Inaasahang kamatayan sa bahay: sino ang unang tatawag at kung ano ang susunod na mangyayari¶

Kung ang isang taong mahal mo ay nabubuhay nang may malubhang karamdaman at ngayon ay namatay na sa bahay, maaari kang makaramdam ng maraming bagay nang sabay-sabay: kalungkutan, ginhawa, kawalan ng laman, pagkahapo, maging ang pamamanhid. Ang lahat ng ito ay normal, at wala sa mga ito ang nangangahulugang mali ang iyong ginagawa. Mahaba at nakakapagod na ang pinagdaanan mo, at hinahayaan kang mapagod.

Ang gabay na ito ay para sa mga pagkamatay na inaasahan, kadalasan kapag ang isang tao ay tumatanggap ng hospice, palliative care, o end of life care sa bahay. Ang pinakamahalagang bagay na dapat malaman ay hindi mo kailangang magmadali. Walang dapat mangyari sa susunod na ilang minuto maliban sa isang mahinahong tawag sa telepono, at ang tawag na iyon ay karaniwang sa nurse o pangkat ng pangangalaga na kilala na ang iyong pamilya. Maaari kang umupo, huminga, at gumastos hangga't gusto mo kasama ang tao bago mo kunin ang telepono.

Gawin ito ngayon¶

1. Manatili kung nasaan ka sandali. Umupo kasama ang tao. Hawakan ang kanilang kamay kung gusto mo. Walang emergency sa kahulugan ng isang karera laban sa oras.
2. Hanapin ang plano ng pangangalaga o ang numero ng hospice. Ito ay madalas na nasa refrigerator, sa isang folder malapit sa kama, o naka-save sa iyong telepono sa ilalim ng "hospice" o "palliative care". Kung hindi mo ito mahanap, hilingin sa ibang tao sa bahay na maghanap.
3. Tumawag muna sa hospice, palliative care, o end of life nurse line, kung mayroon kang planong magsasabi sa iyo. Sabihin, "Namatay na ang mahal ko. Puwede ba kayong magpadala ng nurse." Karamihan sa mga serbisyo ay sumasagot 24 oras sa isang araw.
4. Kung wala kang plano, walang numero, o walang sumasagot, tawagan ang iyong lokal na numero ng emergency (911 sa United States at Canada, 112 sa buong European Union, 999 sa United Kingdom) o sa doktor ng taong iyon. Tingnan ang mga numerong pang-emergency pahina para sa ibang mga bansa. Sabihin nang malinaw na ito ay isang inaasahang kamatayan.
5. Itago ang do-not-resuscitate na papeles kung saan ito makikita kung mayroon man, at ipakita ito sa sinumang darating. Huwag simulan ang CPR kung mayroong wastong utos at sinabi sa iyo ng pangkat ng pangangalaga na ang tao ay hindi dapat i-resuscitate.
6. Hilingan ang isang tao na sumama at maupo sa iyo. Ang isang kaibigan, kamag-anak, o kapitbahay ay maaaring gumawa ng tsaa, tumawag, at nariyan para sa iyo.

Ang lahat ng iba pa, kabilang ang direktor ng libing, mga tawag sa pamilya, at gawaing papel, ay maaaring sumunod sa banayad na bilis.

Wala kang ginagawang masama¶

Kapag ang isang kamatayan ay inaasahan, ang mga tao ay kadalasang nararamdaman na dapat silang maging mahinahon at organisado. Ang ilan ay nabigla pa rin, dahil ang pagiging handa sa iyong ulo ay iba sa pagiging handa sa iyong puso. Ang ilan ay walang nararamdaman.

Ang ilan ay nakadarama ng kaginhawahan na natapos na ang pagdurusa, pagkatapos ay nakonsensya tungkol sa kaginhawahan. Mangyaring malaman na ang lahat ng ito ay karaniwan.

Maaari ka ring magtaka kung napalampas mo ang eksaktong sandali, o kung dapat ay iba ang ginawa mo. Kung natutulog ka, nasa ibang silid, o umiinom ng isang tasa ng tsaa kapag nangyari ito, karaniwan na iyon. Maraming tao ang namamatay kapag walang tao sa silid, at ang ilan ay tila naghihintay hanggang sa lumayo ang pamilya. Hindi ito kabiguan ng pagmamahal o pag-aalaga.

Walang kailangang gawin nang mabilis maliban sa pagtawag sa tamang serbisyo. Maaari mong gawin hangga't gusto mong umupo kasama ang tao, at maaari mong sabihin sa nars kapag handa ka na para sa kanila na dumating.

Who to call first: the short version¶

The right first call depends on whether a plan exists. This table can help you decide.

If you are not sure which row fits, call the emergency number. It is always better to make that call than to wait and worry.

Bakit nauuna ang linya ng hospice kapag may plano¶

Ang mga hospice at palliative care team ay nagpaplano nang maaga kasama ang mga pamilya. Alam nila ang kagustuhan, gamot, at papeles ng tao. Maaari silang magpadala ng isang nars na sinanay upang kumpirmahin ang kamatayan, suportahan ka, at ayusin ang mga susunod na hakbang.

