As humans, we are constantly in a state of change. We come into the world kicking and screaming, and eventually we reach the end of our lives and transition out of it just as memorably. We know that the end-of-life is a natural process that happens to everyone, but still it can be a difficult time for both the individual and their loved ones. For those nearing the end of their life, hospice care provides a vital service by helping patients make that final transitioning process as smoothly and peacefully as possible.
What is Transitioning in Hospice?
Transitioning in hospice is the initial process of dying while receiving end-of-life hospice care. This type of transition can be a time of intense grief and uncertainty as the patient and their family members grapple with the reality of eventual death. However, proper care can help ease this process by providing support and resources to make this process as smooth and comforting as possible for everyone involved.
Hospice providers work with patients and their families to ensure that all of their physical, emotional, and spiritual needs are met during this transitionary time. This includes providing pain management, managing symptoms, and offering support and counseling services.
Transitioning to Death
There are many signs that indicate that a person is transitioning to death. And while these signs vary slightly depending on the individual, it is widely accepted in hospice care that there are two stages of transitioning: pre-active dying and active dying.
Pre-active dying
This first stage of transition typically begins between two to three weeks prior to death. During this stage, the patient experiences a decline in their physical and mental health. At this stage, they may:
- Become less engaged with their surroundings and withdraw from social interactions
- Experience a decrease in appetite
- Be asleep more often
- Have a decrease in output, such as urination and bowel movements
- Become more confused or disoriented and speak incoherently
- Tend to have mood swings
- Speak as though they are ‘leaving’ to go somewhere
- Make peace with their loved ones
Active dying
This second stage of transition is typically shorter, lasting only a few days or hours. During this stage, the patient’s health rapidly declines and they become unconscious or unresponsive. At this stage, they will:
- Experience a decrease in heart rate and respiratory rate
- Have a drop in blood pressure
- Experience a decline in body temperature
- Become unconscious or unresponsive
- Be unable to swallow or speak
- Experience skin changes, such as mottling or discoloration
As the patient transitions from pre-active dying to active dying, it is important for hospice care providers to be there to support both the patient and their family members. This includes providing resources, information, and emotional support as needed.
In addition, hospice workers may try as best as possible to predict the time frame for death so that the patient’s family can have a chance to say their final goodbyes and ideally to be present when the moment comes.
End-of-Life Transition
Nearing the final moments of life, the patient will enter into the last stage of the death process where the body begins to shut down. During this time, the patient may:
- Have irregular breathing patterns
- Experience a noisy breathing known as death rattle
- Take their final breath and die
After the patient has passed away, their heart will stop beating and they will no longer have a pulse. At this point, there is no coming back and death is irreversible.
After Death
Once the patient has passed away, the transition in hospice would be completed, however, providers will continue to offer support to the family members. This may include grief counseling, referrals to support groups, and other resources as needed. Hospice providers are also available 24/7 to answer any questions or concerns that may arise after the death of a loved one.
The next major steps are to inform anyone who should know, getting paperwork in order, and setting things in place for the timing for the funeral and everything associated with it.
If you or someone you know is nearing the end of their life, hospice care can provide vital support during this difficult time. Contact your local hospice provider today to learn more about how they can help ease the transition into death.