The Dying Process
What families may notice as death becomes closer.
Am I eligible for voluntary assisted dying?
You may be eligible for voluntary assisted dying (VAD) only if you meet all the legal rules where you live, and if the required health practitioners assess you as eligible.
4 min readAre they suffering when breathing becomes noisy, irregular or stops for periods?
Noisy or irregular breathing near death can be very upsetting to hear, but it does not always mean the person is suffering.
7 min readCan children be present during a VAD death?
Children may be able to be present during a voluntary assisted dying (VAD) death, but this needs careful planning.
6 min readCan family play music, have a meal or perform a ceremony during a VAD death?
Often, yes.
5 min readCan I apply for VAD even if I am not sure I will use it?
In places where voluntary assisted dying (VAD) is operating, a person can usually ask for information, start the process, and later decide not to continue.
2 min readCan I decide not to return to hospital?
A person with capacity can usually decide not to return to hospital, but they need a clear home care and emergency plan.
3 min readCan someone be sedated continuously until they die?
Yes, continuous palliative sedation until death can be used in some situations.
5 min readCan someone really die at home with proper medical support?
Yes.
5 min readCan someone with a terminal illness access their superannuation early?
Yes, in some cases.
7 min readCan unexpected things happen during a VAD death?
Yes.
6 min readDo I ask my GP about VAD?
Yes, you can ask your GP about voluntary assisted dying (VAD).
5 min readDo I need to call 000 or the police after an expected death at home?
Usually, no.
4 min readDoes a syringe driver mean the person is about to die?
No, not always.
5 min readDoes asking for information about VAD count as my formal first request?
Usually, asking for information about voluntary assisted dying (VAD) is not the same as making a formal first request.
4 min readDoes morphine make someone die sooner?
No, morphine does not usually make someone die sooner when it is prescribed and used carefully for pain or breathlessness in palliative care.
5 min readHow can I tell if someone is dying?
You may be able to tell someone is dying by looking at the whole pattern of change.
4 min readHow can something that slows breathing be safe in somebody who is already dying?
Morphine and some other medicines can slow breathing if the dose is too high for that person.
2 min readHow do families cope with knowing the exact date of a VAD death?
Knowing the planned date of a VAD death can help some families prepare, but it can also create pressure, dread and complex grief.
6 min readHow do I actually start the VAD process?
In most places where voluntary assisted dying (VAD) is operating, the process starts when you make a clear first request to the right kind of health practitioner.
5 min readHow do I find a doctor who provides VAD?
The safest way to find a doctor who provides voluntary assisted dying (VAD) is to contact the official VAD care navigator or support service in your state or territory.
4 min readHow do I know when to give breakthrough medicines at home?
Give breakthrough medicine only when the person's written plan says it is needed for the symptom you are seeing.
4 min readHow do I tell my children that someone they love is dying?
Tell children the truth in clear, gentle words.
5 min readHow early should I start the VAD process?
If voluntary assisted dying (VAD) may matter to you, ask for information early.
6 min readIs a VAD death usually peaceful?
Many families and clinicians expect a voluntary assisted dying (VAD) death to be calm, planned and private.
2 min readIs it normal to feel relief as well as grief after a VAD death?
Yes, relief and grief can happen together after a VAD death, especially when someone had been suffering or the family had been under strain.
5 min readIs this person dying now, and what should I do?
They may be dying now if they are much sleepier or cannot be woken, are no longer eating or drinking, have changed breathing, have cool or mottled skin, pass very little urine, or seem confused, restless or less aware of you.
5 min readIs what I'm seeing normal dying, or are they suffering?
Some changes that look frightening can be part of normal dying.
4 min readShould children visit someone who is dying?
Children can visit someone who is dying if they want to, the visit is safe, and they are prepared for what they may see.
4 min readShould I call an ambulance if someone is expected to die at home?
Not automatically.
4 min readShould I make someone who is dying eat?
No.
4 min readThey've stopped eating and drinking. Are we starving or dehydrating them?
When someone is very close to death, stopping eating and drinking is usually part of the dying process.
5 min readWe've just been told the illness is terminal. What happens next?
Being told an illness is terminal means the treating doctor believes it cannot be cured and is likely to cause the person's death.
7 min readWhat actually happens on the day of a VAD death?
On the day of a voluntary assisted dying (VAD) death, the person either takes the VAD medication themselves or, where the law allows it and the required approvals are in place, an authorised practitioner gives it to them.
