Lefu le lebeletsoeng lapeng: ho bitsa mang pele le se etsahalang kamora moo¶

Haeba motho eo u mo ratang a ’nile a phela ka boloetse bo tebileng ’me hona joale a hlokahetse lapeng, u ka ’na ua utloa lintho tse ngata ka nako e le ’ngoe: ho hlonama, ho imoloha, ho felloa ke matla, ho khathala, esita le ho tsieleha. Tsena tsohle li tloaelehile, 'me ha ho le e' ngoe ea tsona e bolelang hore u e etsa hampe. U fetile nako e telele le e khathatsang, 'me u lumelloa ho khathala.

Tataiso ena ke ea lefu le neng le lebeletsoe, hangata ha motho a ne a fumana tlhokomelo ea bophelo bo botle lapeng. Ntho ea bohlokoa ka ho fetisisa eo u lokelang ho e tseba ke hore ha ho hlokahale hore u potlakele. Ha ho letho le lokelang ho etsahala metsotsong e seng mekae e latelang ntle le mohala o le mong o khutsitseng, 'me mohala oo hangata o ea ho mooki kapa sehlopha sa tlhokomelo se seng se ntse se tseba lelapa la hau. U ka lula fatše, ua hema, 'me ua qeta nako e telele kamoo u ratang le motho eo pele u nka fono.

Etsa sena hona joale¶

1. Lula moo u leng teng nakoana. Lula le motho eo. Tšoara letsoho la bona haeba u lakatsa. Ha ho na tšohanyetso ka kutloisiso ea peiso khahlanong le nako.
2. Batla moralo oa tlhokomelo kapa nomoro ea hospice. Hangata e ka sehatsetsing, sephuthelong se haufi le bethe, kapa e bolokiloe fonong ea hau tlas'a "hospice" kapa "palliative care". Haeba u sa e fumane, kōpa motho e mong ka lapeng hore a shebe.
3. ** Letsetsa setsi sa tlhokomelo ea bakuli ba kulelang lefu, tlhokomelo e thusang ho kokobetsa bohloko, kapa mohala oa mooki oa ho qetela pele,** haeba u na le leano le u laelang hore u etse joalo. Ore, "Moratuwa waka o hlokahetse. O ka romela mooki." Litšebeletso tse ngata li araba lihora tse 24 ka letsatsi.
4. Haeba o se na moralo, ha o na nomoro, kapa ha ho motho ya arabang, letsetsa nomorong ya hao ya lehae ya tshohanyetso (911 United States le Canada, 112 ho pholletsa le European Union, 999 United Kingdom) kapa ngaka ya motho eo. Bona the dinomoro tsa tshohanyetso leqephe la linaha tse ling. Bolela ka ho hlaka hore lena e ne e le lefu le lebelletsoeng.
5. ** Boloka lipampiri tsa ho se tsosolose moo li ka bonoang ** haeba li le teng, 'me u li bontše mang kapa mang ea fihlang. U se ke ua qala CPR haeba ho na le taelo e nepahetseng 'me sehlopha sa tlhokomelo se u boleletse hore motho ha aa lokela ho tsosolosoa.
6. Kopa motho a le mong hore a tl'o lula le uena. Motsoalle, mong ka uena, kapa moahelani a ka etsa tee, a letsa mehala, a ba teng bakeng sa hau.

Ntho e 'ngoe le e 'ngoe, ho akarelletsa le motsamaisi oa lepato, ho letsetsa ba lelapa le ho ngola litokomane, ho ka etsoa ka mokhoa o bonolo.

Ha o etse letho le phoso¶

Ha ho lebeletsoe lefu, hangata batho ba ikutloa hore ba lokela ho khutsa le ho hlophiseha. Ba bang ba ikutloa ba maketse leha ho le joalo, hobane ho itokisetsa hlooho ea hau ho fapane le ho itokisetsa ka pelong ea hau. Ba bang ha ba utloe letho ho hang.

Ba bang ba ikutloa ba imolohile ka hore mahlomola a felile, ebe joale ba ikutloa ba le molato ka topollo eo. Ka kopo tseba hore tsena tsohle li tloaelehile.

Hape u ka 'na ua ipotsa hore na u fositse nako e nepahetseng, kapa hore na u ka be u entse ho hong ka tsela e fapaneng. Haeba u ne u robetse, ka kamoreng e 'ngoe, kapa u tsoa ho fumana kopi ea tee ha e etsahala, hoo ho tloaelehile haholo. Batho ba bangata ba shoa ha ho se motho ka kamoreng, ’me ho bonahala eka ba bang ba ema ho fihlela lelapa le tloha. Hase ho hlōleha ha lerato kapa tlhokomelo.

