Transitioning is the first stage of dying. It describes a patient's decline as they get closer to actively dying. 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.
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.
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.
Hours Before Death Symptoms
In the final hours of life, your loved one's body will begin to shut down. Their circulatory and pulmonary systems will slowly begin to fail. This may lead to falling body temperatures, but may also cause sudden outbursts.
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.
Transitioning is the first stage of dying. It describes a patient's decline as they get closer to actively dying. 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.
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.
Depending on the nature of the illness and your loved one's circumstances, this final stage period may last from a matter of weeks or months to several years. During this time, palliative care measures can help to control pain and other symptoms, such as constipation, nausea, or shortness of breath.
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. Patients appear comforted by the sounds of their loved ones (in person and by phone).
Last Stage of Dying
During the final stage of dying, disorientation and restlessness will grow. There will be significant changes in the patient's breathing and continence.
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.
As a person approaches death, their vital signs may change in the following ways: blood pressure drops. breathing changes. heartbeat becomes irregular.
Terminal agitation is typically seen during the hours or days before death and can be distressing and overwhelming for caregivers.
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.
The duration of the gasping respiration phase varies; it may be as brief as one or two breaths to a prolonged period of gasping lasting minutes or even hours.
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.
Your loved one may become restless and pull on bed linens or clothing, hallucinate, or even try to get out of bed, due to less oxygen reaching their brain. Repetitive, restless movements may also indicate something is unresolved or unfinished in the person's mind.
This is due to a lack of oxygen attributed to labored breathing and the eventual cessation of breathing. The kidneys aren't able to process fluids as before and will also shut down during the dying process. The heart and lungs are generally the last organs to shut down when you die.
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.
Days Before End of Life
It's usually at this point when you hear the death rattle, and your loved one starts coughing more frequently due to respiration problems. While these may sound alarming, they're generally painless for the person. Some people may experience a sudden burst of energy one day before death.
When someone is nearing the end of life, they experience a variety of symptoms. Pain, shortness of breath, anxiety, incontinence, constipation, delirium, and restlessness are just a few signs that a loved one is going through the dying process.
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.