Preparing for End-of-Life Care and Meeting Final Wishes
This article was updated on: 09/09/2018
The National Institute on Aging (NIA) says that end-of-life care is the support and medical care given during the time a loved one is nearing death.
According to NIA, when you are providing end-of-life care and comfort for someone you love, there are generally four areas you can help attend to:
- Physical comfort
- Mental and emotional needs
- Spiritual issues
- Practical tasks
You and your family also need support. A peaceful death means something different to everyone; here are some suggestions for helping your loved one have his or her needs and final wishes met.
What are the options for end-of-life care?
As NIA says, decades ago, most people passed away at home, but advances in medicine have changed that. Today, most Americans receive end-of-life care in hospitals or nursing homes; an increasing number of people are choosing hospice care. Hospice care can be provided at home, a nursing home, an assisted-living facility, or an inpatient hospital. We may not always choose where we die, but if given the choice, a person and/or his or her family may consider the end-of-life care that seems right, who can help provide the care and where, and how to pay for it.
Here are some questions from NIA that may help your loved one and you choose among the different options for end-of-life care:
- What kind of end-of-life care (e.g., hospice or palliative) does your loved one need, and can you help provide it?
- Where would your loved one (if he has a choice) like to spend his or her final days (e.g., a facility or at home)?
- Who will pay for end-of-life care?
How do we prepare to meet final (end-of-life) wishes?
According to the National Institute of Aging (NIA), it may seem overwhelming to make health-care and other decisions for a loved one who is dying, and it’s especially hard when you don’t have written or verbal guidance. Even if you have written documents, some decisions still may not be clear. NIA suggests two approaches for you as a caregiver: one approach (called substituted judgment) is to put yourself in your loved one’s place and try to choose as he or she would have chosen, and the other approach (called best interests) is to decide what would be best for your loved one.
In some situations, you’ve been able to talk beforehand to your loved one about his or her final wishes, and/or have them in writing. According to NIA, written instructions that let others know about the type of end-of-life care one wants is called an advance directive, and may include a living will and health-care power of attorney. A living will records a person’s end-of-life care wishes in the case he or she cannot speak or make decisions. Because a living will cannot give guidance on every situation, you or someone else may want to be considered being named a health-care proxy for your loved one. It’s important to keep copies of these papers in your files and also to give them to the primary doctor.
How do I assist with my loved one’s spiritual needs?
According to the National Institute of Aging (NIA), people who are nearing the end of their lives may have spiritual needs that are just as important as their physical ones. The spiritual needs of your loved one can include finding meaning in his or her life and ending disagreements with others.
Here is some information from NIA about spiritual needs:
- Your loved one may find solace in his or her faith or struggle with his or her spiritual beliefs. It may bring comfort to pray or talk a member of one’s spiritual or religious community come, or read religious texts or listen to religious music.
- Family and friends can talk to your loved one about how important his relationships were.
- Sharing good memories may help your loved one find peace near death.
How can I help with mental and emotional needs at the end of life?
According to NIA, complete end-of-life care includes helping the person who is dying manage her mental and emotional distress. Here is some information from NIA about emotional support at the end of life:
- Your loved one may not want to be left alone, and the simple act of physical contact, like holding hands, a touch, or a gentle massage, can help him or her feel connected to loved ones.
- Some experts say that when death is close, music at a low volume and soft lighting can be soothing. Music therapy might improve mood and help with relaxation and pain.
- Often, just being by the side of your loved one (if possible and you choose to) while he or she is dying is enough, and it may not be necessary to talk or do anything. Your quiet presence can be a gift.
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For more information on end-of-life care, please see:
“Providing Comfort at the End of Life”, National Institute on Aging (NIA), last modified August, 16, 2016, https://www.nia.nih.gov/health/publication/end-life-helping-comfort-and-care/providing-comfort-end-life