Ha ho letho le lokelang ho etsoa kapele ntle le ho letsetsa tšebeletso e nepahetseng. U ka nka nako e telele kamoo u batlang ho lula le motho eo, 'me u ka bolella mooki ha u se u loketse hore ba tle.

Ke mang ea lokelang ho letsetsa pele: mofuta o mokhuts'oane¶

Pitso ea pele e nepahetseng e itšetlehile ka hore na moralo o teng. Tafole ena e ka u thusa ho etsa qeto.

Haeba o sa tsebe hantle hore na ke mola ofe o lekanang, letsetsa nomoro ea tšohanyetso. Kamehla ho molemo ho etsa mohala oo ho feta ho ema le ho tšoenyeha.

Ke hobane'ng ha mohala oa hospice o tla pele ha ho na le moralo¶

Lihlopha tsa tlhokomelo ea bakuli ba kulelang lefu le ho kokobetsa bohloko li rera esale pele le malapa. Ba tseba litakatso tsa motho, meriana le litokomane tsa hae. Ba ka romela mooki ea koetliselitsoeng ho tiisa lefu, ho u tšehetsa, le ho hlophisa mehato e latelang.

Haeba u letsetsa nomoro ea tšohanyetso ho e-na le hoo, basebetsi ba ka fihla ba sa tsebeng motho eo le ba lokelang ho qala ho tsosolosa ntle le haeba ba bona litokomane tse nepahetseng. Sena se ka khopisa motho e mong le e mong. Ke ka lebaka leo lihlopha tsa tlhokomelo ea bakuli ba kulelang lefu li kopang malapa hore a ba bitse pele.

Hobaneng ha nomoro ea tšohanyetso ka linako tse ling e ntse e nepahetse¶

Ho na le linako tseo nomoro ea tšohanyetso e leng mohala o nepahetseng, esita le lefung le reriloeng. Haeba ho se na moralo kapa moralo o sa hlaka, haeba u sa khone ho fihla sehlopheng sa batho ba kulelang lefu, kapa haeba ho etsahetse ntho e sa lebelloang, letsetsa hang-hang. Motho ea amohelang mohala o tla botsa lipotso mme a romelle thuso e nepahetseng.

Haeba motho a ne a sa tsoa kula 'me ho se motho ea kileng a bua ka tlhokomelo ea bophelo, e nke joalo ka lefu la tšohanyetso. Tataiso ho setho sa lelapa se hlokahetseng ka bosiu bo le bong lapeng ho sa lebelloa e hlalosa se etsahalang tabeng eo.

Lipampiri tse bohlokoa: u se ke ua tsosolosa le litaelo tse tšoanang¶

Linaha tse fapaneng li sebelisa mabitso le liforomo tse fapaneng bakeng sa khetho ea motho hore e se ke ea tsosoa. Ha li fetohe, 'me ha li sebetse ka tsela e tšoanang hohle. Ena ke e 'ngoe ea liphapang tse kholo ka ho fetisisa lipakeng tsa linaha, kahoo ka kopo bala karolo e lumellanang le sebaka seo u lulang ho sona ebe u botsa sehlopha sa tlhokomelo.

In some places an order must be a particular signed form to be accepted by paramedics. In others, a conversation or a note in the person's records may not be enough on its own. Ask the hospice team early which form your area uses and where it should be kept, ideally well before the day comes.

If paperwork cannot be found¶

If you cannot find the form, do not panic. Tell the call taker or the nurse straight away. Say, "My loved one was under hospice care and this was expected."

They will tell you what to do, which may include starting CPR. Follow their instruction. The most important thing is to be honest and calm.

If paramedics arrive and start trying to help¶

If paramedics arrive and there is no visible form, they may begin resuscitation. It can feel distressing to watch, but it is their legal duty. Tell them clearly and quickly what you know, and show any paperwork you can find. If the hospice nurse is on the way, tell them so.

If the paperwork is found while they are working, hand it to them at once. They are trained to follow valid orders and will stop when it is right to do so.

What happens after you make the call¶

Once you call the hospice or care team, a nurse will usually come to the home. They may talk to you by phone first and ask whether the person has stopped breathing and whether you are safe. They will tell you not to worry and that you can stay with the person.

When the nurse arrives, they will gently check the person and confirm that death has occurred. They will note the time. They are kind, quiet, and used to helping families. You can ask questions at any time.

