Dying persons may try to hold on until they feel a sense of security and completion. Picking, pulling, and fidgeting behaviors may also be seen. This can result from medications, metabolic changes, or decreased oxygen to the brain.
The care team may be able to help you identify what is happening and help discover a way for your loved one to find release from tension or fear. A dying person will try to hold on, even though it brings prolonged discomfort, in order to make sure those who are left behind will be alright.
Sometimes, dying people hold on to life because they sense that others aren't ready to let them go. Tell your loved one it's all right to let go when they're ready to do so. The assurance that you will be able to carry on—perhaps to help children grow or to fulfill another shared dream—may offer enormous relief.
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.
Little interest in the outside world – The dying person may gradually lose interest in people nearby. They may find it hard to concentrate and they may stop talking. Withdrawing is part of letting go.
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.
Patients may express their pain, anxiety, fear and suffering by crying.
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.
They may have a gasping quality to their breath, known as agonal breathing. Or, their lips will “puff” out with barely a breath, which is called fish out of water breathing. Ultimately, they will breathe their last breath, which may be followed by another one or two in the coming minutes. Their heart will stop.
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.
Go Ahead and Cry
It opens a pathway to a conversation that could be once in a lifetime. Additionally, the loved one who's dying knows others are sad. It could be worse for him or her to not see the family cry; tears are a sign of love and understanding of what's happening.
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.
Hearing is widely thought to be the last sense to go in the dying process. Now, the first study to investigate hearing in palliative care patients who are close to death provides evidence that some may still be able to hear while in an unresponsive state.
Another common end-of-life change is that people may not respond to questions and may also show little interest in their surroundings. Let your loved one sleep and remain peaceful. Offer reassuring words and touches, but don't pressure the person to interact.
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.
You can bring great benefit to a person dying, just by being there, sitting with them, holding their hand or speaking in a calm and reassuring way. These simple things should not be underestimated. Even when the person does not respond, they can probably hear you.
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.
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.
At the end-of-life. 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.
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.
Breathlessness and shortness of breath are also common symptoms at the end of life. Additionally, as dying patients get closer to their last day, they may experience what's known as the death rattle. Over time, mucus and fluids get trapped in your airways and lungs, causing a rattling sound when you breathe.
It can be linked to emotional, physical or spiritual distress. Terminal agitation means agitation that occurs in the last few days of life. You might also hear terminal agitation being described as terminal restlessness, terminal anguish, confusion at the end of life, or terminal delirium.
In that circumstance, palliative sedation doesn't accelerate death, he said. “For other patients who are not actively dying, it might hasten death to some extent, bringing it on in hours rather than days.” He emphasized, however, that in all cases the goal isn't death but relief from suffering.
It is perfectly normal not to cry when someone dies. There is no right or wrong way to grieve, and everyone deals with loss in their own way. It doesn't mean that you don't care, that you are cold, or that you are broken in any way. It simply means that you process your emotions in a different way.