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.
Writing in Palliative Care Perspectives, his guide to palliative care for physicians, he said: “First hunger and then thirst are lost. Speech is lost next, followed by vision. "The last senses to go are usually hearing and touch.”
Gasping is a brainstem reflex; it is the last respiratory pattern prior to terminal apnoea. 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.
Your loved one may sleep more and might be more difficult to awaken. Hearing and vision may decrease. There may be a gradual decrease in the need for food and drink. Your loved one will say he or she doesn't have an appetite or isn't hungry.
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.
This can include wandering attention, aimlessness, and outbursts of emotion. There's no set type of terminal restlessness, however, and this can sometimes make it difficult or even impossible to predict how a patient experiencing symptoms such as terminal agitation may act.
End-of-life transition refers to a person's journey to death, especially in those with a terminal diagnosis. This process occurs differently for everyone. For some, it takes days or weeks; for others, it occurs rapidly. Partnering with a trusted medical team during this time can limit pain.
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.
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.
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.
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.
It is best to think of the decedent's belongings, paperwork, and assets as “frozen in time” on the date of death. No assets or belongings should be removed from their residence. Their vehicle(s) should not be driven. Nothing should be moved great distances, modified, or taken away.
As the blood pools, patches appear on the skin within 30 minutes of death. About two to four hours postmortem, these patches join up, creating large dark purplish areas towards the bottom of the body and lightening the skin elsewhere. This may be less apparent on darker skin. This process is called livor mortis.
Anecdotally, some may report that they've smelled a certain odor when a loved one or patient was near death, while others haven't had the same experience in the presence of someone in the process of dying. Under certain circumstances, some odors will be produced prior to dying, as well as shortly afterwards.
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.
“Our data shows that a dying brain can respond to sound, even in an unconscious state, up to the last hours of life.”
'Peaceful' refers to the dying person having finished all business and made peace with others before his/her death and implies being at peace with his/her own death. It further refers to the manner of dying: not by violence, an accident or a fearsome disease, not by foul means and without much pain.
Will I regret not visiting a dying loved one? You know that time is short with your friend or family member. Once they have passed on, you won't have another opportunity to spend time with them again. Not visiting a terminally ill loved one when you had the chance can lead to lingering guilt.
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.
Death: how long are we conscious for and does life really flash before our eyes? About six minutes after the heart stops, the brain essentially dies.
Talk about memories and accomplishments. Share memories of joyous occasions. Start the conversation with, “Remember when …” Listen and be attentive while the dying person is sharing.
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.
Your loved one may seem to be working hard to breathe -- even making a moaning sound. The moaning sound is just the sound of air passing over very relaxed vocal cords. This indicates that the dying process is coming to an end.
Depression
This is the longest stage because people can linger in it for months, if not years. Depression can cause feelings of helplessness, sadness, and lack of enthusiasm.