Dying is a deeply personal and complex journey, marked by changes in the body’s physical, emotional, and spiritual attributes as it transitions towards the end-of-life. While dying symptoms vary from person to person and may be present for days, weeks, or even months, there are some common signals that healthcare providers and caregivers can recognise as indicators that the end-of-life may be approaching.
Most notably, the dying body often shows physical signs of slowing and shutting down. This is a natural process. Nevertheless, you may notice other changes you want to pay attention to as well. It is important to note that this is a general description of what may happen. The signals described will not necessarily be experienced by everybody or in any order and may appear at different times before death.
Your health care team, especially palliative care professionals, is available to provide information and support. They can also supply medicines and equipment as appropriate to help the dying person maintain their comfort and hygiene. At any time, you can seek their assistance and counsel. During the dying process they are likely to spend more time with those in their care as well as their friends, family, and caregivers.
By recognising these signs of dying, healthcare providers and caregivers can anticipate and respond to the evolving needs of patients and families with empathy, dignity, and respect during the dying process. Caregivers can facilitate a peaceful and meaningful transition for individuals by recognising and honouring the natural progression of the dying process. They can also offer comfort and support according to the patients values, wishes, and preferences, ensuring they receive love, comfort, and compassionate care.
Natural processes such as loss of appetite and thirst occur when the body slows down and requires less energy to function. People with swallowing difficulties may experience distress when fed. The dying person will benefit from sips of water or a moistened mouth swab. Please note that the individual does not experience any pain because of this.
The individual breathing patterns may change. Breathing may be fast, have long gaps between breaths, or be shallow and noisy. The slowing of blood circulation and the accumulation of waste products in the body contribute to these changes. Fortunately, it is not painful or distressing for the person.
As people drink less, less urine is produced, but it may have a stronger odour and darker colour. It is also possible for dying people to lose control of their bladders and bowels. In these cases, pads, equipment, and special absorbent sheets can be used.
Changes in the body may sometimes cause restlessness or agitation due to decreased blood flow to the brain. A natural way to comfort a dying person is to speak to them in a soothing way, gently massaging their hand or forehead, or playing soothing, familiar music.
As coughing and swallowing reflexes slow down, saliva and mucus accumulate in the back of the throat, causing gurgling, bubbling, or other sounds. Usually, this is not distressing to the person. You can prop their heads up with pillows so they can turn their heads to one side. If deemed helpful, the person may be given medications that reduce the production of saliva and mucus to help improve their comfort level.
As a result of changes in the body, a person might sleep often, be drowsy, or have trouble waking up in the morning. When the person seems most alert, you may speak to them softly and naturally, and let them rest when they are ready.
People may experience changes in their body temperature – sometimes their hands, feet, and legs may feel hot and clammy, while other times, they may feel cool. Make the person feel comfortable and warm by providing them with light bedding if they feel cold. If they have too many bed clothes or an electric blanket, they may feel hot, uncomfortable or agitated. You can cool people down as necessary by providing good ventilation in the room, circulate the air with a fan, or using cool damp towels. Because the blood circulation slows down, parts of the person’s body may become blotchy and darker. This is a normal occurrence in the dying process.