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.
There are three main stages of dying: the early stage, the middle stage, and the last stage. These are marked by various changes in responsiveness and functioning. However, it is important to keep mind that the timing of each stage and the symptoms experienced can vary from person to person.
Active decay begins in the period between a week to 10 days following death. Fluids evacuate from the body's orifices and muscles and other soft tissues begin to liquefy. Teeth and nails will fall out in the coming weeks and as the body liquefies, it will lead to a reduction in insect activity.
1 to 2 weeks before death, the person may feel tired and drained all the time, so much that they don't leave their bed. They could have: Different sleep-wake patterns. Little appetite and thirst.
When someone is nearing the end of life, they experience a variety of symptoms. Pain, shortness of breath, anxiety, incontinence, constipation, delirium, and restlessness are just a few signs that a loved one is going through the dying process.
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.
Terminally ill cancer patients near the end of life can experience refractory symptoms, which require palliative sedation. Midazolam is the most common benzodiazepine used for palliative sedation therapy.
As the moment of death comes nearer, breathing usually slows down and becomes irregular. It might stop and then start again or there might be long pauses or stops between breaths . This is known as Cheyne-Stokes breathing. This can last for a short time or long time before breathing finally stops.
In the days before their death, a person's control over their breathing starts to fail. They may breathe more slowly for a while, then more quickly, and so their breathing becomes quite unpredictable overall. Fluid can start to gather in their lungs, and the breathing can begin to sound quite 'rattly'.
When a person is brain dead, or no longer has brain activity, they are clinically dead. Physiological death may take 72 or fewer hours.
You breathe your last breath. Your heart stops beating. Your brain stops. Other vital organs, including your kidneys and liver, stop.
After two weeks, the body starts to bloat and change its color to red after the blood present in the body starts to decompose. Once the corpse surpasses the fourth week, you can witness liquefaction in the rest of the remains. The teeth and nails also begin to fall during this time frame.
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.
End-of-life transition refers to a person's journey to death, especially in those with a terminal diagnosis. This process occurs differently for everyone. For some, it takes days or weeks; for others, it occurs rapidly. Partnering with a trusted medical team during this time can limit pain.
People often become more drowsy and sleep more towards the end of life. This is one of many signs that a person may have when they are in their last few days and hours of life, but not everyone will experience this.
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 emotional discomfort and interpersonal conflicts go hand in hand in causing suffering at the end of life. Financial instability, marital discord, conflicts with family members, and an inability to get one's affairs in order before death are common causes of total pain.
Terminal agitation is typically seen during the hours or days before death and can be distressing and overwhelming for caregivers.
End-of-life rallies are not fully understood, and no one can predict just how long a rally will last. In rare instances, it can last a week or more, but in most cases it's a very brief window to connect with your loved one. Families who understand this can spend that time chatting and making a final connection.