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(515) 326-2001
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End of Life Care


Care By April is a trusted resource, working along side of MercyOne Hospice and Unity Point Hospice Home Care helping those who wish to stay home as long as possible during the End of Life process.  Hospice is a wonderful support system, offering bath aides, massage & music therapy, nurses, and are a great resource for supplies, education and support. However, they are not available on a daily basis to provide hygiene care, activities of daily living, companionship, & respite for loved ones.   

In 2018 I attended and completed  end of life Doula training, and became a part of the the International End Of Life Doula Association (INELDA) . After caring for and helping many of my clients with the dying process over the years,  I realize there is no greater gift than to love, care, and be a part of a life that is ending! This is my passion!  

Please call or text me at (515)-326-2001 and I would be happy to answer any of your questions no matter how simple or complex.


Loosing the ability to care for yourself, and becoming dependant on others can be vulnerable.  These are a few of my favorite ways to give to clients in Hospice care.  

  • Special treats, food, drinks that bring happiness or comfort
  • Playing music through my phone, a radio, tv, and or record player from their era can be calming and bring back fond memories. 
  • Making sure that they are dressed in warm cozy clothes, whether that be their pajamas, nightgowns, sweats, or comfy clothes. Clothes with elastic waist bands make it easier to get up and down for emergency bathroom visits. Nightgowns are easily to get on and off & shirts that are button down or have a full zip make getting dressed or undressed easier and less stressful.
  • Clean, dry bedding and pillowcases
  • Wiping down the bathroom, commode and or urinal  
  • Emptying catheters
  • Clean and organized environment
  • Companionship, listening and emotional support
  • Everyday hygiene, keeping hands, face, and body clean and dry   
  • Preparing meals
  • Help with transfers or ambulation
  • Daily recording of weight, blood pressure and oxygen levels  
  • And much more



Signs and Symptoms three months to one Month

  • Sleeps More
  • Withdraws from the world and people
  • Drifts
  • Food intake decreases
  • Energy level drops
  • Communication slows
  • Weakness increases
  • Decreased Mobility
  • Abandons role in family   


Signs and Symptoms Two Weeks to One Week

  • Disorientation & Confusion 
  • Food & Fluid intake decrease
  • Talks with unseen entities/ loved ones who have passed
  • Secretion buildup in the lungs
  • Blood pressure drops while pulse increases
  • Agitation & restlessness may appear
  • Apnea may occur
  • May spike a low grade fever
  • Skin color and mottling may occur


Days To Hours- Active Dying  

  • Little to no intake of fluids
  • Not eating
  • Barely speaking
  • Unresponsive
  • Buildup of secretions in lungs
  • Open mouth breathing
  • Eyelids partially open but not seeing
  • Decreased urine output
  • Agitation & restlessness
  • Picking at clothes, jerking, and twitching
  • Rise in pulse
  • Drop in blood pressure
  • Change in breathing pattern
  • Extremities become colder
  • Face drained of color
  • Sudden shifts of body temp
  • Limbs stiff
  • Mottling of lower arms and legs
  • Cyanosis in fingertips, toes and lips