Our Final Journey
End of Life
Tools For Viewing
Let's Talk About It
Section 1 - Assistive Technology
Section 2 - Divorce Issues
Section 3 - Drugs/Medications
Section 4 - Checklist, Documents, Forms
Section 5 - Employment Issues
Section 6 - Estate Planning
Advanced Directives & DNR's
Section 7 - Caregiver Resources
Patient Quality of Life: Should Doctors Guess It?
Incontinence Care
Section 8 - Children Seriously Ill
Children of The Chronically Ill
Siblings of Children with Special Health Needs
Guides To Disability Issues
End Stage Hospital & Home Care
Child With A Serious Illness
Individual Family Service Plan (IFSP)
Camps-Special Needs Children
Children's Wish Foundations
Section 9 - For Kids
Section 10 - Family Resources
Section 11 - Patient Resources
Section 12 - Financial Aids
Section 13 - Insurance
Long Term Care Insurance
Section 14 - Legal
Section 15 - Long Term Care
Section 16 - Symptom Support
Section 17 - End of Life
Section 18 - Funeral Planning
Section 19 - After Death Occurs
Hospice FAQS
Symptom Support
Behavoir Strategies
Ill Person's Feelings
Caregiving & Family Harmony
Caregiver Grief ~Article
End of Life
Comforting A Dying Person
End Stages of Life
When Someone Dies
Funeral Planning
Bereavement Fares and Discounts
Common Bonds of Caregiving
Tips For Helping Your Friend
About me
Free Greeting Cards
Estate Planning Definition
Living & Other Trusts
Wills & Beneficiaries
State Laws On Wills
Conservator~Guardianship Definitions
Insurance Issues
Avoiding Probate
Prescription Drug Program I
Prescription Drug Cards II
Disability & SSDI Insurance Questions
Long Term Care Insurance
Employment Issues
Divorce Issues
State Laws-Statutes
Making A Personal File
Emergency Info Form
Emergency Planning
Health Care Surrogate
Forms, Checklist
Family Resources
Patient Resources
Rehab Tools-Assistive Tech. Categories
State Map-Ombudsman Program
NH Your Rights-Fact Sheets
Nursing Homes and Your Rights - Factsheets for some seriously ill or their caregivers.
Long Term Care-Facts & Rights
State & Federal Resources
Drug Resources
Grief & Sorrow
When death nears - Signs and Symptoms
Some Facts About Artificial Nutrition and Hydration
Things To Consider-Artificial Nutrition and Hydration
End of Life
Talking About Choices

Click on any topic to get to information unless a website is shown instead.

Artificial Feeding: What's involved? - This document from Partnership in Caring is in PDF downloadable format.
Our last days are an opportunity to learn lifes last and most powerful lesson: That there is nothing to fear.
End-of-Life Decisions and the Dementia Patient
Making our own decisions is most important as we think of making health care choices.  But as we consider end-of-
life decisions for those suffering from dementia  almost always the decisions fall in the laps of the family since the patient can no longer speak for himself/herself. This comes as no surprise for caregivers because they may have been making many decisions all along. So we really need to think about how to make end-of-life decisions on behalf of another. 
In this chapter we explore ethical issues related to hydration and nutrition in patients with advanced chronic illness.
Fact Sheet:At the End of Life  Although many people would prefer not to think about the end of their lives, planning for the inevitable event increases the chances that your wishes will be met.
Feeding Tubes:
'Finding Your Way: A Guide for End-of-Life Medical Decisions' - a 13-pagebooklet for individuals and families - is  available in English and Spanish. Developed by non-profit Last Acts Partner Sacramento Healthcare Decisions The booklet uses clear, accurate information to help those who are starting the advance care planning process or considering whether to initiate or withdraw life-sustaining treatment when the end of life is near. Contact Sacramento Healthcare Decisions at 919-851-2828 or shd@quiknet.com for more information. To download the order form or preview the booklet, visit:
http://www.sachealthdecisions.org  Copies are $1.50 for 1-2, $1.00 for 3-10, $.75 for 11-24 on this order form.
Food, Nutrition, Artificial Feeding Methods, Constipation and Quality of Life Issues - An excellent article from Hospice explaining the changes in someones body during the end stages of life.
Guidelines for Patient/Family Volunteers
Although written for a Hospice volunteer, this article offers good advice for family and friends who come to visit your loved one.

Links to help support caregivers cope with ethical, moral and legal conflicts in diagnosis and treatment of patients with terminal health conditions
Keeping the Patients Comfortable - A Hospice article on explaining their role in patient care. With most terminal illnesses, symptoms arise which can be quite uncomfortable and which cause a lot of fear and confusion for both patients and families alike. Fortunately, hospice staff are thoroughly trained in how to achieve patient comfort. 
Keeping the Terminally Ill Patient Home: Making It Happen - If your loved one wishes to stay at home up till the very end, then you need to make that wish clearly known to your RN casemanager, the social worker, your physician and any other hospice staff who inquires about your wishes. A good article from Hospice.
"On Our Own Terms"
Final Days <- click
Link to Bill Moyers "On Our Own Terms" series of artcles, including:
  • Dying As a Spiritual Event
  • How to Be with a Dying Person
  • How to Manage Your Pain
  • Preparing for the Death of a Loved One

    Site also has links to articles in PDF format you can download.