What the nurse may do¶

Depending on the country and service, the nurse may:

• Confirm and record the death.
• Contact the person's doctor or the coroner if needed.
• Help wash and prepare the person if you wish, or leave that to a funeral director.
• Remove medical devices such as syringe drivers, patches, or catheters.
• Give you written information on what to do next.
• Help you deal with medicines left in the home.
• Offer to call a funeral director with you or for you.
• Offer to sit with you or call a family member.

You can say yes or no to any of this. If you want to wash and dress your loved one yourself, many services will support that. If you prefer to leave it all to professionals, that is fine too.

Verification of death¶

Verification, sometimes called pronouncement, is when an authorised person confirms that someone has died. Who can do this differs by country:

• In the United States, a hospice nurse, doctor, or in some states a coroner can pronounce death. A physician or the medical examiner then signs the death certificate.
• In the United Kingdom, a doctor or trained nurse can verify an expected death. A doctor, usually the GP or hospital doctor, completes the medical certificate of cause of death, and the family then registers the death.
• In Canada, a physician, nurse practitioner, or in some provinces a registered nurse can confirm and pronounce death. The rules depend on the province or territory.
• In Australia, a doctor or in some states a trained nurse can verify death. A doctor completes the certificate, and the funeral director helps with registration.

You do not need to know these details in advance. The nurse who comes will explain what applies to you.

While you wait for the nurse¶

The nurse may take an hour or two to arrive. This time is yours. It does not have to be used for anything practical.

Some families light a candle, play favourite music, say a prayer, or share memories. Others simply sit quietly. Some people open a window as part of a custom or belief. You can do whatever feels right, as long as it is safe.

What to leave as it is¶

For an expected death, there is usually less to leave untouched than in a sudden death, but a few things should still wait:

• Do not throw away any medicines. The nurse will tell you what to do with them.
• Do not remove the person's ID bracelet or medical alert items yet.
• Keep the care plan and paperwork where the nurse can find them.
• Leave the bed and room mostly as they are until the nurse has finished.

You can gently close the person's eyes, straighten their blanket, and place their hands comfortably. Many nurses encourage this. If you are not sure, ask when you call.

Who to tell¶

You may want to tell family and friends. You do not need to do this before the nurse arrives, and you can ask someone else to make the calls for you. If you want to send a short message, you can write, "I am so sorry to tell you that [name] died peacefully at home today. I will call you when I can."

Keep a simple list of who has been told. When many people are grieving at once, it is easy to lose track.

Medicines and equipment left in the home¶

After a hospice death there are often medicines, oxygen cylinders, syringe drivers, and other equipment at home. This can feel upsetting, and you do not have to deal with it right away.

Medicines¶

Hospice and palliative care teams often have a clear process for medicines. In some places, the nurse can help you dispose of them according to local rules. In others, you should keep them secure until a pharmacist, nurse, or take-back scheme collects them.

Official guidance in many countries asks that you not flush medicines down the toilet or throw them in household waste unless the label says so. Use a pharmacy take-back scheme, community take-back day, or the hospice's own disposal arrangement. Do not give leftover medicines to anyone else. If there are strong painkillers or controlled drugs, keep them out of sight and locked away until they are collected.

Equipment¶

Hospital beds, oxygen concentrators, commodes, and other items are often loaned by the hospice, a health service, or a charity. The team will usually tell you who to call to collect them. You do not have to do it today. Many families like to wait a few days or weeks.

Syringe drivers and devices¶

A nurse will often remove these themselves. Do not try to disconnect them unless you have been shown how. If a device is alarming, you can silence it and call the number on the device or the hospice.

Choosing and calling a funeral director¶

You can call a funeral director once the death has been confirmed, either with the nurse's help or afterwards. There is no need to choose anyone in a hurry. You can take your time, and you can make the call the next morning if you prefer.

If you already have a plan with a funeral home, call them. If not, ask a friend, a faith community, the hospice team, or a local bereavement service for suggestions. You are allowed to ask for prices and to choose a funeral director who feels right for you.

What to say on the call¶

You can say, "Our loved one died at home today. The nurse has confirmed the death. We would like to talk about the next steps." They will ask for the name, address, and a few other details, and they will explain how they can help.

Funeral directors in most countries can collect the person at any hour. Some will come within an hour or two, and others will arrange a time that suits you. You do not have to say yes to the first time offered.

Consumer rights¶

In many countries, funeral homes must give you a clear written price list on request. In the United States, the Funeral Rule from the Federal Trade Commission requires this. In the United Kingdom, funeral directors must display prices and give written quotes under rules from the Competition and Markets Authority. Ask for an itemised list if you feel unsure.

If something goes wrong with a funeral home, the guide on funeral home mix-ups, delays, or overcharging explains your rights.

