You can simply sit with them, perhaps holding hands. Hearing is said to be the last sense to go, so you may want to talk, read aloud, sing or play music. Your cultural or spiritual traditions may require someone to be present, and this may also be the time to perform any rituals.
Staying close to someone who is dying is often called keeping a vigil. It can be comforting for the caregiver or other family members to always be there, but it can also be tiring and stressful. Unless your cultural or religious traditions require it, do not feel that you must stay with the person all the time.
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.
Don't try to wake them. Let them sleep and wake on their own. Talk to your loved one. Your loved one can likely hear you, even if they look to be asleep.
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 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.
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.
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.
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.
These messages of the dying may be a symbolic way to ask for permission to die or to address an end of life need. Maybe they are looking for a way to say goodbye, or address an issue they regret. What is said often has meaning to the dying person and is linked to their own life experience.
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. In some cases, the person comes from a culture or a family in which death is simply not discussed.
“First hunger and then thirst are lost. Speech is lost next, followed by vision. The last senses to go are usually hearing and touch.”
Terminal agitation is typically seen during the hours or days before death and can be distressing and overwhelming for caregivers.
Seriously ill patients encountered by hospice and palliative care clinicians are at risk for thirst due to dehydration, electrolyte disturbances, hypotension, xerostomia, and immobility which can impede access to water.
The signs and symptoms of active dying include: Long pauses in breathing; patient's breathing patterns may also be very irregular. Blood pressure drops significantly. Patient's skin changes color (mottling) and their extremities may feel cold to the touch.
Your loved one should be turned and repositioned at least once every 2 hours.
For some people, the dying process may last weeks; for others, it may last a few days or hours.
Feeling very sad and crying often is a very normal part of the dying process. However, feeling down or depressed most of the time is not normal. Thinking a lot about death or suicide and feeling guilty or worthless are often signs of depression. Depression is common in people who are dying and should be treated.
About six minutes after the heart stops, the brain essentially dies.