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Thoughts on comfort care

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    Posted: Oct 29 2012 at 12:08am

Rachel .......and others,

You asked on "Mom's update - not a good" http://forum.tnbcfoundation.org/moms-update-not-a-good-one_topic10398.html
"Any thoughts or suggestions you have to make this final stage easier please fire away."

Will share some thoughts and ideas which are both mine and from some books, programs and other people.
Every one is an unique individual and each situation is unique. Pick and choose what may be
helpful.   

In your posts, you have referred to hospice care as comfort care. These thoughts can be considered
whether a person chooses comfort care within hospice care or outside of a hospice care.
You have already done many or similar things related to what will be mentioned.

Prior to comfort/hospice care or early in comfort/hospice care:
- What things does the person wish to do? What things are important to the person?
          Are there places the person would like to go to/visit?
          Are there people the person would like to visit or call?
          Are there people the person would like to come to visit them?
- With a loved one, have a life review conversation. We all like to feel our lives have meaning.
        Help the person remember the important and meaningful events in their lives.
- If there have not been recent family pictures, now might be the time to consider taking some
        family pictures.        (Rachel, which you have already done.)
- Financial papers in order:
          Will, durable power of attorney, health care power of attorney (health care proxy).
          Living Will.
          Do all financial accounts that need a beneficiary have a beneficiary named?
          When appropriate/applicable and with professional advice, check on how all assets
               are named/titled...... may be of help for later.
- If applicable and depending on person's preference, arranging for spiritual support visits from
               the worshipping community.
- Is the family aware of the person's wishes regarding funeral services?
           Sometimes the family does not know the person's wishes regarding the wedding ring.
- Does the person wish to leave notes for anyone.....for now or to be opened later?
- Do any family member wish to write a note to the person?

At any time:
- Consider doing things the person likes and enjoys.
             If the person likes fresh flowers, get person's favorite flower(s) often.
             If the person has a favorite meal/ice cream/dessert etc, serve while person can enjoy it.
             If the person enjoys music, find and play the favorite CDs etc.
             Are there special poems the person would like read to them?
             Are there special favorite books....on audio books that the person would like?
             If the person liked to do slow dances, maybe put on some music and with a loved one do a
                    slow dance....or just rock in place with a loved one to music.       
             Is there a rocking chair in the house? Rocking can stimulate the parasympathetic (relaxation)
                    nervous system.

When person starts to need more rest and sleep:
    Surroundings: Is there a ocean/lake/water picture or a soothing nature scene picture that person
                                   can easily see?    Or other favorite picture/scene?
                               Are there special pictures of family/friends or a few special things that the person
                                    would like to be able to glance at easily?
                               Is playing a favorite CD softly comforting?
                               If a person is experiencing a little effort in breathing, a small fan in the room to
                                    circulate the air can help. (This would be if a health provider already determined
                                    no need for oxygen.)
When activity decreases: Importance of frequent position changes (to prevent skin redness/breakdown).
                                                 .......whether sitting or lying down.
Oral care: Need for good mouth care.   This need increases as/if person begins to sleep more.
                    Keep lips moistened.

A wise person told me: even when a person's passing is expected and one knows that.......
it can still be a big shock and surprise when it happens.

Remember the caregiver needs to take care of them self.......so they can continue to give care.

Rachel.... you are already doing the most important things:
     Following your heart as you have been doing right along.
                 You are by your nature and your gifts an exceptionally loving and caring daughter,
                 advocate and caregiver.
     Loving your Mom and being in the present moment as much as possible.


With caring thoughts,
Grateful for today............Judy



Addendum:

This is for when the end of comfort care/hospice is approaching.

If you feel this additional info, may be helpful, continue reading.
If you feel this additional info would not be helpful, please disregard the following.

One may wish to talk with the hospice provider and/or other supportive/professional provider
       about what to expect when the end of comfort care is approaching BEFORE reading the following.
One may or may not wish to read the following at this time:
       10 signs of approaching end of comfort care.
       One may wish to read in presence of hospice provider or other supportive/professional person.
       http://www.caring.com/articles/signs-of-death
       What to expect when witnessing a passing
       http://www.caring.com/articles/witness-passing-away

Edited by Grateful for today - Nov 04 2012 at 11:24am
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