Supporting a loved one through the end of life is challenging.
Families want to provide comfort and ensure the best care for their loved one. And patients in hospice also want to support and comfort those close to them as they face loss.
Here at Envision Hospice, we understand how tough this time can be. But you don’t have to do this alone. We’re here to help you understand the hospice stages of dying timeline, know what to expect, and get the support you need.
The Hospice Stages of Dying Timeline
Hospice is a specialized kind of care for patients facing an illness with a life expectancy of six months or less. As a patient’s condition progresses, they typically move through several stages. The stages of this process can vary from one person to the next, but there’s generally a pattern to the physical and emotional changes patients experience as they near the end of life.
At each stage, hospice care focuses on:
- Comfort: Making sure the patient is as comfortable as possible. A big part of this is accomplished by managing pain and symptoms.
- Dignity: Prioritizing the patient’s dignity. Hospice should be a time of respecting wishes and preferences.
- Support: Quality hospice care provides patients and families with the emotional and spiritual support they need.
Each person’s experience is unique, and the stages of dying might not happen in a linear or predictable manner. That’s why hospice teams are trained to respond to the individual needs of patients and families. This helps us to provide tailored care through this difficult time.
As a patient nears the end of life, it’s typical to notice changes like increased sleep, changes in breathing, and decreased responsiveness. These changes are a natural part of the process.
And through this time, our team is here to manage these symptoms so your loved one can be as comfortable as possible. Here are some of the signs that are common during the end-of-life timeline.
| Physical Signs | Emotional Signs | |
| Early Stage(usually days to months before passing) | – Decreased appetite and weight loss – Increased fatigue and sleep – Withdrawal from social interactions and activities – Changes in breathing patterns | – Reflecting on life and resolving unfinished business – Variability in alertness and cognition – Periods of disorientation or confusion |
| Middle Stage (days to weeks before passing) | – Further reduction in appetite and fluid intake – Significant decline in physical strength and the ability to move around – Changes in being able to regulate body temperature (like having cool extremities) – Irregular heartbeat and altered breathing (such as Cheyne-Stokes respiration) | – Increased withdrawal and less interest in surroundings – Potential hallucinations or visions – Need for reassurance and presence of loved ones |
| Late Stage(days to hours before passing) | – Profound weakness and minimal responsiveness – Mottling of the skin and a drop in blood pressure – Irregular breathing patterns (sometimes with long pauses) – Incontinence or reduced urine output | – Possible surge of energy or clarity (often called a “rally”) – Sense of calm or acceptance – Reduced need for communication or a preference for a peaceful environment |
Ways To Provide Emotional and Practical Support During The Hospice Stages of Dying Timeline
As a patient’s illness progresses, there are ways that loved ones can offer support — both emotionally and by meeting physical needs.
Here are some ways that you can offer emotional support to your loved one in hospice:
- Be Present: Sometimes, just being there is enough. You might hold their hand, sit quietly, or talk softly. Your presence with a patient can be incredibly comforting and provide a sense of peace.
- Open Communication: Talk about your feelings, fears, and wishes. Tell them that you love them. This can help everyone feel more connected and at peace. Your openness may also create an opportunity for your loved one to express any last thoughts or wishes they might have.
- Honor Their Wishes: You can show love by respecting a patient’s wishes about care and their environment. When possible, knock before coming in. Ask for permission before making changes to their setting. Do they prefer soft lighting? Do they get overwhelmed by too many visitors at once? Being sensitive to these things can help them feel more in control during this time.
Emotional support is crucial, but there are also practical ways to meet a patient’s needs. Here are some ways to help meet those needs:
- Bring Their Comfort Items: A favorite blanket. Photos. Music. Bringing familiar items can provide comfort and a sense of security for a patient.
- Foster a Calm Atmosphere: A calm and peaceful atmosphere can help ease a patient’s anxiety. Here at Envision Hospice, we work to provide a soothing space for patients and their loved ones.
- Household Tasks: In some situations, it might be helpful to assist with daily chores. Helping with laundry, cleaning, and grocery shopping can reduce a patient’s stress.
- Pet Care: Patients are often concerned about the welfare of their furry friends. Feeding, walking, and caring for a patient’s pet can take that worry off of their mind.
- Collaborate With the Hospice Team: Talk with your hospice team about the patient’s individualized care plan. Let them know about any new symptoms, pain management concerns, or questions you might have. We’re here to make sure your loved one is comfortable and has the best possible care.
This is another reason why it’s so important to have a hospice team that you trust. Open communication is vital between all members of your hospice team.
(Self-Care for Caregivers Is Important, Too)
As a caretaker, it’s important to take care of yourself too. Caring for a loved one can be exhausting (both emotionally and physically).
It’s okay (and necessary!) to:
- Take Breaks: Envision Hospice offers respite care services so you can have time to recharge and take care of your own health and well-being.
- Seek Support: You might consider joining a caregiver support group or talking with a counselor. Sharing your experiences with others going through similar situations can be a great source of strength and comfort. Our team can help connect you with these resources.
How Patients Can Support Their Loved Ones
When you think of hospice support, you probably think about caring for a patient. But hospice also supports patients’ loved ones.
Many hospice patients want to support their families during this time, too.
If you’re a patient nearing the end of your life, here are some ways that you can help your loved ones through this process:
- Share Memories: Talk about happy times with loved ones. Let them know you’re grateful for them. Sharing these moments can be comforting for families. This is also a way to create lasting memories for your loved ones.
- Write Letters: You might consider recording a message or writing a message to your loved ones. This can be a meaningful way to stay connected and offer comfort even after you’re gone.
- Help Them Understand Your Wishes: Helping your family understand your wishes can bring clarity and reassurance to your family. Making your wishes clear can also reduce conflict and reassure your loved ones that they’re honoring your preferences.
This can actually make the grieving process easier for them.
Supporting Whole Families Through the Hospice Timeline
When the time comes, we’re here to support patients’ loved ones through the next steps. After a patient passes, our team will help you through contacting authorities and making funeral arrangements. We’re here to help with any logistical aspects and provide the support you need.
After a patient passes away, it’s important for their loved ones to be able to grieve and process their loss. Grieving is a very personal process, and we’re here to provide the resources you need to work through both emotional and practical aspects of your loss. We can connect loved ones with grief counseling and support groups to help you cope with your loss.
At Envision Hospice, we’re dedicated to ensuring that you and your loved ones receive the best support possible. With exceptional care, emotional support, and individualized treatment plans — we’re here to help.