorten lifespan, its effectiveness as a powerful pain reliever is certain and verified. If you are in severe pain, see your doctor to find the best solution.
- In some cases, it may be appropriate to seek complementary non-traditional methods of pain management, such as holistic medicine, medical marijuana, or other treatments that are not part of classical medicine. As long as these treatments do not interfere with other treatments you are undergoing, your doctor is likely to approve them, and they are worth trying.
Step 2. Stay home as much as possible
While not everyone has the luxury of paying for palliative care at home, you should consider what creates the greatest comfort and peace of mind in your particular situation. Perhaps in the hospital you would have more help and care, but at home you will certainly feel more comforted and peaceful. As a terminally ill person, you may be entitled to home care; inquire at the relevant ASL and ask your caregiver to fill out the application form.
If you are able to leave the hospital, try to get out as often as possible. Even a few simple and short walks can help you distract yourself for a while from the beeps of hospital machinery, and allow you to give a nice change of pace
Step 3. Deal with the symptoms of dyspnea quickly
Dyspnea is a general term for respiratory difficulties in the terminal phase, and can affect the ability to communicate easily, resulting in frustration and discomfort. You can manage to deal with it and take care of yourself with a few simple techniques.
- Keep your head elevated by raising the bed on the side of the headboard and keep the window open if possible to allow fresh air to circulate as much as possible.
- Depending on your health condition, you may also want to consider using a vaporizer or receiving additional oxygen directly through your nose.
- Sometimes fluid can collect in the throat causing irregular breathing; in this case you can reduce it by turning to one side or by undergoing a compensation procedure that your doctor can perform.
Step 4. Address skin problems
By spending a lot of time lying down, the skin on the face can become dry and irritated and can be an unnecessary discomfort in this final stage of life. With aging, skin problems worsen and it becomes important to deal with them quickly.
- Keep your skin clean and hydrated as much as possible. Use a lip balm and non-alcoholic moisturizers to soften the skin and prevent it from cracking. Wet cloths and ice cubes can also sometimes be effective to soothe dry skin and soften lips.
- In addition, under certain circumstances, what are called "bedsores" can form, ulcers due to pressure on the skin that develops after a long time in the supine position. Check carefully for dark spots on your heels, hips, lower back, buttocks and neck. Turn to your side and change positions every few hours to try to prevent these sores, or place a rubber mat under sensitive spots to reduce pressure.
Step 5. Test and manage your energy levels
The routine of hospital life is tough for everyone, and constant blood pressure control and intravenous drips can make it difficult to sleep well. Be honest about any feelings of nausea, temperature sensitivity, and energy levels you experience, so that you can rest well and try to conserve as much energy as possible.
Sometimes, in the terminal phase, medical personnel interrupt the continuous routine checks, when they realize that they become useless. This way you can probably relax more easily and get the rest you need to keep yourself energetic and active enough
Step 6. Ask questions and stay informed
You may soon feel heartbroken, confused and frustrated being in the hospital and unable to be in control of your life anymore. It can be very emotionally helpful to try to stay as informed as possible and regularly ask your doctor about your questions. Try asking him these kinds of questions:
- What is the next course of action?
- Why do you recommend this exam or treatment?
- Will this procedure make me feel better or not?
- Will this speed up or slow down the process?
- How is the program of this treatment developed?
Part 2 of 3: Making Agreements
Step 1. Prepare an advance declaration of treatment in time.
A living will is only valid if it is a document or series of written documents that explain what you want during end-of-life care. It can describe a variety of topics, including your wishes for care, what to do if you become unable to understand or want to, as well as assign a power of attorney or power of attorney.
At the moment in Italy there is still no specific law on living wills; therefore ask a lawyer or a notary if you need to authenticate your writing or not. These are things you probably don't want to spend too much time or money on and would rather take care of yourself, so there is a tendency to delegate this task to others
Step 2. Prepare to transfer your real estate to your heirs
It is very comforting to know that you have taken care of everything on time and that you will not leave big or stressful decisions on others when you are gone. If you are able to do this, it is important to carefully draft all legal documents.
- A will of life describes the type of health care you will want to receive and, if you do not want to be subjected to persistent treatment, which procedures you will want to implement and under what circumstances; you can also indicate what and who can decide for you in case you become unable to make your own decisions. You can get help from a lawyer in drafting the living will, which must be prepared in advance.
- You can draw up a document with your last wishes with the aim of designating the assets to the heirs, assigning the guardians for the minor children and clarifying any last directives you want to give. This is a bit different from a life donation that transfers ownership immediately rather than waiting after death.
Step 3. Consider drawing up a health power of attorney
In some cases, it may be a good idea to delegate these responsibilities, instead of assigning a delegation, in case you are unwilling or unable to make these decisions on your own. Power of attorney is often given to an adult child or spouse, who will be tasked with making decisions about your health as things get worse.
Step 4. Consider assigning the power of decision for health care to a lawyer, if necessary
In some cases, it can be difficult to choose or assign delegation responsibilities to a private person, so you might think about entrusting the task to a lawyer. This is a fairly common procedure and can be a relatively stress-free way to leave technical responsibilities to someone else so that you can focus only on your own comfort and emotional responsibilities.
A health power of attorney is different from a general power of attorney, which provides financial help after death. While both options may be appropriate, it is important to distinguish between them
Step 5. Plan for the funeral and leave arrangements for your remains
While it can be quite frustrating, it's important to decide what you want to happen to your body after death. There are many options and considerations, depending on your culture and religious faith.
- If you would like a funeral or religious ritual to be performed after death, you should arrange the ceremony yourself or delegate the responsibility to a loved one. Prepare everything you need for the church, the funeral home and so on, if this helps you find peace of mind for your death.
