Confusion and Delirium

Confusion and Delirium

Posted on: June 24, 2014

As the time of death approaches, your patient may exhibit increased restlessness and/or repetitive actions, such as pulling at bed linens or repeatedly reaching for something in the air that is not visible to anyone else but the patient. This is sometimes referred to as “terminal anxiety.” You may also observe increased confusion as your patient is closer to death.

For devotees of Lord Krishna hearing the chanting of the Hare Krishna mantra or listening to a soft bhajan (soft, musical chanting) may decrease the restlessness often experienced in this later stage of a terminal disease.

(Please Note: At this point in your patient’s condition, loud drums and kartals/cymbals , even the playing of a harmonium, may add to his/her agitation and restlessness. Soft chanting, quiet voices, and dim lighting are recommended at this time.)

Reading Krishna’s pastimes aloud (such as in Krsna Book) may also help to ease anxiety. Speak calmly and assuredly and never in a tone which can be taken by the patient as condescending. Soft lighting and decreased environmental noise and other stimuli may help to relax your patient as well. (From “The Final Journey” page 190)

In his book, “How We Die,” Dr. Sherwin B. Nuland, M.D. writes,

“When a man is dying, the walls of his room enclose a chapel, 

and it is right to enter it in hushed reverence.”

I have found this advice to be very important to remember. Try to make the atmosphere in the room reflect the consciousness of your patient by remembering the following guidelines:

* Provide dim lighting since the patient’s eyes will be sensitive to light at the end-stage of his or her life.

*Again, visitors can chant softly without the use of kartals, drums, or even harmoniums. Simply soft voices chanting the Hare Krishna maha-mantra is all that is required, as was exemplified when Srila Prabhupada was departing from this world from his room in Vrindavan, India. Patients are sensitive to loud sounds, like kartals, at this end-stage.

*No slamming doors.

*No laughing or unnecessary talking.

*No talking above a whisper within the patient’s room. Please remember that your patient can still hear until the last breath. Everything that is being said in the room can be heard by the patient even when he or she is unresponsive. 

*The mood in the room should be one of great respect. After all, a Vaishnava is preparing to leave this world.  This is a very serious time and being allowed to witness such an event is a tremendous privilege. 

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