Some individuals remain continent and some become incontinent near the end of the body’s life. If your loved one is continent, you can assist them to the toilet or get a bedside commode if this is easier for them. Balancing safety, while trying to maintain dignity at end of life can be challenging. Try to make accommodations to maintain dignity / autonomy when / as you are able by allowing your loved one to safely toilet themselves / get out of bed to use the toilet.

If your loved one is incontinent or becomes incontinent make sure to have adult diapers / briefs and wipes. You want to ensure that you are checking regularly and changing their diapers / briefs as they become soiled. Remember being clean and dry means comfort for most and can help avoid any skin breakdown or developing bed sores as well.

Depending on your loved one’s skin and diagnoses, bathing may not be the most pleasant experience for them. Bathing can contribute to your loved one feeling vulnerable and exposed. Bathing can also leave them feeling physically chilled and quite exhausted. If you and / or your loved one decide bathing is desired / necessary, be sure to take great care, making sure the process is as gentle, kind, seamless and quick as possible.

Make sure you have gathered all of your supplies like a basin of warm water, clean and soft washcloths and a few dry towels. Try to keep your loved one covered with a towel, especially their private areas, to maintain your loved one’s dignity, respect and privacy as much as possible. Start on the face and move downward, leaving private areas for last. Make sure to pat, not rub or scrub, your loved one’s skin. Make sure to fully dry your loved one, paying special attention to areas where skin touches skin, like under the arms, breasts, or between the buttocks. Some times a light dusting of powder or cornstarch in these areas can be helpful.

Making sure to change your loved one’s linens frequently, can be everything to maintain your loved one’s clean and comfortable environment. Make sure to have a second set of sheets and blankets as well as multiple pillows for repositioning. Changing linens can be beautifully timed either during the bathing process or immediately after bathing. When turning your loved one on their side to bathe their back, you can removed half the sheets and place the new sheets on the bed. When turning them to the other side, you can remove the old / soiled sheets and pull the fresh sheets over to complete the sheet change. 

If your loved one is bed bound, repositioning every two hours is recommended to prevent skin breakdown. Please note that when the body is within hours of death, repositioning may not be necessary and should be avoided if it causes great discomfort for your loved one.

Brushing your loved one’s teeth, if they are bed bound, can be more challenging. At this stage, a “toothette” or small, clean washcloth to wipe the teeth / tongue, while bringing moisture to the mouth, is quite helpful. It is important to make sure your loved one’s head of the bed is elevated (if they are in a hospital bed at home). You can sponge their mouth every hour as needed for comfort / moisture.

If your loved one’s skin is not too sensitive to touch, applying lotion with gentle massage to your loved one’s hands and feet can be quite a lovely and therapeutic experience for your loved one and the caregiver as well. Your loved one does not have to be awake or participatory to enjoy this. 

Never underestimate the bond that touch can form for our bodies, as well as our hearts. 

Think of the habits your loved one kept while they were able to care for themselves. If they styled their hair and applied makeup, they may like to continue this when they are unable to provide themselves self care. If your loved one has been bed bound, their hair can begin to get matted, especially if they have long hair. A few times a day, you can use a gentle brush to keep their hair from getting too tangled or knotted. If they have long hair, start at the bottom and gently work your way up to the scalp. Make sure to stay very gentle and stop for any signs of discomfort or displeasure. 

If your loved one wore makeup daily, helping them with a little touch of their makeup can be lovely. Remember, it’s not about the end result, it’s about the process and what it represents to your loved one.