It's hard to lose a loved one. There seems like there is always another question you want answered to help prepare for the passing of yourself or a loved one. Who do you ask? What do you ask? Are there questions that just shouldn't be asked?
Every question is valid. There are simply no stupid questions, just questions left unanswered. This month's article is regarding those questions you might have. If you still have questions, please feel free to ask. Probably someone else has the same question and is looking for an answer too
The BC Government has also provided an excellent website with link to how to prepare for an upcoming death, funeral preparations, and what to do after a death. Click on the picture below for the link.
PREPARING FOR APPROACHING DEATH
When a person enters the final stage of the dying process, two different but closely interrelated dynamics will be at work.
On the physical plane, the body begins the final process of shutting down, which will end when all the physical systems cease to function. Usually this is an orderly, non-dramatic, and progressive series of physical changes which are not medical emergencies requiring invasive interventions. These changes are a normal, natural way the body prepares itself to stop. The most appropriate kinds of responses are comfort-enhancing measures.
The other dynamic of the dying process is the emotional-spiritual-mental plane. This is a different kind of process. The dying person’s spirit begins the final process of releasing from the body, its immediate environment, and all attachments. This release tends to follow its own priorities. This may include the resolution of whatever is “unfinished business” the dying person has and receiving permission to “let go” from family members.
When a person’s body is ready and wanting to stop, but the person is still unresolved or not reconciled over some important issue or with some significant relationship, he or she may tend to linger in order to finish whatever needs finishing even though he or she may be uncomfortable or debilitated.
On the other hand, when a person is emotionally/spiritually/mentally resolved and ready for this release, but his or her body has not completed its final physical shut down, the person will continue to live until that shut down process ceases.
These events are the normal, natural way in which the spirit prepares to move from this existence into the next dimension of life. The most appropriate kinds of responses to these changes are to support and encourage this transition and release.
The experience we call death occurs when the body completes its natural process of shutting down, and when the spirit completes its process of reconciliation. These two processes need to happen in a way that is appropriate and unique to the values, beliefs and lifestyle of the dying person.
As you seek to prepare yourself as this event approaches, the members of your care team (Doctors, nurses, hospice workers, clergy, etc …) want you to know what to expect and how to respond in ways that will help your loved one accomplish this transition with support, understanding and ease. This is the great gift of love you have to offer your family member as this moment approaches.
Not all signs and symptoms of dying will occur with every person, nor will they occur in the sequence with which they are listed. Each person is unique and needs to do things in his or her own way. This is not the time to try and change your loved one, but the time to give full acceptance, support and comfort.
The following emotional-spiritual-mental and physical signs and symptoms of impending death are offered to help you understand the natural kinds of things which may happen and to help you respond appropriately as the dying person prepares for itself for the final stages of life. Not all signs and symptoms of dying will occur with every person, nor will they occur in the sequence as they are listed.
COOLNESS
The person’s hands and arms, feet and then legs may be increasingly cool to the touch. At the same time, the color of the skin may change. This is normal. The circulation of blood will decrease to the body’s extremities and become reserved for the most vital organs. Keep the person warm with a blanket, but do not use an electric blanket.
SLEEPING
The person may spend an increasing amount of time sleeping and appear to be uncommunicative or unresponsive. They may even be difficult to awaken at times. This normal change is due in part to changes in the metabolism of the body. It is not uncommon to see people sleeping up to 17 – 20 hours out of a day.
Sit with your loved one, hold his or her hand, but do not shake it or speak loudly. Speak softly and naturally. Plan to spend time with your loved one during those times when he or she seems most alert or awake.
Do not talk about the person in the person’s presence. Speak to him or her directly as you normally would, even though there may be no response. Never assume the person cannot hear. Hearing is the last of the senses to leave.
DISORIENTATION
The person may seem to be confused about the time, place, and identity of people surrounding him or her including close and familiar people. This can be very upsetting if family members are not recognized or confused with someone else by the person preparing to pass away.
This disorientation can be caused by several factors, including: Medications, metabolic changes and the toxins released by cancerous tumours.
Identify yourself by name before you speak rather than to ask the person to guess who you are. Speak softly, clearly and truthfully when you need to communicate something important such as: “It’s time to take your medication so you won’t hurt so much”.
Whatever you do, do not manipulate the patient to meet your needs.
INCONTINENCE
The person may lose control of urine and/or bowel functions as the muscles in those areas become relaxed.
Keeping your loved one clean and comfortable is of utmost importance. If in hospital, this will be taken care of by hospital staff. If you are caring for the person at home, discuss with your home care nurse what can be done to protect bedding and assist in keeping your loved one clean and comfortable.
A urinary catheter is put in place in many cases, as the person becomes too weak to use a toilet or commode. The catheter drains urine from the bladder into a collection bag. As death approaches, the urine becomes darker in colour (like tea), decreases in amount and in many cases, eventually ceases to be produced.
RESPIRATORY CONGESTION
The person may have gurgling sounds coming from his or her chest as though there were marbles rolling around inside. These sounds can become quite loud.
This is a normal change due to the decrease of fluid intake and an inability to cough up normal secretions. This gurgling does not appear to cause any increased anxiety or pain in the dying person but it does cause a fair amount of worry for family members who are at the bedside.
Discuss your concerns with the physician, as there is medication that can be given to dry up these secretions in an attempt to diminish the noise.
Suctioning the person is not usually done as it causes discomfort and can actually increase the secretions due to the stimulation of the suctioning process.
Gently turn the person’s head to the side to allow gravity to drain the secretions.
You may also gently wipe the mouth with a moist cloth. Maintain good oral care: use glycerine swabs to moisten and cleanse the mouth and keep the lips moist with lip balm, Vaseline or other products of your choice.
WITHDRAWAL
The person may seem unresponsive, withdrawn, or in a comatose-like state. This indicates preparation for release, a detaching from surroundings and relationships, and a beginning of letting go.
Since hearing remains all the way to the end, speak to your loved one in your normal tone of voice, identifying yourself by name when you speak, hold his or her hand and say whatever you need to say that will help the person let go.
VISION-LIKE EXPERIENCES
The person may speak or claim to have spoken to persons, who have already died, or to see or have been to places not presently accessible or visible to you.
This does not indicate a hallucination or a drug reaction.
The person is beginning to detach from this life and is preparing for the transition so it will not be frightening to them in most cases. If it is frightening, reassure them that what they are experiencing is normal.
Do not contradict, explain away, belittle or argue about what the person claims to have seen or heard. Just because you cannot see or hear it does not mean it isn’t real to your loved one. Affirm his or her experience. This is a normal and common occurrence. You may hear caregivers say, “He/she is more in the other world than they are in this one”.
DECREASED SOCIALIZATION
As death approaches, the world of the dying person shrinks and they may only want to be around a very few or even only one person.
This is a sign of preparation for release and affirms from whom the support is most needed in order to make the appropriate transition.
If you are not part of this inner circle at the end, it does not mean you are not loved or are not important. It means that you have already fulfilled your task with your loved one, and it is time for you to say “Good-bye”.
If you are part of the final inner circle, consider it an honour and a gift. The dying person needs your affirmation, support and permission to die.
UNUSUAL COMMUNICATION
The person may make a seemingly out of character statement, gesture or request.
For example: You may be asked to find a map or to get a pair of wings. This indicates that he or she is ready to say good-bye and is testing you to see if you are ready to let them go.
Accept the moment as a beautiful gift when it is offered. Kiss, hug, hold, cry and say whatever you most need to say.
GIVING PERMISSION
Giving permission to your loved one to let go, without making him or her guilty for leaving or trying to keep him or her with you to meet your own needs, can be difficult.
A dying person will normally try to hold one, even though it brings prolonged discomfort at times, in order to be sure those who are going to be left behind will be all right. Therefore, your ability to release the dying person from this concern and give him or her assurance that it is all right to let go whenever he or she is ready is one of the greatest gifts you have to give your loved one at this time.
SAYING GOOD-BYE
When the person is ready to die and you are able to let go, then it is time to say “good-bye”.
Saying this is your final gift of love to your loved one for it achieves closure and makes the final release possible.
Don’t be afraid to hold the person, lie next to them in bed, hold their hand and be sure to say everything that you need to. It may be as simple as “I love you”. It may include recounting favourite memories, places and activities you shared. It may include saying, “Thank you for ….”.
Tears are normal and a natural way of saying “good-bye”. Don’t hide your tears or apologize for them. Tears express your love and help you to let go.
HOW WILL I KNOW WHEN DEATH HAS OCCURRED?
Although you may be prepared for the death process, you may not be prepared for the actual moment of death. It may be helpful for you and your family to think about and discuss what you would do if you were the one present at that time.
The death is not an emergency.
Don’t panic.
The signs of death include such things as no breathing, no heartbeat, release of bowel and bladder, enlarged pupils, eyes slightly open, no blinking, relaxed jaw and mouth slightly open.
If you are in the hospital when this happens there may be a nurse in the room with you.
Don’t be afraid to ask someone to stay with you if that is what you wish.
If your loved one chooses to die at home, a simple call to your home care nurse or the physician, if that is the plan, is all you need to do at that time.
THINGS TO DO SOON AFTER A DEATH HAS OCCURRED
1. Contact the funeral director. He will assist and guide you through the arrangements, most of which may already have been pre-planned. For example:
• Date, place, time, and type of service
• Pallbearers
• Flowers and/or designation of memorial gifts
• Information for the obituary
• Registration of death certificate
• Disposition of flowers after the service
• Information for eulogy
• Selection of music and/or hymns
A member of the clergy may assist you with these latter two points as well.
2. Locate the Will.
3. Executor of the Will or person designated by the executor should collect personal belongings from Dunrovin Park Lodge or Maple House and sign the Personal Belonging form. Staff will assist with packing. Unwanted items may be donated to the facility.
4. Provide the funeral home with clothing for the deceased.
5. Make a list of immediate family, close friends, and organizations to be contacted.
6. Arrange hospitality for visiting relatives and friends including a gathering after the service at home or a church hall.
ADDITIONAL DETAILS TO CONSIDER
1. Send appropriate acknowledgements to express thanks for gifts or help.
2. Assemble all important papers.
3. The funeral director will obtain original copies of the Death Certificate for you. Additional copies can be obtained from Vital Statistics BC or your local Provincial office.
4. An income tax form must be filed in the year of the person’s death.
5. Have the Will probated, if necessary.
6. Check on all debts and instalment payments before paying. Some may carry insurance clauses that will cancel debts or loans (i.e. mortgage).
7. Beware of unethical door-to-door salespersons at this time; especially representing themselves as delivering/collecting for something to be authorized by the deceased. You can say NO!
8. Notify the following if applicable:
QUESNEL FUNERAL DIRECTORS
582 Front Street
Quesnel, BC V2J 2K6
992 – 6723
All funeral needs can be addressed through Clayton Funeral Directors if you are a resident of Quesnel. The costs of arrangements with a funeral director vary depending on the type of service. Price lists are available at any time on their website. Please feel free to contact the funeral home for further information.
Basic Service (for all deaths) includes transferring the deceased from the place of death; transportation to the crematorium and/or cemetery and administration fees.
Funeral Service
The term “funeral” implies that the body is present during the immediate post death activities, which may include:
a. Viewing of the deceased, which helps to reinforce the finality of death. It is often beneficial to see that suffering has ended.
b. A public or private ceremony held in a church or funeral home.
c. Committal service at a graveside or crematorium.
Memorial Service
Includes the basic service plus a religious or secular service without the presence of the deceased.
The following may also be included:
• Transferring the deceased from the place of death
• Embalming
• Viewing
• Caskets
• Burial permits
• Cosmetic care
• Newspaper notices
• Flowers
• Donations to clergy and organist
• Family transportation
• Memorial Cards
• Registration of death
• Acknowledgement cards
• Hearse
• Cemetery costs
• Cremation services
QUESNEL CEMETERIES
Quesnel Municipal Cemetery
City Hall
405 Barlow Street
Quesnel, B.C. V2J 2C3
(250) 992 – 2111
Cemeteries have a special garden where cremated remains may be scattered. They may not be scattered on golf courses or cultivated parks.
The alternatives for cremated remains are:
• Scattering in a designated garden
• Placement in columbium
• Burial
• Scattering in the wild or at sea
• Storage in an urn