I Am Living

Often, the dying body gives a clear indication of what is happening to it, namely, slowing and shutting down. Below we list some of these signals.

Please note that this is a general description of what may happen. It is important to note that not every signal described will be experienced by every person or in any particular order. It is possible that these signs will appear days or hours before death.

These physical signals are part of the natural process of the dying person’s body gradually slowing down and eventually shutting down. However, you may notice other changes you’re concerned about as well. Your health care team, and especially palliative care professionals, is available to offer support and information. They can also provide medicines and equipment which will assist the dying person in terms of comfort and hygiene. You can ask for their help at any time; they expect to spend more time with the people in their care, their family, friends, and caregivers during the dying process.

Appetite and thirst

Loss of appetite and thirst is a natural process which shows that the body is slowing down and less energy needs to be consumed as less energy is progressively being spent. It is not painful for the person. Feeding a person with swallowing difficulties may be distressing for them. Sips of water or a moistened mouth swab will help the dying person.

Breathing

It is possible for breathing patterns to change. Breathing may be fast, there may be long gaps between breaths, or it may be shallow and noisy. A slowing of the blood circulation and the accumulation of body waste products contribute to these conditions. It is not painful or distressing for the person.

Incontinence

Because the body is drinking less, less urine is produced, but it may become stronger in odor and darker in color. Dying persons may also lose control of their bladder and bowels. Pads, equipment, and special absorbent sheets can be used in these circumstances.

Restlessness

A decrease in blood flow to the brain and other changes in the body can cause restlessness or agitation. Try speaking to the dying person in a natural way. You may also gently massage the person’s hand or forehead, or play soothing, familiar music for a calming effect.

Secretions

Coughing and swallowing reflexes slow down, causing saliva and mucus to collect in the back of the throat, causing a gurgling, bubbling or other noise. This usually does not cause distress to the person You can support their head with pillows, so their head is turned to one side. Additionally, medications can be given to reduce the production of saliva and mucus to improve the person’s comfort.

Sleep and alertness

A person’s body may change, causing them to sleep a lot, be drowsy, or find it hard to wake up in the morning. It is best to speak softly and naturally to the person when they seem most alert, and to allow them to rest when they wish.

Temperature

A change in body temperature may occur. Sometimes, the person’s hands, feet, and legs may feel hot and clammy to the touch, while other times, they may feel cool. Parts of the person’s body may become blotchy and darker, because the blood circulation of the blood slows downs. This is a normal occurrence in the dying process. If the person feels cold, keep them warm with light bedding. If they have too many bed clothes or an electric blanket, they may feel hot and agitated. Cool them down by providing good room ventilation, circulate the air with a fan or use dam, cool damp towels.