    Palliative care and pain management

  • Some Facts About Artificial Nutrition and Hydration
    What is artificial nutrition and hydration? Is artificial nutrition and hydration different from ordinary eating and drinking? Will the withdrawal of artificial nutrition and hydration lead to a long and painful death? Is there evidence that avoiding artificial nutrition and hydration contributes to a more comfortable death? Is it ever appropriate to give artificial nutrition and hydration to patients who are at the end of life?

    Swallowing Problems... How Thickeners Can Help

    Things To Consider-Artificial Nutrition and Hydration                 Some points to think about when making decisions about the use of artificial nutrition and hydration and the importance of honoring your loved ones wishes.


    SAVE - education about suicide prevention and to speak for suicide survivors.

    Straight Talk on Suicide-Teenagers: learn about what puts a teenager at risk for suicide, the warning signs

    Suicide-Links for prevention contacts and survivors.

    Suicide isn't painless-Almost no one kills themselves because they don't want to live. Most people kill themselves because they want to live so much.

    Suicide prevention in primary care-written for doctors but helpful to families

    Suicide - Web Sites from Excite Health:
    . Guides & Directories
    . Bereavement
    . Illness & Injury
    . Research
    . Support & Prevention
    . Survivors
    . Youth/Teen

    When The End Is Close
    Explains the natural way in which the body prepares itself to stop, and the most appropriate kinds of responses.
    When a person enters the final stage of the dying process, two different dynamics are at work which are closely interrelated and interdependent. 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 and undramatic progressive series of physical changes which are not medical emergencies requiring invasive interventions. These physical changes are a normal, natural way in which the body prepares itself to stop, and the most appropriate kinds of responses are comfort enhancing measures.
    Signs and Symptoms
    The days and hours leading to the moment of death can be rich with meaning and expressions of love. Knowing the normal physical processes can make this time more peaceful. When a person is close to death, a natural series of changes occurs. These changes usually are not medical emergencies and the goal at this point is to keep the dying person as comfortable as possible.
    A Gentle Death:
    Freedom to Choose at Life's End 
    When all hope for a cure is gone, a person's individual beliefs and values about end-of-life care should govern every treatment choice. Choice In Dying has  learned that *having a choice* makes all the difference. Patients describe choice as the "key to the room of suffering [they] have been locked in," and the remedy for despair and hopelessness. Once the knowledge of choices is gained families describe an uplifted mood and if there had been plans for violent suicide, these disappear.
    The Ultimate Emotional Challenge
    A dying person is grieving the loss of control over life, of body image, of normal physical functions, mobility and strength, freedom and independence, security, and the illusion of immortality. He is also grieving the loss of an earthly future, and reorienting himself to an unknowable destiny.

    Comforting A Dying Person
    "Comfort" is more than just pain reduction; the patient will need spiritual and emotional comfort as well.  The hospice team attempts to achieve "comfort" in a number of ways. Describes the steps to making the terminally ill patient comfortable both psychially and mentally.

    Constipation is a common and uncomfortable problem. During illness, there are many reasons to be constipated These reasons may include less activity, less fluids, general weakness, and the side effect of a medication (especially strong pain medications).

    From Your Hands to God's Arms -Saying Good-bye
    There comes a time to say good-bye. Letting go is one of the most powerful expressions of faith and greatest parting gifts you can offer your dying loved one. The words uttered allow you to give up control (and many hours of care giving), trusting instead in God's love. Your words also offer your loved one the comfort of knowing that you trust in God so that he can draw strength from your faith and assurance.
    General Comfort At End
    Little things you can do to help with dry mouth, aching, sore skin and "accidents".
    Keeping Watch -
    Readings, Prayers and Spiritual Resources for Those Keeping Vigil and Giving Care
    Lack of Appetite
    It is very normal to have little appetite, for foods to lose or change flavor, and to feel full after a few bites. Here are a few hints that may help:
    The basic premise of how massage helps the dying is touch.  The American Massage Therapy Association states that massage has both physical and mental benefits
    Some people who are very sad sleep all of the time. They say that they are not sad when they are sleeping. You may find that it will help to talk about it, even if it can't solve everything.

    The Body Speaks-A Modern Maturity Guide to end of life

    People who are sick or elderly may be touched very little - especially if their family is not near or their spouse has died, or if they live in a caretaker environment such as a nursing home. These people especially need caring people around them - to hold their hand, rub their back, brush their hair, or to just hold them when they need someone. Families often feel regretful after a loved one's death if they have not spent time with the patient to comfort and to demonstrate caring and love.
    Respite From Thoughts

    The Daily Motivator


    Near Death and Other Experiences

    Spirituality & Faith in PDF Format From Finding Our Way In English, Chinese and Spanish

    Treating Mind, Body and Spirit


    Email Webmaster~Jean E. Miller