End of Life Issues

What Happens at the End of Life?

Diane Carbo

Oct 30, 2023 — 10 min read

The end of life is a difficult and emotional topic

The end of life is a difficult and emotional topic to discuss, but it is an important one. Understanding what happens at the end of life can help us properly prepare for it and provide comfort to those we are close to. This guide will offer an introduction to the topic that explores what happens at the end of life and why it is important, how to prepare for it, and advice for those going through this experience. We will also look at the legal, financial and healthcare considerations during this time.

This guide is intended to provide understanding and support to both individuals nearing the end of life and their family members. By tackling this difficult subject in a straightforward manner, we can be better prepared for this stage of life and approach it with a sense of peace.

Overview of the End of Life Process

At the end of life, many things happen in a specific order. The timeline of events can vary depending on individual circumstances, but there are some general steps that occur.

The first step is when an individual starts to experience signs and symptoms that can be associated with the end of life, such as pain, shortness of breath, or a decline in cognitive functioning. This is when medical professionals may start to discuss end-of-life care options with the individual and their family.

The next step in the timeline is when an individual enters hospice care or palliative care. This usually happens when they no longer wish to receive medical treatments that are intended to prolong their life. This may happen because a person has decided they wish to spend their last days in comfort rather than prolonging their life with medical treatments that cause more pain and discomfort. During this time, pain medication and sedation are typically given to help make the person as comfortable as possible.

The following step is when the individual begins to experience physical and mental changes as death approaches. This can include changes in breathing, skin color, body temperature, and mental state. During this time, medical professionals will be monitoring the individual closely and providing care to ensure that they remain as comfortable as possible.

The final step is when an individual passes away. During this time, family and friends may come together to pay their respects. It is important to remember that everyone deals with death differently, so it is important to be supportive and respectful of others in these difficult times.

Healthcare Considerations

At the end of life, healthcare is an important aspect to consider. When an individual is nearing the end of their life, there can be a variety of medical issues that require attention, both physically and emotionally. To prepare for this, it’s important to consider both short-term and long-term care decisions in order to ensure the best quality of life possible near the end of life.

When it comes to end of life care, there are four types of care to consider; curative, comfort, hospice, and palliative. Curative care is focused on finding treatment, and potentially curing, a particular medical condition. Comfort care is similar to curative care, but is focused only on providing relief from pain and symptoms that cannot be cured. Hospice care is focused on providing comfort and supportive services for those who have a terminal illness. Finally, palliative care is focused on providing care to individuals with serious illnesses to help treat physical, emotional, and spiritual symptoms.

It’s also important to think about what type of decision maker should be involved in end of life care. For those who have created an advance directive, such as a living will, healthcare decisions will already be made in writing. However, if you do not have a document in place, it’s important to designate someone who is knowledgeable about the individual’s wishes and values and can make decision accordingly.

Advanced Preparation

An important part of preparing for the end of life is pre-planning and protecting one's wishes. Advance directives are legal documents that allow an individual to express their healthcare and medical choices in advance, in case they are unable to do so when the time comes. Advance care directives are a way to ensure that your wishes are known and respected.

Advance directives can include instructions on choosing a healthcare proxy or healthcare power of attorney, who is the person responsible for making medical decisions if the individual is unable to do so. It also includes medical decisions such as whether or not to be resuscitated, which treatments to accept or reject, palliative care preferences, and end of life directives.

It’s important to discuss these advance directives with loved ones, as well as a healthcare professional, to ensure that all wishes and intentions are clear and understood. Making sure that this information is in writing and properly stored is the best way to ensure that your wishes are respected.

Legal Aspects of End of Life

End of life can be complicated, not only emotionally, but also legally. It is important to be aware of the different legal documents that can be prepared ahead of time in order to ensure that your wishes are respected and honored.

There are several legal documents that should be considered when a person is in their final stages of life. Advance directives such as living wills and do not resuscitate orders are documents that can be created to outline one's wishes if they are diagnosed with a terminal illness. Power of attorney documents can be created to allow one to designate an individual to handle their financial and medical decisions if they become unable to do so themselves. Finally, if an individual wishes to provide for their family members after they are gone, it is important to have a will in place that outlines how they wish to divide their assets.

By having these documents in place ahead of time, you can help to ensure that your family does not have to make difficult decisions on your behalf. It is also important to discuss your wishes with your family, to make sure that everyone is on the same page and that they understand what your intentions were for these documents.

Final Caring Moments

Making the end of life as comfortable as possible is an important part of caring for a loved one. The focus is on providing comfort and living their remaining days as fully as possible, rather than on struggling with treatments that may provide only a short-term benefit.

Hospice care is an important part of easing the end of life journey. It focuses on spiritual, emotional, and physical needs, with specific comfort measures that can increase the comfort and dignify the last days of life.

Other important considerations at the end of life include addressing pain levels, creating a safe and comfortable environment, managing symptoms such as nausea or fatigue, practicing spiritual care, attending to the emotional needs of the individual, and planning for any special events that may be meaningful such as a party or memorial.

Financial Planning at the End of Life

The end of life process can be a stressful and expensive time for both the individual and their family. It is important to plan ahead financially, to ensure that all financial considerations are taken into account.