Kung tatawagan mo na lang ang numerong pang-emergency, maaaring dumating ang isang tripulante na hindi kilala ang tao at kinakailangang magsimula ng resuscitation maliban kung makakita sila ng wastong papeles. Ito ay maaaring nakakainis para sa lahat. Kaya naman hinihiling ng mga hospice team na tawagan muna sila ng mga pamilya.

Why the emergency number is sometimes still right¶

There are times when the emergency number is the right call, even in a planned death. If there is no plan or the plan is not clear, if you cannot reach the hospice team, or if something unexpected has happened, call without delay. The call taker will ask questions and send the right help.

If the person was only recently ill and nobody had talked about end of life care, treat it as a sudden death. The guide on a family member who died overnight at home unexpectedly explains what happens in that case.

Paperwork that matters: do not resuscitate and similar orders¶

Different countries use different names and forms for a person's choice not to be resuscitated. They are not interchangeable, and they do not work the same way everywhere. This is one of the biggest differences between countries, so please read the part that matches where you live and then check with the care team.

Sa ilang mga lugar ang isang order ay dapat na isang partikular na nilagdaang form upang tanggapin ng mga paramedic. Sa iba, ang isang pag-uusap o isang tala sa mga talaan ng tao ay maaaring hindi sapat sa sarili nitong. Tanungin ang pangkat ng hospice nang maaga kung aling bahagi ang ginagamit ng iyong lugar at kung saan ito dapat itago, mas mabuti bago dumating ang araw.

Kung hindi mahanap ang papeles¶

Kung hindi mo mahanap ang form, huwag mag-panic. Sabihin kaagad sa tumatawag o sa nars. Sabihin, "Ang aking mahal sa buhay ay nasa ilalim ng pangangalaga sa hospice at ito ay inaasahan."

Sasabihin nila sa iyo kung ano ang gagawin, na maaaring kasama ang pagsisimula ng CPR. Sundin ang kanilang tagubilin. Ang pinakamahalagang bagay ay maging tapat at mahinahon.

Kung dumating ang mga paramedic at nagsimulang subukang tumulong¶

Kung dumating ang mga paramedic at walang nakikitang anyo, maaari silang magsimula ng resuscitation. Maaaring nakababahalang panoorin, ngunit ito ay kanilang legal na tungkulin. Sabihin sa kanila nang malinaw at mabilis ang iyong nalalaman, at ipakita ang anumang papeles na mahahanap mo. Kung papunta na ang nars ng hospice, sabihin sa kanila.

Kung ang papeles ay matatagpuan habang sila ay nagtatrabaho, ibigay ito sa kanila kaagad. Sila ay sinanay na sundin ang mga wastong utos at titigil kapag ito ay tama na gawin ito.

Ano ang mangyayari pagkatapos mong tumawag¶

Sa sandaling tumawag ka sa hospisyo o pangkat ng pangangalaga, isang nars ang karaniwang pumupunta sa bahay. Maaaring kausapin ka muna nila sa pamamagitan ng telepono at tanungin kung huminto na sa paghinga ang tao at kung ligtas ka. Sasabihin nila sa iyo na huwag mag-alala at maaari kang manatili kasama ang tao.

Pagdating ng nurse, dahan-dahan nilang susuriin ang tao at makumpirma na naganap na ang kamatayan. Tatandaan nila ang oras. Mabait sila, tahimik, at sanay tumulong sa mga pamilya. Maaari kang magtanong anumang oras.

Ano ang maaaring gawin ng nars¶

Depende sa bansa at serbisyo, ang nars ay maaaring:

• Kumpirmahin at itala ang pagkamatay.
• Makipag-ugnayan sa doktor ng tao o sa coroner kung kinakailangan.
• Tulungang hugasan at ihanda ang tao kung gusto mo, o iwanan iyon sa isang direktor ng libing.
• Alisin ang mga medikal na device gaya ng mga syringe driver, patch, o catheter.
• Bigyan ka ng nakasulat na impormasyon kung ano ang susunod na gagawin.
• Tulungan kang makitungo sa mga gamot na naiwan sa bahay.
• Mag-alok na tumawag sa isang direktor ng libing kasama mo o para sa iyo.
• Mag-alok na umupo kasama mo o tumawag sa isang miyembro ng pamilya.

Maaari kang magsabi ng oo o hindi sa alinman sa mga ito. Kung gusto mong ikaw mismo ang maglaba at magbihis ng iyong mahal sa buhay, maraming serbisyo ang susuporta diyan. Kung mas gusto mong ipaubaya ang lahat sa mga propesyonal, ayos lang din.

