They Know They're Dying Dying is a natural process that the body has to work at. Just as a woman in labor knows a baby is coming, a dying person may instinctively know death is near. Even if your loved one doesn't discuss their death, they most likely know it is coming.
“First hunger and then thirst are lost. Speech is lost next, followed by vision. The last senses to go are usually hearing and touch.”
A conscious dying person can know if they are on the verge of dying. Some feel immense pain for hours before dying, while others die in seconds. This awareness of approaching death is most pronounced in people with terminal conditions such as cancer.
Visions and Hallucinations
These visions are considered normal. The dying may turn their focus to “another world” and talk to people or see things that others do not see. This can be unsettling, and loved ones may not know how to respond.
The first organ system to “close down” is the digestive system. Digestion is a lot of work! In the last few weeks, there is really no need to process food to build new cells. That energy needs to go elsewhere.
When a patient is transitioning, they are typically bedbound due to exhaustion, weakness, and fatigue. They are less responsive and sleeping most of the time. They may sluggishly rouse when you tap them on the shoulder. They may have a more difficult time waking up.
Hospice has a program that says that no one should have to die alone, and yet this hospice nurse is telling me to take a break? Some patients want to die when no one else is there. Hospice professionals know that companionship while dying is a personal preference.
Physical signs
Facial muscles may relax and the jaw can drop. Skin can become very pale. Breathing can alternate between loud rasping breaths and quiet breathing. Towards the end, dying people will often only breathe periodically, with an intake of breath followed by no breath for several seconds.
As a person approaches death, their vital signs may change in the following ways: blood pressure drops. breathing changes. heartbeat becomes irregular.
Coronary artery disease causes most cases (80%) of sudden cardiac death. In people who are younger, congenital (since birth) heart defects or genetic abnormalities in their heart's electrical system are often the cause. In people age 35 and older, the cause is more often related to coronary artery disease.
It is best to think of the decedent's belongings, paperwork, and assets as “frozen in time” on the date of death. No assets or belongings should be removed from their residence. Their vehicle(s) should not be driven. Nothing should be moved great distances, modified, or taken away.
Terminal agitation is typically seen during the hours or days before death and can be distressing and overwhelming for caregivers.
As the blood pools, patches appear on the skin within 30 minutes of death. About two to four hours postmortem, these patches join up, creating large dark purplish areas towards the bottom of the body and lightening the skin elsewhere. This may be less apparent on darker skin. This process is called livor mortis.
"When we imagine our emotions as we approach death, we think mostly of sadness and terror," says psychological scientist Kurt Gray of the University of North Carolina at Chapel Hill. "But it turns out, dying is less sad and terrifying – and happier – than you think."
Although death has historically been medically defined as the moment when the heart irreversibly stops beating, recent studies have suggested brain activity in many animals and humans can continue for seconds to hours.
So, what does it feel like to die? As these studies record, death by cardiac arrest seems to feel either like nothing, or something pleasant and perhaps slightly mystical. The moments before death were not felt to be painful. We don't know if this would extend to other causes of death, but still, it is reassuring.
The immediate aftermath of dying can be surprisingly lively. For the first few minutes of the postmortem period, brain cells may survive. The heart can keep beating without its blood supply. A healthy liver continues breaking down alcohol.
Phase 1: Hypostasis
This occurs within an hour to several hours after death. The blood vessels collapse. Pooling of blood due to gravity can occur but will leave white gaps at pressure areas. Regurgitation of gastric contents can occur, as can the emission of semen.
Go Ahead and Cry
It opens a pathway to a conversation that could be once in a lifetime. Additionally, the loved one who's dying knows others are sad. It could be worse for him or her to not see the family cry; tears are a sign of love and understanding of what's happening.
It's a simple act – a swift gesture that takes little effort, but says so very much: the opening of a window for “the soul” of the loved one to pass through once they have died.
Another common end-of-life change is that people may not respond to questions and may also show little interest in their surroundings. Let your loved one sleep and remain peaceful. Offer reassuring words and touches, but don't pressure the person to interact.
Consciousness fades. Often before death, people will lapse into an unconscious or coma-like state and become completely unresponsive. This is a very deep state of unconsciousness in which a person cannot be aroused, will not open their eyes, or will be unable to communicate or respond to touch.
At the end-of-life. The end-of-life period—when body systems shut down and death is imminent—typically lasts from a matter of days to a couple of weeks. Some patients die gently and tranquilly, while others seem to fight the inevitable.