Signs of Impending Death
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.
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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.
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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.
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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.
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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.
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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.
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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".
