Months before Death

Decreased appetite

• Offer smaller, more frequent meals
• Provide foods high in nutrition
• Use favorite foods to stimulate appetite
• Discuss dietary preferences-? sweet, salty

Increased sleepiness

• Allow time and space for sufficient rest and sleep
• Ensure comfortable sleeping environment
• Encourage relaxtion techniques

Increased sense of ambivalence to people or the environment around them

• Respect need for solitude
• Provide emotional support and reassurance
• Encourage communication

Increased pain and nausea

• Adjust pain medications as needed
• Use anti-nausea medications as prescribed
• Provide comfort measures

Increased risk of infections

• Maintain hygiene and skincare
• Preventative measures - minimize retention of urine, skin care, getting out of bed if possible and safe

Noticeable weight loss

• Nutritional supplements are generally not helpful
• Monitor for skin breakdown- increased risk