The two primary considerations are expected and unexpected expenses. Expected expenses include medical costs such as home health care or hospice care, medications, funeral arrangements, and memorial costs. Unforeseen expenses may include legal bills, costs associated with long-term care, or debt incurred after death.

It is important to be aware of any insurance policies that may cover any of these costs. It is also helpful to inquire about programs that offer assistance with funding for end of life services. These programs may be offered through private agencies, government programs, non-profit organizations, or faith-based groups.

It is important to create a financial plan that accounts for both expected and unexpected costs. This can involve setting aside money for future expenses or setting up a trust fund to ensure that those costs are taken care of in the event of death.

Relieving Stress During the End of Life Process

Dealing with end of life issues can be stressful and overwhelming, both for the individual and their family. It is important to remember that it is okay to take care of yourself and manage your stress levels. Here are some tips to help you cope during this difficult time:

Engage in activities that bring joy: Take time to do things that bring you happiness, such as reading a book, gardening, or spending time with friends.
Seek out support: Talking about your feelings and concerns with a trusted friend or family member can give you the emotional support you need to get through this difficult time. Additionally, seeking professional counseling or a support group is an option.
Practice mindfulness: Take a few minutes to focus on your breath. Concentrate on each inhalation and exhalation to create a sense of stillness and clarity.
Focus on the present: Try to stay focused on the here-and-now rather than trying to anticipate the future. Staying in the moment can help relieve some of the fear and anxiety associated with the end of life process.

Remember, there is no “right” way to deal with end of life issues. Every person has different needs and what works for one person may not work for another. Do what feels right for you and don’t be afraid to reach out to others for help.

Personal Experiences

The end of life process can be a difficult time for everyone involved. It can be especially difficult to cope with the loss of a loved one, particularly if you have been with them through the later stages of their life. Hearing personal stories from those who have been through similar experiences can help us to understand and come to terms with our own emotional journey.

There are many sources of personal stories that can help us to understand the process of the end of life. Whether you are looking for practical advice, spiritual guidance, or just a chance to share your story with others, these resources can be invaluable in helping us cope with the loss of a loved one. Here are some examples of personal stories that may provide helpful insight:

Alzheimer's Association - A collection of personal stories about Alzheimer's disease and the end of life.
The Conversation Project - An organization dedicated to empowering individuals to share their end of life wishes with their families.
Hospice Foundation of America - A collection of personal stories about the experience of hospice care.
My Hospice - An online platform allowing individuals to share their experiences of hospice care and bereavement.

These resources are available to anyone looking to hear the personal stories of those who have gone through the process of saying goodbye to a loved one. Whether you are looking for inspiration, comfort, or practical tips, these stories can provide invaluable guidance.

Coping Mechanisms

Losing a loved one is a difficult and heartbreaking experience. It can be both emotionally and physically exhausting. Everyone copes with loss differently, but there are several methods which may help an individual get through this difficult time.

First and foremost, it is important to allow yourself to feel the sadness and take time to process your emotions. Grief counselor, Julia Samuel, encourages people to “allow themselves to sit in the pain so it can be processed rather than trying to avoid it.” You may find it helpful to talk with a mental health professional or join a support group. It is also important to take care of yourself during this time by focusing on activities such as physical exercise, relaxation techniques, and eating nutritiously.

Communicating your feelings to close friends and family members can also be beneficial. Expressing your thoughts and feelings with someone who is supportive and understanding can provide comfort. If you have children, talking to them about their feelings is important. Encourage them to express their feelings in a safe and non-judgmental environment.

Maintaining routines can also be beneficial. Keeping a regular schedule, such as going to bed and waking up at the usual times, can create a sense of security and comfort. Some people find comfort in writing a journal or creating a photo album. Whatever method you choose to cope with the loss of a loved one, know that it is a process and takes time to heal.

Alzheimer's Disease: Addressing End of Life Considerations

Alzheimer's disease is a degenerative condition that affects the brain over time. It can cause significant changes in a person's physical and mental health, often resulting in extended periods of declining ability and decreasing independence. As the person progresses through the stages of Alzheimer's, end of life considerations become more and more important.

One of the most important things to consider is making sure that the person's wishes are documented. A Living Will or Advance Directive should be completed to ensure that medical decisions are handled according to the person's wishes. Family members or other individuals close to the individual should also be involved in helping to make these decisions.

It is also important to create a safe and comfortable environment. There may need to be modifications to the home, such as installing handrails, or changes to daily routines, such as providing more assistance with eating. In addition, regular visits from medical professionals should be arranged to monitor the person's health and provide additional support.

Finally, it is important to provide emotional support for the person suffering from Alzheimer's. They may have difficulty expressing their needs and feelings, and it is important to be attentive to these needs. It is also important to provide the loved one with opportunities to remain engaged in activities they used to enjoy, such as gardening or listening to music. This will help to provide them with a sense of comfort and security.

Conclusion and Action Steps

Navigating the end of life can be difficult, emotionally and physically. By understanding the timeline of events that take place at the end of life, preparing in advance, and paying attention to legal and financial considerations, it is possible to make this process as comfortable as possible. Additionally, those who are going through the end-of-life process should be aware of the available resources and support systems, both during the person's final days and for the grieving period afterwards.

To recap, here are some of the actionable steps you can take when addressing the end of life: