Palliative Care
The Psychological Signs
 Psychological and emotional withdrawal
People
approaching the end of life often lose interest in the world around
them. The reasons for this vary, but they may feel it is time to let
go of this life or are taking the time to look inward. Sometimes,
dying individuals only want a small group around them. Sometimes
they may want to speak to a chaplain. Family members and
friends who are not a part of this group should not feel hurt.
Patient withdrawal does not mean that those outside the small
group are not appreciated, loved and important. It simply means
that they have already provided all that was needed by the
dying person.
Restlessness
Restlessness is common when a person is
reaching the end of life and it is partly due to decreased amounts
of oxygen to the brain. A person may pull at the bed linens or
perform repetitive tasks. This should not be cause for alarm or
something a patient should be discouraged from doing. Family
members can try to soothe their loved one by speaking to him or
her in a soft tone about a happy memory, playing relaxing music,
stroking the person’s head or holding his or her hand, while
always offering reassurance of safety and support.
Confusion or disorientation
As the body’s metabolism
continues to change, the person may become increasingly confused
and disoriented. He or she may become unsure of where
they are, confused about time and may not recognize family or
friends. This can be upsetting, but it is important that the people
surrounding the patient remain calm, speak softly and explain
whatever is confusing. Tell the patient who you are and say the
names of every new visitor.
Seeing visions
Often people at the end of life will “see” a
relative or friend who has died, have conversations with God, or
imagine they have returned to an earlier time or place in their
life. Though family and friends cannot see or hear the vision,
they should affirm the vision. Whatever visions your loved one is
having are most likely giving him or her comfort.
Sudden energy
Sometimes, at the very end of life, a
burst of energy may be experienced. Although it does not mean
the patient is beginning to recover, this is an opportunity to enjoy
a brief period with your loved one while he or she has energy and
is alert.
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