Delirium is common during the final days of life. Most patients have a lower level of consciousness. They may be withdrawn, be less alert, and have less energy. Some patients may be agitated or restless, and have hallucinations (see or hear things not really there).
Not everyone approaching the end of life has pain. If you do, your doctor or nurse will assess the pain and decide on a suitable medicine and the correct dose to manage it. They'll ask you (or your family or carers, if you're not able to communicate) questions about the pain.
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.
One of the wildest innovations is “living funerals.” You can attend a dry run of your own funeral, complete with casket, mourners, funeral procession, etc. You can witness the lavish proceedings without having an “out-of-body” experience, just an “out-of-disposable-income” experience.
They might close their eyes frequently or they might be half-open. Facial muscles may relax and the jaw can drop. Skin can become very pale. Breathing can alternate between loud rasping breaths and quiet breathing.
Your heart no longer beats, your breath stops and your brain stops functioning. Studies suggest that brain activity may continue several minutes after a person has been declared dead. Still, brain activity isn't the same as consciousness or awareness. It doesn't mean that a person is aware that they've died.
It's normal to feel shock, sadness, anger and helplessness. But for some people, the feeling they're unable to cope with their situation does not go away, and they feel too low to be able to do any of the things they want to. If this happens to you and these feelings persist, it may be helpful to talk to a doctor.
The heart is the last organ to fail.
Muscle cells live on for several hours. Bone and skin cells can stay alive for several days. It takes around 12 hours for a human body to be cool to the touch and 24 hours to cool to the core. Rigor mortis commences after three hours and lasts until 36 hours after death.
Sometimes the breathing may be fast, and at other times there may be long gaps between breaths. Breathing may be shallow or noisy. This, too, is due to blood circulation slowing down and a build up in the body's waste products. It is not painful or distressing for the person.
Gasping is also referred to as agonal respiration and the name is appropriate because the gasping respirations appear uncomfortable, causing concern that the patient is dyspnoeic and in agony.
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.
Physical, mental, and behavioral changes are common. In the week or two before death, the dying process speeds up. They may start being confused and periodically not making sense. Their bodily process may slow down or become erratic, but the person may also appear restless.
Within one hour: Primary flaccidity (relaxation of muscles) will occur almost immediately followed by pallor mortis (paling of the skin). At two to six hours: Rigor mortis (stiffening of muscles) will begin. At seven to 12 hours: Rigor mortis is complete.
Livor mortis is defined as the first stage after death. It means "discoloration of death" or "wound of death" in Latin. Liver mortis occurs within 20 to 30 minutes after death and lasts for the first 12 hours.
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.
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.
The dying patient — In the last hours and days of life, cough can affect up to 80 percent of patients; contributory factors are asthenia, muscle weakness, and increased respiratory secretions.
Often before death, people will lapse into an unconscious or coma-like state and become completely unresponsive. This is a very deep state of unconsciousness in which a person cannot be aroused, will not open their eyes, or will be unable to communicate or respond to touch.
In the hours before death, most people fade as the blood supply to their body declines further. They sleep a lot, their breathing becomes very irregular, and their skin becomes cool to the touch. Those who do not lose consciousness in the days before death usually do so in the hours before.
We enter heaven immediately upon our death, or our souls sleep until the second coming of Christ and the accompanying resurrection.
If the person dies at home unexpectedly without hospice care, call 911. Have in hand a do-not-resuscitate document if it exists. Without one, paramedics will generally start emergency procedures and, except where permitted to pronounce death, take the person to an emergency room for a doctor to make the declaration.
Hospital staff will tell next of kin about the death
When a person dies in hospital the staff will contact the next of kin as soon as possible to let them know what's happened. You or someone else close to the person may need to go to the hospital to identify the person.