A person is actively dying or in active labor as we call it in our book when he or she is in the last few days and hours of life. The body systems are shutting down. The patient is unresponsive and not able to take in food or fluids. There are changes in circulation, breathing and body temperature. There are simple things we as caregivers can do, to provide comfort to our loved ones at this time.

• Continue to talk to the patient. Though he may not respond he can still hear you. Explain what you are doing and provide reassurance, saying things like, “We will be ok,” “You’re doing a good job,” and, “Your work is done.”
• Soft music and prayers can be comforting.
• If there are breathing difficulties, raise the head of the bed a little, and turn her on to her side if there are secretions in the throat.
• If the patient is feverish which is normal at this time, have a fan blow gently over the patient but not directly on her. The movement of air from the fan can also provide relief when breathing is labored.
• Reposition the patient every few hours and keep giving pain meds as ordered even if he is unresponsive, as he may be experiencing pain but cannot tell you. Look for nonverbal signs of pain like grimacing or rapid breathing.
• Apply cool washcloths to her forehead if the patient is feverish and dress in light cotton gown or tee shirt, or leave naked, as some patients prefer.
• Good mouth care is important. Use toothettes or swabs to sponge mouth with cold water, putting a few drops of vegetable oil in the water to coat the mouth, then apply lip balm.
• Maintain a peaceful atmosphere in the room, having excessive conversations in other rooms.

Caring for loved ones who are dying can be difficult as we watch them slip away. We often feel helpless and think that we should be doing more. But remember, your loving presence at the bedside is the greatest gift you can give.

—Katie