- If you want to be buried, decide where and near which family members you will want to be, if you have not yet made these decisions. Book a burial site, making a down payment and making arrangements with a local funeral home if necessary.
- If you wish to donate organs, make sure your donor status is up to date and accurate, according to your wishes. Make sure that all your loved ones and friends are aware of this decision of yours, so that after death they make the necessary contacts.
Part 3 of 3: Living Your Last Days Better
Step 1. Do what feels natural to you
There is no right or wrong way to die. Some people may wish to spend as much time as possible with friends and family, while others may find solitude in solitude by choosing to face the last few days alone. Still others may decide to do things they have always loved and make the most of what they still have to live, while some people may continue their daily routine.
- Don't be afraid to have fun or spend time laughing. There is nowhere written that the last days of life must be sad and melancholy. If all you want to do is watch your favorite football team and joke around with the family, go for it.
- It's your life. Surround yourself with things and people that you want company. Make your happiness, comfort and serenity a priority.
Step 2. Consider freeing yourself from job responsibilities
Few people want to spend more time in the office when they know they have a terminal illness; one of the most common regrets among people who are about to die is precisely that of having worked too much and having lost precious time. Try not to spend the time you have left, if it's not a lot, doing things you don't want to do.
- This choice of yours is unlikely to create a major financial problem for your family in a short amount of time, so focus on what's most important: addressing your and your family's emotional needs.
- Sometimes some people can find more energy and comfort by maintaining the work routine, especially if they feel physically strong enough to do it. If you find it natural and reassuring to keep working, do it.
Step 3. Hang out with friends and loved ones
One of the greatest regrets of those facing a quick death is that they are unable to maintain contact with old friends and relatives. However, you can easily remedy this by giving yourself the opportunity to spend some time with them, face to face if possible, and reconnect.
- You don't necessarily have to talk about what you are going through if you don't want to. You can tell about your past or focus on current events. The important thing is that you try to maintain a positive atmosphere, as you want it to be.
- If, on the other hand, you want to confide in it, do it. In this case, freely express what you are going through and open up to the people you trust by describing the pain you feel.
- Even if you don't have much energy to laugh or chat, just having loved ones around can make you feel good and comfortable.
- Depending on your family situation, it may be easier to meet relatives in large gatherings, seeing entire families at once, or you can choose to focus on one-on-one meetings. The latter help you slow down time, focusing on quality rather than quantity, and could be a great way to maximize the time you have left.
Step 4. Focus on ending romantic relationships with confidence
It is quite common on the verge of death to want to clear up and recover complicated relationships. This can mean a variety of things, but it typically focuses on resolving disputes and moving forward in a less burdensome way.
- Make an effort to end discussions, debates or misunderstandings so that you can proceed with peace of mind. You shouldn't engage in arguments and keep arguing, but rather have both of you come to the conclusion that you disagree and end the relationship on a positive note.
- While you probably can't be around your loved ones constantly, you can think about dating them in turns so that you are rarely alone.
- If you can't see family members you care about in person, at least one phone call can make a difference.
Step 5. Decide how much you want to disclose about your condition
If your health status is unknown to most of your friends and family, then you might choose to notify people individually and keep them updated, or keep everything private. There are advantages and disadvantages to each choice, but it is something you have to evaluate for yourself.
- Making people aware of what's to come helps you get closer to the end of life and feel ready to leave. If you want to share your heartache, open up and let friends and family know. You can talk to them individually, to make it more personal and private to only those you care about most, or make a public announcement. This, however, will prevent you from avoiding the topic and concentrating on lighter things in the following weeks and months, which many sufferers find negative.
- If you decide to keep the situation confidential, then you will be able to enjoy greater privacy and dignity; it is a choice that many prefer. Although this way you won't be able to share your pain, if you feel like you want to go through it all alone, then don't tell anyone.
Step 6. Try to keep a light atmosphere
You probably don't want to spend your final days reading Nietzsche and contemplating emptiness - unless you're the type of person who loves these things. Try to get all the pleasure you can from life. Have a glass of good whiskey, watch the sunset or chat with an old friend. Live your life.
When you are facing death, you don't necessarily have to force yourself to handle the situation. Unfortunately, this is unavoidable and she will manage you. For that reason, use the time you have left to enjoy the company of the people and things you love, don't focus on death
Step 7. Be open with what you want from others
One thing you will likely have to deal with is the fact that close people will not know how to deal with your death. They may seem even more upset, hurt, and worried about you. Try to be as honest as you are kind to your family members when discussing your wishes and feelings.
- Although you want nothing more from them than a little optimism, comfort and support, you may find that they have a hard time managing their despair - it is completely natural. Accept that people are doing their best and sometimes they need a break. Try not to get angry or feel bad about their reaction.
- Sometimes, some family members seem to show no emotion at all. Don't even think it's indifference: it's their - controlled - reaction to your illness, and they're trying not to bother with their emotions.
Step 8. Talk to your spiritual advisor if needed
Discuss with the parish priest, the rabbi or another authority of your faith to help you feel less alone in the world and reassure you that there is a divine purpose for you too. Talking to a religious friend, reading scripture, or praying can also help you find peace. If you are well enough to be able to go to a church, mosque or synagogue, then know that you could benefit from spending some time with the members of your religious community.
If you have no faith, don't feel compelled to change your ideas or beliefs about the afterlife - that's not how you lived after all. End your life exactly as you lived it
Step 9. Don't end your life prematurely
If you are looking for a way to die in peace because you want to end your existence, then you should seek help immediately. You should talk to a trusted friend or family member, get hospitalized, and do whatever it takes not to be alone. Perhaps you may believe that you have no alternative to suicide, but with the right help you will realize that there are many reasons to continue living and that there is a bright future for you too. If you really want to die peacefully, then you should try to live life as best as possible.
