Signs of Impending Death

 

The "Hands of Time"

Signs of Impending Death

The Duke Family Support Program's "Tool Kit for Alzheimer's" offers information on the signs of impending death. Those signs are listed below with slight modifications to include all individuals approaching death.

"The following signs and symptoms of impending death may help families understand the natural changes that happen during the dying process and how to best respond. As each person is unique, all of these signs and symptoms will not occur with everyone, nor will they occur in this particular sequence." This information is intended to help with the natural worry and fear that often accompanies approaching death.

 

Decreased Food and Fluids and Related Effects
As the body no longer desires or tolerates food and fluids, the person normally eats and drinks less. The person loses weight, and skin becomes thin and tears easily. Urine output decreases and urine becomes more concentrated. Swallowing problems and choking are common; proper positioning can reduce choking.

  • Never force food or fluids.
  • Use glycerin swabs to keep the mouth and lips moist.

Increased Sleeping and Withdrawal
The person may spend more time sleeping at the end of life or withdraw by closing his or her eyes.

  • Never assume that the person cannot hear what is being said in the room.
  • Sit with the person, hold his or her hand gently; speak softly and naturally.

Incontinence
People with end-stage dementia lose control of the bladder and of bowels.

  • Reposition and change pads frequently to avoid use of disposable undergarments.

Breathing Pattern Change and Congestion
Breathing may become shallow, irregular, fast, or abnormally slow. Changes in breathing patterns or irregular shallow breathing patterns may cause a moaning-like sound when individuals exhale. Congestion is common.

  • Try elevating the person’s head by raising the head of the bed or by using pillows.
  • Turn the person’s head to the side.

Changes in Temperature and Skin Color
The person’s arms and legs may become cold, hot, or discolored.

  • Keep the person warm if they appear cold, but do not use electric blankets.

Restlessness and Disorientation
The person may make restless and repetitive motions such as pulling at sheets or clothing or calling out repetitively. He or she may groan, scream, or mumble loudly. The person may have visions or call out to people long dead and become increasingly confused about his or her identity and the identity of loved ones.

  • Hold the person’s hand or gently massage the forehead.
  • Talk reassuringly, read to the person, or repeat favorite prayers or music.

At the Time of Death
At the time of death, breathing ceases, heartbeat ceases, the person cannot be aroused. The eyelids may be partially open with the eyes in a fixed stare, the mouth may fall open, and bowel and bladder contents may be released as the body relaxes.

  • When the death occurs, take time to call a supportive person to be with you before making other calls.

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What is a "Deathbed Vision"?

When a family member is close to death or has immediately passed on, other family members may experience dreams or visions where the person close to death "visits" them to reassure them or comfort them. Sometimes, the person near death will report that they have seen relatives who have already passed on or that they see angels. Accounts are that they are there to escort the dying person to "the other side".

 

Hands Reaching

 

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