If you are not sure the person has died¶

In the minutes after a long illness, it can be hard to tell. The person may look peaceful, as if sleeping. Breathing at the end of life can be very slow, with long pauses, and families sometimes wonder whether a pause is the last one.

You do not have to decide this by yourself. Call the hospice line and say, "I think she has died, but I am not sure." The nurse can talk you through what to look for, or come to check. If the nurse cannot be reached, call your local emergency number and explain that you are not sure.

Do not worry about calling too early. Nobody will mind. Waiting quietly and calling for guidance is always acceptable.

Common things families notice¶

Some things surprise families, and they are usually normal. The body may relax and the face may soften. The skin may become cooler and pale.

A small sound or movement may happen shortly afterwards as the body settles. If any of this worries you, tell the nurse, who has seen it many times and can explain it kindly.

When there are other people in the home¶

Haeba bana, beng ka uena ba hōlileng, kapa baeti ba le teng ka tlung, kōpa motho e mong hore a ba hlokomele ha u ntse u etela batho. Ba bolelle ka khutso le 'nete hore motho eo o hlokahetse le hore mooki o tseleng. Tataiso ea ho ho bolella bana le bacha ka lefu e fana ka mantswe a bonolo bakeng sa mongwaha ka mong.

A flow for an expected death at home¶

flowchart TD
    A["Moratuoa oa hau o hlokahetse lapeng mme ho ne ho lebelletsoe"] --> B["Lula le bona nako e telele kamoo u ratang"]
    B --> C{"Do you have a hospice or palliative care plan"}
    C -->|"Ee"| D["Call the hospice or care team line"]
    C -->|"No or unsure"| E["Call your local emergency number or the doctor"]
    D --> F["Nurse comes and confirms the death"]
    E --> G["Crew attends and may need to follow their protocol"]
    F --> H["Doctor or coroner informed as needed"]
    G --> H
    H --> I["Bitsa motsamaisi wa lepato ha o se o lokile"]
    I --> J["Rest, eat something, and ask for support"]

After the nurse has gone¶

When the nurse and funeral director have left, the house may feel very quiet. This is often the hardest moment. You may feel flat, lost, or suddenly very tired. It is normal for the body to feel heavy after a long period of caring.

Leka ho ja ho hong le ho noa metsi. Haeba u ’nile ua hlokomela motho ka libeke kapa likhoeli, ’mele oa hao o ka ’na oa fokola. Ha ho hlokahale hore u etse letho bosiung bona.

Boroko le bosiu ba pele¶

U ka 'na ua se ke ua robala, kapa ua robala lihora tse ngata. Ka bobeli li tloaelehile. Haeba u na le bothata ba ho robala, u ka leka seno se futhumetseng, kamore e khutsitseng, kapa ho ba le motsoalle. Ka kopo qoba ho sebelisa joala ho thethefatsa maikutlo, kaha hangata ho thatafatsa matsatsi a latelang.

Haeba u na le meriana ea ho robala eo ngaka ea hao e e laetseng, latela litaelo tse leiboleng. U se ke ua noa meriana ea mang kapa mang. Haeba u tšoenyehile ka bophelo ba hau, letsetsa ngaka kapa mooki oa hau.

Feeling relief¶

Ka mor'a ho kula nako e telele, ho imoloha ke maikutlo a tloaelehileng. Batho ba bangata ba ikutloa ba le molato ka hona. Ho imoloha ha ho bolele hore u ne u rata motho hanyenyane. Ho bolela hore u thabetse hore ebe mahlomola a felile le hore ho leta nako e telele ho felile.

U ka ikutloa u imolohile le masoabi ka nako e le 'ngoe. Motswako ona o tlwaelehile mme hangata o kokobela ha nako e ntse e tsamaya.

Matsatsi a latelang¶

Once the first day has passed, a few steps will need doing. The guide to the first hours and days after a death at home has a full checklist. In short:

• A death certificate or medical certificate will be completed by a doctor.
• Lefu le tla hloka ho ngolisoa le ofisi e nepahetseng, e fapaneng ho ea ka linaha le libaka.
• A funeral or other farewell can be arranged at your own pace.
• Ba lelapa le metsoalle ba ka bolelloa, ka thuso.
• Chelete, liak’haonte tsa banka le litaba tsa molao li ka ema matsatsi a seng makae.

Hospice and palliative care teams usually offer bereavement support to families for many months after a death. Ask the team about counselling, support groups, or phone calls. Many families find these helpful.

If you were the main caregiver¶

Being a caregiver can be all consuming, and when it ends, there can be a sudden empty space. You may feel lost or unsure of your role. You may also feel exhausted and physically unwell.

