10 Signs Death Is On Your Doorstep

10 Signs Death Is On Your Doorstep    

    By Paula Spencer Scott,  Caring.com senior editor

No one can predict the moment of death.   But physicians and nurses involved in end-of-life care know that   certain symptoms are usually associated with the body's shutting down.   These signs of approaching death are specific to the natural dying   process (apart from the effects of particular illnesses the person may   have).
Not all dying symptoms show up in every person, but most people   experience some combination of the following in the final days or hours:

1. Loss of appetite

Energy needs decline. The person may begin to resist or refuse meals   and liquids, or accept only small amounts of bland foods (such as hot   cereals). Meat, which is hard to digest, may be refused first. Even   favorite foods hold little appeal.
Near the very end of life, the dying person may be physically unable to swallow.
How to respond: Don't force-feed; follow the person's cues   even though you may be distressed by a loss of interest in eating.   Periodically offer ice chips, a popsicle, or sips of water. Use a   moistened warm cloth around the mouth and apply balm to the lips to keep   them moist and comfortable.

 2. Excessive fatigue and sleep

The person may begin to sleep the majority of the day and night as   metabolism slows and the decline in food and water contribute to   dehydration. He or she becomes difficult to rouse from sleep. The   fatigue is so pronounced that awareness of immediate surroundings begins   to drift.
How to respond: Permit sleep. Avoid jostling the person   awake. Assume that everything you say can be heard, as the sense of   hearing is thought to persist, even when the person is unconscious, in a   coma, or otherwise not responsive.
   3. Increased physical weakness
A decline in food intake and lack of energy leads to less energy,   even for activities like lifting one's head or shifting in Bed . The   person may even have difficulty sipping from a straw.
How to respond: Focus on keeping the person comfortable.

4. Mental confusion or disorientation

Organs begin to fail, including the brain. Higher-order consciousness   tends to change. "Few conditions leave people hyperaware when they're   dying," says palliative-care physician Ira Byock, author of Dying Well.
The person may not be aware of where he or she is or who else is in   the room, may speak or reply less often, may respond to people who can't   be seen in the room by others (see Passing Away: What to Expect When Witnessing a Loved One's Death), may seem to say nonsensical things, may be confused about time, or may act restless and pick at Bed linens.
How to respond: Remain calm and reassuring. Speak to the person softly, and identify yourself when you approach.

5. Labored breathing

Breath intakes and exhales become raggedy, irregular, and labored. A   distinctive pattern called Cheyne-Stokes respiration might be heard: a   loud, deep inhalation is followed by a pause of not breathing (apnea)   for between five seconds to as long as a full minute, before a loud,   deep breath resumes and again slowly peters out.
Sometimes excessive secretions create loud, gurling inhalations and exhalations that some people call a "death rattle."
How to respond: The stopped breathing or loud rattle can be   alarming to listeners, but the dying person is unaware of this changed   breathing; focus on overall comfort. Positions that may help: the head   slightly elevated with a pillow, sitting up well-supported, or the head   or lying body tilted to the side slightly. Moisten the mouth with a wet   cloth and moisturize with lip balm or petroleum jelly.
If there's a lot of phlegm, allow it to drain naturally from the   mouth, since suctioning it out can increase its quantity. A vaporizer in   the room might help. Some people are given oxygen for comfort. Be a   calm, physical presence, stroking the arm or speaking softly.

6. Social withdrawal

As the body shuts down, the dying person may gradually lose interest   in those nearby. He or she may stop talking or mutter unintelligibly,   stop responding to questions, or simply turn away.
A few days before receding socially for the last time, the dying   person sometimes surprises loved ones with an unexpected burst of alert,   attentive behavior. This can last less than an hour or up to a full   day.
How to respond: Be aware that this is a natural part of the   dying process and not a reflection of your relationship. Maintain a   physical presence by touching the dying person and continuing to talk,   if it feels appropriate, without demanding anything back. Treasure an   alert interlude if and when it occurs, because it's almost always   fleeting.

7. Changes in urination

Little going in (as the person loses interest in food and drink)   means little coming out. Dropping blood pressure, part of the dying   process (and therefore not treated at this point, in tandem with other   symptoms), also contributes to the kidneys shutting down. The   concentrated urine is brownish, reddish, or tea-colored.
Loss of bladder and bowel control may happen late in the dying process.
How to respond: Hospice   medical staff sometimes decides that a catheter is necessary, although   not in the final hours of life. Kidney failure can increase blood toxins   and contribute to a peaceful coma before death. Add a Bed pad when   placing fresh sheets.

 8. Swelling in the feet and ankles

As the kidneys are less able to process bodily fluids, they can   accumulate and get deposited in areas of the body away from the heart,   in the feet and ankles especially. These places, and sometimes also the   hands, face, or feet, take on a swollen, puffy appearance.
How to respond: Usually no special treatment (such as   diuretics) is given when the swelling seems directly related to the   dying process. (The swelling is the result of the natural death process,   not its cause.)

  9. Coolness in the tips of the fingers and toes

In the hours or minutes before death, blood circulation draws back   from the periphery of the body to help the vital organs. As this   happens, the extremities (hands, feet, fingers, toes) become notably   cooler. Nail Beds may also look more pale, or bluish.
How to respond: A warm blanket can keep the person   comfortable, or he or she may be oblivious. The person may complain   about the weight of coverings on the legs, so keep them loose.

10. Mottled veins

Skin that had been uniformly pale or ashen develops a distinctive   pattern of purplish/reddish/bluish mottling as one of the later signs of   death approaching. This is the result of reduced blood circulation. It   may be seen first on the soles of the feet.
How to respond: No special steps need to be taken.

Note: These general signs of impending death can vary in   sequence and combination from person to person. If a person is on life   support (respirator, feeding tube), the process dying follows can be   different. The signs of death listed here describe a natural dying   process.


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