Pagpapatunay ng kamatayan¶

Ang pagpapatunay, kung minsan ay tinatawag na pagpapahayag, ay kapag kinumpirma ng isang awtorisadong tao na may namatay. Sino ang makakagawa nito ay naiiba ayon sa bansa:

• Sa United States, ang isang hospice nurse, doktor, o sa ilang estado ay maaaring ipahayag ng coroner ang kamatayan. Ang isang manggagamot o ang medikal na tagasuri ay pumipirma sa sertipiko ng kamatayan.
• Sa United Kingdom, maaaring i-verify ng isang doktor o sinanay na nars ang inaasahang kamatayan. Ang isang doktor, kadalasan ang GP o doktor ng ospital, ay kumukumpleto ng sertipiko ng medikal ng sanhi ng kamatayan, at pagkatapos ay irerehistro ng pamilya ang pagkamatay.
• Sa Canada, ang isang doktor, nurse practitioner, o sa ilang probinsya ay maaaring kumpirmahin at ipahayag ng isang rehistradong nars ang kamatayan. Ang mga tuntunin ay nakasalalay sa lalawigan o teritoryo.
• 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¶

Maaari kang tumawag sa isang direktor ng libing kapag nakumpirma na ang pagkamatay, alinman sa tulong ng nars o pagkatapos. Hindi na kailangang pumili ng sinumang nagmamadali. Maaari kang maglaan ng oras, at maaari kang tumawag sa susunod na umaga kung gusto mo.

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¶

Ang ilang mga bagay ay nakakagulat sa mga pamilya, at karaniwan silang normal. Maaaring mag-relax ang katawan at maaaring lumambot ang mukha. Ang balat ay maaaring maging mas malamig at maputla.

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¶

If children, older relatives, or visitors are in the house, ask someone to look after them while you make the call. Tell them calmly and truthfully that the person has died and that a nurse is on the way. The guide to pagsasabi sa mga bata at kabataan tungkol sa isang kamatayan offers simple words for each age.

A flow for an expected death at home¶

flowchart TD
    A["Your loved one has died at home and it was expected"] --> B["Sit with them for as long as you like"]
    B --> C{"Do you have a hospice or palliative care plan"}
    C -->|"Oo"| 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["Call a funeral director when you are ready"]
    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.

Try to eat something and drink water. If you have been caring for someone for weeks or months, your body is likely depleted. You do not have to do anything else tonight.

Sleep and the first night¶

You may not sleep, or you may sleep for many hours. Both are normal. If you have trouble sleeping, you can try a warm drink, a quiet room, or the company of a friend. Please avoid using alcohol to numb the feelings, since it often makes the following days harder.

If you have a sleeping medicine that your doctor prescribed, follow the instructions on the label. Do not take anyone else's medicines. If you are worried about your own health, call your doctor or a nurse line.

Feeling relief¶

Pagkatapos ng mahabang karamdaman, ang kaginhawahan ay isang pangkaraniwang damdamin. Maraming tao ang nakonsensya tungkol dito. Ang kaluwagan ay hindi nangangahulugan na hindi mo minahal ang tao. Nangangahulugan ito na natutuwa ka na natapos na ang pagdurusa at natapos na ang mahabang paghihintay.

You can feel relief and sorrow at the same time. This mix is normal and usually softens over time.

The days that follow¶

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.
• The death will need to be registered with the appropriate office, which varies by country and region.
• A funeral or other farewell can be arranged at your own pace.
• Family and friends can be told, with help.
• Money, bank accounts, and legal matters can wait for a few days.

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 and the hospice home care guide describe what happens in the final hours, in case you want to understand what you saw.

Mga pagkakaiba ayon sa bansa¶

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

Sa Estados Unidos¶

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.

Sa 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.

Sa 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.

Sa 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 pag-aalaga sa iyong sarili sa matinding kalungkutan for physical symptoms, sleep, food, and when to seek help. For now, remember the basics:

• Drink water and eat something small.
• Rest when you can.
• Stay close to people who care about you.
• 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 mga numerong pang-emergency page lists crisis lines for many countries, including 988 in the United States and Canada.

Isang tala sa pagsasanay sa first aid¶

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.

Mga madalas itanong¶

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.

Gaano kabilis kailangan kong tumawag ng direktor ng libing?¶

Walang nakatakdang deadline sa mga unang oras, at maraming pamilya ang naghihintay hanggang umaga. Karaniwang kukukumpirmahin muna ng nars o doktor ang pagkamatay. Pagkatapos ay maaari mong tawagan ang isang direktor ng libing kapag handa ka na, at maaari nilang kolektahin ang iyong mahal sa buhay sa oras na angkop para sa iyo.

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.

Sinuri ang mga pinagmulan¶

• 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.

Naiiba ang mga pamamaraan ayon sa bansa, rehiyon, at tagapagbigay ng pangangalaga. Sundin ang mga tagubilin ng iyong hospice team at mga lokal na opisyal.

Mga kaugnay na gabay¶

• Family member died overnight at home unexpectedly
• First hours and days after a death at home
• Hospice and end of life crisis
• Inaalagaan ang iyong sarili sa matinding kalungkutan
• Death of a spouse or partner who handled everything