Please be patient. Rest, eat regularly, and let others help. Consider seeing your own doctor in the coming weeks, because long periods of caring can take a toll. The guide to hospice and end of life emergencies le ea hospice home care guide describe what happens in the final hours, in case you want to understand what you saw.

Liphapang ka linaha¶

Rules differ, so please check locally. These notes are general guidance only.

United States¶

Hospice agencies are required to offer a 24 hour phone line. Calling them rather than 911 is usually right if the person was enrolled in hospice. The hospice nurse can pronounce death in most states, and a funeral home collects the person. The hospice or doctor completes the medical part of the death certificate, and the funeral director usually files it with the state.

United Kingdom¶

Call the out of hours district nurse, the palliative care helpline in your care plan, or the GP out of hours service. If you are unsure, call NHS 111. A doctor must complete the medical certificate, and the death is normally registered within five days in England and Wales. If the death was not expected after all, call 999.

Canada¶

Call the palliative care team, home care nurse, or after hours line listed in your plan. If you have none, call the person's doctor or your local emergency number. Procedures for who can pronounce death differ by province. Funeral homes and provincial civil registration offices handle registration.

Australia¶

Call the community palliative care service, the GP, or the after hours line in your care plan. If none is reachable, call 000. A doctor or authorised nurse confirms the death, and the funeral director helps with registration in your state or territory.

Looking after yourself¶

Please see the guide to ho itlhokomela ka mesarelo e bohloko for physical symptoms, sleep, food, and when to seek help. For now, remember the basics:

• Noa metsi 'me u je ntho e nyenyane.
• Phomola ha o khona.
• Lula haufi le batho ba u tsotellang.
• Do not make big decisions.
• Tell someone if you feel very low or unsafe.

If you ever feel that you cannot go on, or you think about harming yourself, call your local emergency number or a crisis line right away. The dinomoro tsa tshohanyetso page lists crisis lines for many countries, including 988 in the United States and Canada.

Molaetsa oa koetliso ea thuso ea pele¶

If you would like to feel more prepared for future emergencies, a hands-on first aid course from the Red Cross, St John Ambulance, or a local provider is a good idea. There is no hurry, and many caregivers find that learning later helps them feel steadier. For today, you are allowed to rest.

Lipotso tse botsoang khafetsa¶

Should I call the emergency number or the hospice when someone dies at home under hospice care?¶

If a hospice or palliative care plan exists, call the hospice or care team line first, because they know the person and the paperwork. Calling the emergency number can lead to a crew who must try resuscitation if they do not see valid paperwork. If you cannot reach the hospice, or there is no plan, call your local emergency number and say clearly that the death was expected.

Do I have to wait for the nurse before I do anything?¶

You can sit with your loved one for as long as you like before and after you call. Try not to remove medical devices or throw away medicines until the nurse has been, because they will tell you what to do. You may gently close their eyes, straighten their blanket, and stay close. If you are unsure, ask the nurse on the phone.

How soon do I need to call a funeral director?¶

There is no set deadline in the first hours, and many families wait until the morning. The nurse or doctor will usually confirm the death first. You can then call a funeral director when you feel ready, and they can collect your loved one at a time that works for you.

What should I do with leftover medicines?¶

Keep them secure and out of sight, and do not flush them or give them to anyone else. Ask the hospice nurse, a pharmacist, or your local health service about take-back schemes or disposal arrangements. Strong painkillers and controlled drugs should be locked away until they are collected.

Mehloli e hlahlobiloe¶

• NHS (United Kingdom): "What to do after someone dies", "Verification of expected death", and end of life care guidance.
• GOV.UK (United Kingdom): "Tell us once" and guidance on registering a death.
• Hospice UK: guidance for families after a death at home.
• National Hospice and Palliative Care Organization (United States): "What to do when death occurs" and guidance on hospice and 911.
• Federal Trade Commission (United States): The Funeral Rule.
• Government of Canada and provincial palliative care resources on advance care planning and DNR orders.
• Australian Government Department of Health: palliative care at home and advance care directives; Services Australia: what to do when someone dies.
• ReSPECT process and DNACPR guidance from the Resuscitation Council UK.
• Red Cross (American Red Cross, British Red Cross): support after a bereavement.

Procedures differ by country, region, and care provider. Follow the instructions of your hospice team and local officials.

Litataiso tse amanang¶

• Family member died overnight at home unexpectedly
• First hours and days after a death at home
• Hospice and end of life crisis
• Ho itlhokomela ka mesarelo e tebileng
• Death of a spouse or partner who handled everything