Caregiver's Guide

Tips on Providing a Comfortable Environment

A comfortable environment is an important psychological component that can improve the perception of life for the patient. Some ideas for how you can alter the room include:

• Soft lighting may increase relaxation. If bright lights are needed to administer care, they should be turned off as soon as possible to reduce the irritation.
• Provide an outdoor view if possible - turn the bed so it can face a large window with as much of an outdoor view as possible.
• Decorate in an attractive manner. Ask your loved one about his or her favorite colors for use in decorating. Many people find drawings from children and grandchildren and other pictures or signs from loved ones pleasurable.
• Ask your patient where he or she would like to stay in the house. Some people like to set up a bedroom in the living room so they can be part of the household. Still others like to be in a back part of the house away from the heavy traffic center.
• Consider the use of music to set a mood.
• Allow pets to visit. A visit from a favorite animal can do wonders to lift the spirit.

Help to resolve the patient's unfinished business

One of the most valuable services a caregiver can provide is helping a terminally ill patient achieve a sense of closure.

People near the end of their life commonly to want to take certain actions or have certain experiences before they die. Sometimes, it is to do or see something important or pleasant again, such as being with friends or visiting an especially meaningful place. Sometimes, it is to say things to acquaintances or relatives or to resolve some old misunderstanding or conflict. Arranging for these experiences can be substantial undertakings, involving contacting other people and organizing travel.

Also, the patient may be concerned about personal finances and other business. He or she may need your help in getting a will prepared or updated, or in consolidating his financial assets. Facing death makes some people feel they should tie up loose ends. You patient may need your help contacting and working with lawyers and accountants.

Support the patient's spiritual concerns

Spiritual concerns raise fundamental questions about life, and these profound questions become especially important as life nears its end. As a caregiver, you can support the patient in thinking about his or her own answers to these questions. Even if you do not share the patient's faith, respect it.

Spiritual questions are not answered easily, of course. For those people whose faith gives answers and comfort, your support of that faith will be both helpful and appreciated. For those who are troubled by uncertainty, you can help by sharing your own questions and uncertainties - showing that their concerns are normal and reasonable.

Professionals such as clergy or counselors can be very comforting to the person you are caring for - provided that he or she wants their help. Be careful to avoid seeming like you are pushing religion on the patient. Bringing in someone who is not wanted can backfire and cause rather than resolve problems. Let the person you are caring for know that you will be happy to arrange visits by clergy or others who could help - but that this decision is entirely up to him or her. Health care professionals can help you locate counselors, and hospital chaplains usually are experienced in working with people near the end of their lives and may be able to help.

If the patient is seriously depressed because of spiritual concerns, seek help from a mental health professional or clergy with training in mental health care. Also, be available to listen. Speaking with another person helps to put one's thoughts in perspective and also to see that others appreciate and understand them. The patient may want to make sense of life his or her experiences - to reminisce, talk about the past, and look for meaning in what has happened. Let the person you are caring for know about your willingness and availability for these discussions when and if he or she wants them. If you find it very difficult to listen to the patient's concerns, then find someone, such as a member of the clergy, family member, or friend, who can.

For people whose religion is important and gives meaning to both their lives and their dying, you can help by asking questions that allow them to tell you, if they wish, what about their faith has helped them through life and is helping them now. You must be careful to accept and respect views that are different from your own, however. Think about how you can support the patient's faith by playing hymns or other religious music or by installing a religious symbol in the room or by reading inspirational literature out loud. Maybe the patient would like to invite in clergy for as a bedside prayer service.

Share your views and feelings when you are asked or think that he or she would like to ask. Hearing another person's thoughts and feelings can be helpful to someone who is troubled by spiritual problems, but always let the person you are caring for be your guide - never impose. Sometimes, reading together from spiritual writings can be comforting and may help to resolve unanswered or unresolved questions. These readings also can provide an opportunity to share how you feel about these issues as well.

You may be worried yourself about spiritual questions. Watching and helping someone who is dying sometimes can bring up very difficult issues. You might encounter concerns about the unfairness of the situation, fears about your own death, and general confusion and anxiety about what life is about. Clergy, counselors, and health professionals can be helpful. They can listen and help you to think through these issues.

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