Unconsciousness

Unconsciousness occurs when the patient does not respond to verbal or painful stimuli. It may be due to a lack of oxygen to the brain, tumor moving into the brain, changes in metabolic balance, or impending death. In a terminally ill person, unconsciousness may occur slowly over time, progress from withdrawal to a coma-like state, and last for days or weeks. It might also occur just before death.

What to look for:

• Withdrawal from activity and communication
• A lack of interest in surroundings
• Changes in mental status
• Failure to respond to stimulation
• Increasing lethargy and weakness

What to do:

• Continue to talk to and to touch the patient just as if she or he was conscious
• When you do anything for the patient, tell step-by-step what you are doing
• Turn the person every two hours
• Use side rails
• Massage skin with lotion
• Place ice chips or a dropper full of water in the side of the mouth, or squeeze drops of water from a cloth into the mouth frequently
• Keep the lips moist with lip balm
• Use Natural Tears or normal saline in the eyes to keep them moist
• The patient will no longer be able to swallow oral medication. A sublingual (under the tongue) form is available for some medications

When to call hospice:

• If the person suddenly becomes unconscious or has a change in mental status
• If the person is unable to take medications
• If the person has not eaten in two days