Signs That Death Is Near
Certain signs and symptoms can help a caregiver know when death is near. They
are described below, along with suggestions on how to manage them. It is
important to know that not every patient has all of them. Also, even if any of
the symptoms are present, it does not always mean that your loved one is close
to death. A member of the patient's health care team can give you more
information about what to expect.
Drowsiness, sleeping more, or being unresponsive: You and your family can plan
visits and activities for times when your loved one is alert. It is important
to speak directly to the patient and talk as if he can hear, even if there is
no response. Most patients are still able to hear after they are no longer able
to speak. Patients should not be shaken if they do not respond.
Confusion about time, place, and/or identity of friends and family members:
Your loved one may also seem restless, or have visions of people and places
that are not present Or she may see, hear, and talk to loved ones who have
died. She may pull at bed linens or clothing. Gently remind them of the time,
date, and people who are with them. Try to be calm and reassuring. These should
not be treated as hallucinations. You don't need to convince her that her
visions aren't real.
Being more withdrawn and less social: Speak to your loved one directly. Let him
know you are there for him. He may be aware and able to hear, but unable to
respond. Some experts say that giving the patient permission to "let go" can be
helpful.
Less need for food and liquids, and loss of appetite: Allow your loved one to
choose if and when to eat or drink. Ice chips, water, or juice may be
refreshing if she can swallow. Lip balm may help to keep the mouth and lips
moist.
Loss of bladder or bowel control: Keep your loved one clean, dry, and as
comfortable as possible. Place disposable pads on the bed beneath the patient
and remove them when they become soiled.
Dark urine or decreased amount of urine: You can ask a member of the health
care team about the need for a catheter. A member of the health care team can
teach you how to take care of it if one is needed.
Skin becomes cool to the touch or bluish in color: It's okay to use blankets to
warm your loved one. Avoid warming the patient with electric blankets or
heating pads, which can cause burns. Take comfort knowing that even though the
skin may be cool, the patient is probably not aware of feeling cold.
Rattling or gurgling sounds while breathing: These may seem loud or may seem
irregular and shallow. Your loved one may also breathe fast and then slow.
Turning his body to the side and placing pillows under the head and behind the
back may help. Although this kind of breathing may seem scary to you, it does
not cause discomfort to your loved one. An extra source of oxygen may help. If
he can swallow, ice chips also may help. A cool mist humidifier may help as
well.
Turning the head toward a light source: Leaving soft, indirect lights on in the
room may help.
Becoming harder to control pain: It is important to provide pain medicines as
your loved one's doctor has prescribed. You should contact the doctor if the
current dose does not seem to help. With the help of the health care team, you
can also look into methods such as massage and relaxation to help with pain.
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