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.
They Know They're Dying
Dying is a natural process that the body has to work at. 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.
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.
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.
Even when vascular collapse is the primary event, brain and lung functions stops next. The heart is the last organ to fail.
No – not everyone gets pain in their last weeks, days or hours of life. Some people have no pain at all. However, we know that many people with a terminal illness do experience pain. For people who are in pain, there are different things that can help including medication, support and other practical things.
Irregular breathing, panting and periods of not breathing may occur. Changes in breathing are very common and indicate a decrease in circulation to the internal organs. While these changes are not usually bothersome to the patient, they can be distressing to family members. Elevating the head may provide relief.
Individual experiences are influenced by many factors, including the person's illness(es) and medications, but there are some physical changes that are common. For some people, the dying process may last weeks; for others, it may last a few days or hours.
This difficult time may be complicated by a phenomenon known as the surge before death, or terminal lucidity, which can happen days, hours, or even minutes before a person's passing. Often occurring abruptly, this period of increased energy and alertness may give families false hope that their loved ones will recover.
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.
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.
The pain is caused by the overwhelming amount of stress hormones being released during the grieving process. These effectively stun the muscles they contact. Stress hormones act on the body in a similar way to broken heart syndrome.
If your loved one in hospice care becomes nonverbal and unresponsive, it's easy to believe the misconception that they can't hear you. A recent study, however, reveals that hearing is the last sense that remains for dying patients.
Studies indicate that hearing is the last of the senses to be lost. We therefore encourage you to continue to talk to the person even if they appear to be unconscious.
In line with their decreasing appetite, dying people may also have reduced bowel movements or have difficulty urinating and passing waste. It's also common to experience incontinence over time—usually due to a terminal illness or surgery.
It is normal to have less energy as you approach the end of your life. You may find you need help to do things you usually do for yourself. You may also need to rest more. Tiredness and weakness can make it harder for you to focus or take part in what is going on around you.
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.
According to a research most hospital deaths occur between 3am to 4am. This is the time in a day when the body tries to prepare for the activities of the next day while the brain tries to dispose some information to give space to the future happenings of the next day.
Generally, when one is transitioning, they likely have days — or even weeks — to live. I have seen some patients completely skip the transitioning phase and some stay in it for weeks. When a patient is transitioning, they are typically bedbound due to exhaustion, weakness, and fatigue.
It quite often gives the patient comfort when they are reaching up and smiling. Speaking to loved ones who have died before them. Now there is reaching and grabbing in an agitated state for which then it is a different ball game and they need to be treated for terminal agitation.
Mottling of skin before death is common and usually occurs during the final week of life, although in some cases it can occur earlier.
Terminal restlessness generally occurs in the last few days of life.
Humans have an instinctive desire to go on living. We experience this as desires for food, activity, learning, etc. We feel attachments to loved ones, such as family members and friends, and even to pets, and we do not want to leave them.