Some people may have a condition causing them to be very ill and may need palliative care for only a few weeks. Others may need end of life and palliative care at intervals over a period of months or years.
Palliative care can last for a short duration, comprised of a number of days or weeks, but this can also go on for a number of years – the duration is based upon the individual and their needs. FACT: Palliative care can be given in different settings, such as your home, in hospital, in a care home or hospice.
Nearing the end of life
Everyone's experiences are different, but there are changes that sometimes happen shortly before a person dies. These include loss of consciousness, changes to skin colour, and changes to breathing.
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.
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.
While the pre-active stage lasts for about three weeks, the active stage of dying lasts roughly three days. By definition, actively dying patients are very close to death, and exhibit many signs and symptoms of near-death.
Final Weeks of Life
Increase in the need to sleep, having to spend the large majority of the day in bed/resting. Difficulty eating or swallowing fluids. A decrease in the patient's ability to communicate and/or concentrate. A general lack of interest in things that used to interest them, and a strong feeling of apathy.
Activity usually decreases significantly in one's final days and hours and it's natural to sleep more, even during the day. 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.
As a result of discontinuing eating, patients can die in as early as a few days. For most people, this period without food usually lasts about 10 days, but in rare instances, it can last several weeks.
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.
A good death is “one that is free from avoidable distress and suffering, for patients, family, and caregivers; in general accord with the patients' and families' wishes; and reasonably consistent with clinical, cultural, and ethical standards.”
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.
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.
It's normal for a dying person to sleep more. They may generally become less interested in what is going on around them, and have less energy to take part, but this does not necessarily mean they're no longer hearing what you say to them.
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).
Stage One: Stable
The first phase of palliative care involves designing and creating a treatment plan suitable for the patient's specific condition. The patient and their family will work closely with the care team to identify the physical and medical needs of the patient and who can best provide the necessary care.
Others start to cry and feel as though they won't be able to stop. Some people become angry and scared. Or they feel numb, as though they have no emotions. These are all very common and natural reactions.
An old, frail or ill person who stops taking in calories and fluids may only linger for a few days, gradually falling deeper and deeper into sleep. A person whose body is stronger may take two or even three weeks to deteriorate to the point of coma.
This stage is also one of reflection. The dying person often thinks back over their life and revisits old memories.4 They might also be going over the things they regret.
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.
Your loved one should be turned and repositioned at least once every 2 hours. Try not to disturb your own sleep.
INTRODUCTION — The symptoms of cough, stridor, and hemoptysis are common in palliative care patients with advanced life-threatening illness, especially cancer. These respiratory symptoms may be frightening to patients, families, and caregivers.