In the hours before death, most people fade as the blood supply to their body declines further. They sleep a lot, their breathing becomes very irregular, and their skin becomes cool to the touch. Those who do not lose consciousness in the days before death usually do so in the hours before.
What are the signs that death is near? Someone who is very close to death will likely refuse food and water. Their breathing and heart rates will slow and/or be abnormal and their hands, arms, feet, or legs may be cool to the touch. They may also be agitated, anxious, and confused.
The active stage of dying generally only lasts for about 3 days. The active stage is preceded by an approximately 3-week period of the pre-active dying stage. Though the active stage can be different for everyone, common symptoms include unresponsiveness and a significant drop in blood pressure.
Livor mortis usually sets in 20 to 30 minutes after death and increases in intensity until it becomes fixed at about 12 hours. Assessment of livor mortis can be useful in determining the approximate time of death or cause of death, based on the approximate stage of lividity and the specific coloration.
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. And if a technician strikes your thigh above the kneecap, your leg likely kicks, just as it did at your last reflex test with a physician.
The first visible change to the body—occurring 15 to 20 minutes after death—is pallor mortis, in which the body begins to pale. Pallor mortis occurs because blood stops moving through the capillaries, the smallest of the body's blood vessels.
Visions and Hallucinations
Visual or auditory hallucinations are often part of the dying experience. The appearance of family members or loved ones who have died is common. 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.
Research suggests that even as your body transitions into unconsciousness, it's possible that you'll still be able to feel comforting touches from your loved ones and hear them speaking. Touch and hearing are the last senses to go when we die.
In the hours before death, most people fade as the blood supply to their body declines further. They sleep a lot, their breathing becomes very irregular, and their skin becomes cool to the touch. Those who do not lose consciousness in the days before death usually do so in the hours before.
The important findings, along with observations of long-time palliative care doctors and nurses, show: Brain activity supports that a dying patient most likely can hear. Even if awareness of sound cannot be communicated due to loss of motor responses, the value of verbal interactions is measurable and positive.
Periods of rapid breathing, and no breathing for brief periods of time, coughing or noisy breaths, or increasingly shallow respirations, especially in final hours or days of life.
Terminal agitation is typically seen during the hours or days before death and can be distressing and overwhelming for caregivers.
The pre-active phase of dying usually occurs two to three weeks prior to death. During this time, patients experience symptoms such as: Increased periods of sleep and lethargy. Withdrawal from social interaction.
You might be unable to stop crying and worrying. Or you might feel that there is no point in doing anything. You might also find it difficult to see life going on as normal for most people. It can feel very strange to watch people go about their daily lives, do shopping, drive, and work.
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.
Decompensation progresses over a period of minutes even after the pulse is lost. Even when vascular collapse is the primary event, brain and lung functions stops next. The heart is the last organ to fail.
The immediate seconds and minutes after death
Muscles including sphincters relax which means dying people may defecate or urinate.
They might close their eyes frequently or they might be half-open. Facial muscles may relax and the jaw can drop. Skin can become very pale. Breathing can alternate between loud rasping breaths and quiet breathing.
Gasping respiration in the dying patient is the last respiratory pattern prior to terminal apnoea. The duration of the gasping respiration phase varies; it may be as brief as one or two breaths to a prolonged period of gasping lasting minutes or even hours.
Just before death some people become restless, agitated and confused. This is known as terminal restlessness. It often occurs within the last few days of life. Terminal restlessness can be caused by a range of things and sometimes calming drugs are needed.
If the body feels warm and no rigor is present, death occurred under 3 hours before. If the body feels warm and stiff, death occurred 3-8 hours earlier. If the body feels cold and stiff, death occurred 8-36 hours earlier. If the body is cold and not stiff, death occurred more than 36 hours earlier.
What Happens One Hour After Death? At the moment of death, all of the muscles in the body relax (primary flaccidity ). The eyelids lose their tension, the pupils dilate, the jaw may fall open, and the joints and limbs are flexible.
For approximately the first 3 hours after death the body will be flaccid (soft) and warm. After about 3-8 hours is starts to stiffen, and from approximately 8-36 hours it will be stiff and cold. The body becomes stiff because of a range of chemical changes in the muscle fibres after death.