As a patient nears death, it is common for their breathing patterns to change. These end-of-life breathing patterns can happen very quickly, or it can occur over many hours or even days. This is a normal part of the dying process as the body begins to slowly shut down.
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.
Shallow or irregular breathing
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.
Changes in breathing
The deep, rapid breathing may be followed by a pause before breathing begins again. Your breathing may also become more noisy as a result of the build-up of mucus. The body naturally produces mucus in your breathing system, including the lungs and nasal passages.
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. Reassuring your loved one it is okay to die can help both of you through this process.
When someone is dying, their heartbeat and blood circulation slow down. The brain and organs receive less oxygen than they need and so work less well. In the days before death, people often begin to lose control of their breathing. It's common for people to be very calm in the hours before they die.
How Long Does the Active Stage of Dying Last? 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.
Terminal restlessness generally occurs in the last few days of life. Around 42 percent of hospice patients experience agitation during their final 48 hours. But even more develop symptoms before then, which may not subside until death.
As the brain dies, the respiratory system often responds with periods of no breathing (apnea), where the time between breaths becomes longer and longer. The respiration rate may decrease below 8 breaths per minute.
In the final hours of life, your loved one's body will begin to shut down. Their circulatory and pulmonary systems will slowly begin to fail. This may lead to falling body temperatures, but may also cause sudden outbursts. Your loved one will also experience greater difficulty interacting with the outside world.
As someone approaches death, their body begins to show symptoms. Breathing patterns change and secretions collect in the throat. This can create a rattling sound known as the death rattle. It is a part of the dying process.
A person who experiences agonal respiration may stay alive for five minutes. There is a possibility to revive the person after that. But according to MedlinePlus.gov, within five minutes of oxygen depletion, brain cells begin to die. Within 10 minutes, significant organ and brain damage may occur.
Minutes from dying
Their breath may become very shallow and just the lower part of the jaw moves, known as mandibular breathing. Or, they may have significant pauses between breaths — up to a minute (apnea). They may appear as though they are opening and closing their mouth without actually breathing.
Agonal breathing or agonal respirations are medical terms used to describe insufficient breathing that often sounds like snoring, snorting, gasping, or labored breathing. The person will appear to be choking or having an involuntary gasp reflex.
One of the breathing rhythm changes is called Cheyne-Stokes breathing; a cycle of anywhere from 30 seconds to two minutes where the dying person's breathing deepens and speeds up, then gets shallower and shallower until it stops.
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.
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.
The person's skin may feel cold and change colour. The person's hands, feet, ears and nose may feel cold to the touch (this is due to reduced circulation). Occasionally, a person's hands or other parts of the body may swell a little. Their skin may also become mottled and blue or patchy and uneven in colour.
So with simple bedside observations, a clinician can predict what is going to happen to the patient by detecting the signs, such as respiration with mandibular movement, which essentially means the jaw drops during breathing. This is a telltale sign that the patient will die in the next few days.
Changes in Vital Signs in the Last Days of Life
1 demonstrates the changes in vital signs in the final two weeks of life. Systolic blood pressure (P < 0.001), diastolic blood pressure (P < 0.001), and oxygen saturation (P < 0.001) each showed a significant decrease in the final three days of life.
Although it can include end of life care, palliative care is much broader and can last for longer. Having palliative care doesn't necessarily mean that you're likely to die soon – some people have palliative care for years. End of life care offers treatment and support for people who are near the end of their life.
Someone with a terminal illness may live for days, weeks, months or years. It often depends on their diagnosis and any treatment they are having. It can be difficult for healthcare professionals to predict exactly how long someone with a terminal illness will live (their prognosis).