A clinical study that focused on hospitalized patients in nursing homes from ingression to death found that the patients not only suffered pain. These dying patients also had severe problems with breathing, experienced nausea, were filled with anxiety, depressed and could not sleep properly. Beside these symptoms we also find the death rattle in most patients the last hours and days. Death rattle is a sound that is deep waterish from the throat. The sound is caused by reduced abilities to swallow, causing problems in the respiration system by liquids. This accumulation of liquids in the throat creates this painless rattle sound that is combined with normal respiration.
Of the nursing home patients, 39% died suddenly and unexpected within 12 months. When a patient dies in this way we find no extra use of pain killers and no preparation of their family. The personal did not detect the closing death in this group, and this indicates a need for competence.
One interesting aspect is that so many suffer from respiration difficulties. They feel like becoming strangulated and cannot catch their breath. 53% died from respiration related issues.
The normal palliative therapy for dying patients in nursing homes is a type of morphine. The effect is a relaxation that causes a deeper and more relaxed respiration. If the person has anxiety he can get medicine that reduces anxiety. It is also possible to reduce the death rattling from the liquids in the throat. This administration of palliative treatment need to be more used and the doctors need to become more awake.
Communication with the nursing home patients might be complicated by the fact that about 80% suffers from dementia. As we easily understands this might delay the understanding of pain and suffering in the patient. Doctors need to follow the patient differently when a patient is not able to express their experiences.
Patients in a nursing home get in average 8 different medicaments to treat different diseases. They require a profound attention from the nurse and the doctor to monitor properly. Perhaps many are left to themselves more than they should have been.
In short, 80% of the norsing home patients have dementia and 39% dies unnexpected the first year after hospitlization. 46% dies with severe pain and 53% of respiration related issues. Before dying most of these patients manifested severe problems with breathing, nausea, an increasing anxiety and depressed. They had insomnia and days before dying they manifested the death rattle.