4 min readWhat are anticipatory medicines and why have they been prescribed?
Anticipatory medicines are medicines prescribed in advance in case symptoms happen suddenly, especially when someone is being cared for at home near the end of life.
4 min readWhat does dying from COPD look like?
Dying from COPD often involves worse breathlessness, less energy, more chest infections and flare-ups, and needing more help with daily life.
4 min readWhat does dying from dementia look like?
Dying from dementia usually looks like a long, gradual loss of abilities, followed by a clearer final decline.
4 min readWhat does dying from frailty look like?
Dying from frailty often looks like a slow loss of strength and reserve.
4 min readWhat does dying from heart failure look like?
Dying from heart failure can be gradual, sudden, or a mix of both.
3 min readWhat does dying from kidney failure look like?
Dying from kidney failure usually means the kidneys can no longer remove enough waste and extra fluid from the body.
3 min readWhat does dying from motor neurone disease look like?
Dying from motor neurone disease usually happens because the muscles needed for breathing become too weak.
6 min readWhat exact words do I need to say to ask about VAD?
You do not usually need magic words to ask about voluntary assisted dying (VAD).
3 min readWhat happens after a VAD death?
After a VAD death, the usual after-death steps still happen, but some paperwork and reporting are handled through the state or territory VAD system.
5 min readWhat happens if my GP objects to VAD?
Your GP may be allowed to object to voluntary assisted dying (VAD) and choose not to take part.
6 min readWhat happens if someone cannot communicate shortly before a planned VAD death?
If someone cannot communicate shortly before a planned voluntary assisted dying (VAD) death, the VAD team must check what the law requires at that point.
6 min readWhat happens if someone changes their mind at the last minute with VAD?
If someone changes their mind before taking or being given voluntary assisted dying (VAD) medication, the process should stop.
7 min readWhat happens if someone loses capacity before completing the VAD process?
If a person loses decision-making capacity before completing the voluntary assisted dying (VAD) process, they usually cannot continue to access VAD.
4 min readWhat happens if the family disagrees about treatment at the end of life?
If family members disagree about treatment at the end of life, the first step is usually a careful meeting with the treating team.
5 min readWhat happens immediately after someone dies at home?
If the death was expected, there is usually no need to call `000` or the police straight away.
5 min readWhat help is available if I have to stop working to care for someone who is dying?
If you need to stop work or reduce hours to care for someone who is dying, help may include workplace leave, flexible work discussions, Centrelink carer payments, Carer Gateway support, respite, social work help and financial counselling.
2 min readWhat is different about grief after a VAD death?
Grief after a VAD death can include ordinary grief as well as feelings linked to planning, secrecy, disagreement, relief or the known date of death.
3 min readWhat is palliative sedation?
Palliative sedation is the careful use of sedating medicines to reduce a dying person's awareness so severe suffering can be relieved.
4 min readWhat is the difference between palliative care, palliative sedation, stopping treatment and VAD?
Palliative care, palliative sedation, stopping treatment and voluntary assisted dying are different.
4 min readWhat should children expect when they visit someone who is dying?
Children should be told, in plain words, what may be different before they visit someone who is dying.
5 min readWhat should we organise after being told someone may only have months to live?
If someone may only have months to live, start with the supports that affect comfort, decision-making and safety: medical contacts, palliative care, medicines, home support, legal and financial documents, carer support, and the person's wishes for care.
2 min readWhat support is available for families after a VAD death?
Families after a VAD death can seek support from palliative care, VAD services, GPs, grief services, counselling, spiritual care and crisis lines.
5 min readWhat support is needed for someone to die at home?
Someone dying at home usually needs a planned mix of medical care, nursing support, practical help, equipment, medicines, after-hours advice and family or friend support.
7 min readWho can be present during a VAD death?
The person choosing voluntary assisted dying (VAD) usually decides who they want with them, if anyone.
5 min readWhy are they hallucinating, picking at the sheets, trying to get out of bed or calling for dead relatives?
These behaviours can happen near the end of life.
6 min readWill VAD hurt?
Voluntary assisted dying (VAD) is intended to cause death after the person takes or is given a prescribed VAD substance.
5 min readWould a feeding tube make someone stronger near the end of life?
Usually, a feeding tube does not make someone stronger when they are actively dying.
4 min readWould IV fluids help someone who is dying?
Sometimes IV fluids help in palliative care, but they do not usually help when a person is actively dying and the body is shutting down.