Death and Dying: What to Expect
Navigating the final days and moments of a loved one's life can be an immensely challenging and emotional journey. Understanding what to expect during this time can provide some measure of comfort and support.
Here, we offer insights into the process of death and dying, aiming to provide information and guidance for those facing this difficult reality.
Each person is unique therefore not all these signs/symptoms may occur, nor will they be in the same sequence. It is hard to predict when a person will die and sometimes it seems that the person is lingering on. Although it may appear distressing, it is useful to know that most of the time the patient is not in any pain, and it is just a part of the dying process.
We know this is a difficult time and encourage you to care for yourself and accept the support of friends, family and staff. Caring for your loved one is of the utmost importance to us, and we are here to explain, support and care.
The Final Days:
Physical Changes:
The body often begins to shut down gradually. This can manifest in decreased appetite and thirst, and increased fatigue. The body does not need much energy at this time and the digestive system cannot easily process foods or fluids. If they stop drinking it may be because it is too much effort – you can help someone with a dry mouth by offering drinks through a straw (do not give fluids if the person coughs soon after they swallow), moistening the mouth with a damp sponge, or by placing ice chips in their mouth (providing they are conscious and can still swallow).
Arms and legs may become cold, hot, or discoloured. The underside of the body may become discoloured as circulation decreases. This is a natural change indicating that the falling circulation is supporting only the most vital organs. Apply warmth if the person feels or appears cold, but do not use an electric blanket. If they continually remove the covers, then allow just a light sheet or use a fan.
Emotional and Spiritual Shifts:
Alongside physical changes, individuals may experience emotional and spiritual transformations. They may become more reflective, peaceful, or withdrawn as they prepare for the end of life. It's essential to provide emotional support and validation during this time - Reassuring them that they can let go and not worry about you may be a significant gift. Your help may be needed to arrange spiritual or religious practices, visits of friends, family or by listening to your loved one.
Increased Sleepiness:
Your loved one may spend an increasing amount of time sleeping and appear to be uncommunicative, unresponsive, and at times difficult to rouse. This is a natural part of the body's decline and can offer relief from discomfort. Sit and hold their hand, speak softly and naturally - never assume that they cannot hear or feel, as we do not know how well the senses function at this stage of life.
Pain and Symptom Management:
Pain and other symptoms such as nausea, shortness of breath, confusion or restlessness can arise. Healthcare providers can offer medications and other interventions to manage these symptoms effectively and enhance comfort where necessary.
The Last Moments:
As someone approaches the final moments of life, their body typically undergoes further changes as it prepares for the final stage of the dying process:
Changes in Breathing:
The regular breathing pattern may change when someone is close to death. A particular pattern consists of breathing irregularly with shallow respirations, or periods of no breathing for 5 to 30 seconds, followed by a deep breath. Sometimes there is a moaning-like sound on exhaling. This is not distress, but the sound of air passing over relaxed vocal cords. These patterns are very common and indicate a decreased circulation in the part of the brain that controls breathing.
Breathing may become loud and noisy if mucous has built up in the airways – it can often sound like a percolator. These sounds are from mucus that would normally be cleared if they were more alert or awake. It is often referred to as the "death rattle" and is a natural part of the dying process. It can be distressing or upsetting for those around to hear, but it is not distressing for the person.
Holding hands, speaking gently and reassuring them may be all that is required to provide comfort.
Decreased Responsiveness:
The individual may become less responsive to stimuli and may eventually lose consciousness altogether. It's essential to continue offering comfort and reassurance, even if they cannot respond verbally.
Moments of Clarity:
Despite decreased consciousness, some individuals experience moments of clarity or lucidity in the final hours or minutes of life. These moments can be precious opportunities for connection and closure.
Physical Changes:
In the moments leading up to death, the body's vital functions gradually decline until they cease altogether. Loved ones may notice a profound sense of peace or a serene expression on the individual's face as they pass away.
At the time of Death
- Breathing ceases
- Heartbeat ceases
- Unrousable
- The eyelids may be partially open with the eyes in a fixed stare
- The mouth may fall open as the jaw relaxes
The body will remain soft and warm for some time. You can touch and hold your loved one if this is what you wish to do. Some people like to stay after death and others do not. Spend as much time as you feel you need.
You will need to speak to a funeral director after the death, but contact does not have to be immediately. It is always helpful if you have made arrangements with a funeral home prior to the death so that you know who to call, especially at a time when you are feeling stressed.
Bereavement Support
The care we provide does not stop once a loved one has died, it simply extends itself to family, friends and carers and aims to help you adjust to a new way of living.
