Signs that death is near
Most of us don’t know what to expect when someone nears death. The unknown is often very scary, so understanding what may be going on can help reduce fear and anxiety for the dying person, their family and their caregivers. What are the signs that death is near?
Usually, when a person nears death, their bodily functions begin to slow down. But it’s important to understand that every situation is different. Showing one or more of the following signs does not necessarily mean the end is near.
Withdrawal (social isolation)
The person can become more or less indifferent to his surroundings. She loses interest in activities she used to enjoy, and does not want to talk or be social. She may also become irritable or restless.
As the body stops functioning, the dying person loses interest in those around him. She may stop talking, mutter unintelligibly, stop answering questions, or just turn her back.
A few days before cutting themselves off from their surroundings, the person can sometimes surprise those close to them with a last outpouring of joy and affection, which can last less than an hour and up to a whole day.
It is normal to feel sorry when a loved one seems to pull away from us, but we should not feel personally targeted.
As they approach death, a person may sleep more, be drowsy, or be difficult to wake up. She can fall asleep even while talking. She may also slowly lose consciousness in the days or hours before her death.
When visiting someone with advanced cancer, it is good to remember that visits can be tiring and difficult for someone who is dying. Visits should be short and there should be only a few people at a time.
The person can hear you even if they are unconscious and unable to answer you. Talk to him directly. You can also touch her gently when talking to her. If you must talk about matters that might disturb her, leave the room to prevent her from overhearing you.
Reduced food and fluid intake
When the end approaches, the body slows down. The person does not need as much food and fluids as before, so they are neither hungry nor thirsty. Don’t trust your instincts, but try to let her decide when and what she wants to eat or drink.
The person approaching death may have difficulty swallowing. If this is the case, do not force her to eat or drink, as she may suffocate or be at greater risk of contracting a lung infection.
You can often offer him liquids in the form of sips of water, pieces of ice or juice, for example. Using a moisturizing pad or spray will help relieve his dry mouth. Apply a balm or lubricant to her lips to moisturize them.
Changes in breathing
Breathing changes as you approach death. It can slow down or be fast and shallow. Sometimes the person stops breathing for several seconds at a time. A pattern of irregular breathing called Cheyne-Stokes breathing is commonly seen in people who are dying: the breathing is very deep and rapid, then short, and then the person does not breathe for a while.
Secretions can build up in the back of a person’s throat, causing a grumbling or gurgling sound when they breathe. These noises can worry family members and visitors, but the person is usually unaware that they are occurring.
Breathing can sometimes be easier if the person is lying on their side or if pillows are placed under their head and behind their back. Using a humidifier can also improve comfort.
If necessary, the healthcare team can reduce the amount of secretions by suction or by using medication; oxygen therapy is also a possible option in some cases.
Loss of bladder or bowel control
Some people lose control of their bladder or bowel because the muscles in the pelvis are relaxed. This is called incontinence.
To keep your loved one comfortable, always make sure they are clean and dry. Use a liner to protect the bedding and change it when it gets dirty.
Sometimes a tube (catheter) is used to drain the urine, which may be darker and less frequent.
The healthcare team may use a tube called a catheter to collect urine in a bag. This urine may be darker than normal. If the person does not eat or drink a lot, the amount of urine and stools will be reduced.
When the end approaches, the skin can change. It may appear pale, mottled, or bluish. It can become thin, dry and flaky. Redness may appear on the joints of the hands and legs. The hands or feet may feel cool to the touch, but the person is not cold.
To keep your loved one comfortable, you can use lightweight blankets or sheets. Avoid electric blankets or cushions, no electric cushions or heaters since they may cause burns.
Wash the person with lukewarm water, using a non-drying cleanser. Blot up all traces of water and then apply a light, unscented moisturizer, gently massaging the skin. Avoid rubbing red areas or areas with thinning skin.
Sometimes a person who is dying becomes agitated, anxious or confused. This state of confusion and disorientation is sometimes called delirium and it is one of signs that death is near…
The delirious person may not recognize relatives or friends, know what day or what time it is, or where they are. She may also see things that others cannot see or speak to them (hallucinations). She may try to get out of bed or move more when lying down. She can completely change her sleep cycle so she can sleep during the day and stay awake at night. A delirious person may make jerky movements of the arms and legs that they cannot control.
Delirium can upset family members and caregivers, especially if their loved one becomes aggressive or mean. Try to remember that a delusional person is unaware of the way they are acting and their actions do not reflect their true feelings or beliefs.
Sometimes the condition of a person approaching death improves briefly and unexpectedly. She is more alert and can interact with those around her. For family members, this improvement may give hope that the person will be better and that the prognosis was not good.
As difficult as it may be, it is important to remember that these changes are only temporary and the person’s condition will worsen again. However, this respite (rest break) can allow you to share serious feelings or thoughts with the dying person and to make a deeper connection in the last days or hours before their death.
Summary table of signs that death is near and symptoms of “dying”
|1 to 3 months before death||1 to 2 weeks before death||A few days to a few hours before death|
|Accentuated weight loss
Change in skin color
Sweating or fever
Sleep a lot
Eyes half open and glassy
Digestive and urinary system
Repulsion (disgust) for certain foods (meat, sugar)
|Difficult diet (mainly in liquid form)
Possibility of nausea and vomiting
Possibility of faecal and urinary incontinence
Possible incontinence (lack of voluntary control over urination or defecation)
Possibility of discharge of secretions through the mouth
|Dyspnea on exertion (sensation of running out of the air and of not being able to breathe fast or deeply enough during physical activity)||Shortness of breath at the slightest effortIrregular breathing
Possible congestion or blockage
|Difficult breathing accompanied by rales (a small clicking or crackling sound in the lungs)Longer breathing pauses|
|Tekanan darah dan nadi normal||Low blood pressureFaster pulse||Low blood pressurePulse weak|
|Detachment and withdrawal||Possible disorientation and confusionRestlessness, daydream||Possible agitation (the state or feeling of being agitated—anxious, bothered, or worried)Semi-comatose state (marked by or affected with stupor and disorientation but not complete coma)|
NB: Signs of death listed above describe a process of natural death. They can vary from person to person. If a person is kept alive artificially (respirator, feeding tube), the process of death may be different.
When a little voice whispered in my ear:
“There it is, he’s gone”, I really became aware
of the word “die” and I died with you…
Life fell apart and I had to
with my strength and those you left me,
relearn to live, to live without you…
to live for me.
Knowing these different signs that death is near can help get you through this painful time without being more distraught (worried upset) than you already are. And if you are not “affected” by this poetry, rejoice and, above all, enjoy every moment when the people you love are still alive and well with you. CARPEDIEM!
Information: Cleverly Smart is not a substitute for a doctor. Always consult a doctor to treat your health condition.
Photo credit: Max Pixel