Signs of Dying - How to Tell When Death is Near

Signs of Dying - How to Tell When Death is Near


Signs
of Dying - How to Tell When Death is Near




Many times caregivers for the dying want to know what signs they
can look for that hint at approaching death. Although there is no
absolute progression of stages that the dying go through, there are some
signs that you can watch for to know that death is near. There are two
main phases that the dying go through prior to actual death. The first
stage is called the pre-active phase of dying and the second phase is
called the active phase of dying. It is important to understand that not
all patients will clearly exhibit these stages –this is just a
guideline. The signs that the dying person exhibits will be heavily
dependent on the nature of the illness or physical condition of the
patient. The pre-active phase of dying may last weeks or months, while
the active phase of dying is much shorter and lasts only a few days, or
in some cases a couple of weeks.
Signs of Dying — Pre-active Phase

• Subject withdrawals from social activities and spends more time
  alone or at home
  
• Subject speaks of “tying up loose ends” and may be concerned with
  finances - wills, trusts, insurance
  
• May show a desire to speak to family and friends and make amends or
  catch up
  
• Increased anxiety which can result in restlessness, the inability to
  get comfortable, confusion, agitation and nervousness
  
• Loss of interest in daily activities
  
• Increased inability to heal from bruises, infections or wounds
  
• Loss of interest in eating or drinking
  
• Increased periods of inactivity, lethargy or sleep
  
• Subject may begin to speak about dying, state they are going to
  die or ask questions about death
  
• May state that they see people who are already dead
  
• Edema - the swelling of the body or extremities with fluid
  
• Apnea - subject may experience periods where breathing stops for
  several seconds before starting again. This can happen while awake or
  sleeping
  
• The dying may request to speak with a religious leader or show
  increased interest in praying or repentance
  

Signs of Dying — Active Phase

• Major changes in respiratory health buildup of fluid in the lungs,
  congestion, longer periods of apnea, and abnormal breathing patterns
  such as cycles of slow then fast breathing
  
• Subject states that he or she is going to die soon
  
• Difficulties swallowing liquids or the resistance of all food and
  drink
  
• Marked changes in personality, acting wildly, severe agitation or
  hallucinations
  
• Increased difficulty waking subject from sleeping, the inability to
  arouse them at all, or a coma-like state
  
• Subject is unresponsive or cannot speak
  
• Subject does not move for longs periods of time
  
• The extremities — hands, feet, arms and legs — feel very cold to
  touch. Subject may say that they are numb or cannot felt at all
  
• Mottling of the arms, legs, hands and feet giving a blue or purple
  splotchy appearance to the skin
  
• Decrease in urination with urine darkening in color or changing
  colors
  
• Urinary or bowel incontinence
  
• A continued drop in blood pressure to 20 to 30 points below normal
  range or a systolic pressure below 70 with a diastolic below 50 points
  
• Loss of hearing, feeling, smell, taste or sight at the final stage
  
  
  Often, the dying can sense people in the room or hear
  you speaking to them up to the very end. Talking to the dying can
  comfort even if you don’t think they hear you. Your presence is felt and
  that can help the dying feel less afraid or alone. It is important to
  be supportive of the dying and loving. The Dalai Lama’s book, “Advice on
  Dying: And Living a Better Life” states that the soul is aware of its
  surroundings and crying or grieving should be avoided while in the room
  with the dying. The goal is to provide the dying with a warm and
  relaxing atmosphere to die in peace and hearing their loved ones crying
  and depressed can cause sadness, fear or anxiety for the dying. Always
  have someone by the dying person’s side, if possible. Friends and family
  members can take turns so no one person gets too tired. Please remember that all people will not share these signs, as each
  person’s death is as individual as they are. These signs of death are
  merely a guide to what may or often happens. If you suspect that death
  is nearing it is important to be vigilant. Death can occur very suddenly
  or at any time. If your loved one wants someone with them when they
  die, it is important to keep watch as things can progress rather
  quickly. Some go through few signs and die within minutes of a change
  being noticed. It is best not to delay or put off visiting.First published on about.com for The New York Times. © Death and
  Dying Online. All rights reserved. No part of this article may be
  reproduced without the written consent of the author.