Most of us don’t know what to expect when a person is close to death. The unfamiliar is often very scary, so understanding what may happen can help ease the fear and anxiety of the dying person, family and caregivers.
In general, as a person gets closer to death, their body functions start to slow down. But it’s important to understand that every situation is different. Having one or more of the signs below doesn’t necessarily mean that the person is close to death.
Breathing changes as death approaches. It may slow down or become quick and shallow. Sometimes breathing may stop for several seconds at a time and then start again. An irregular breathing pattern, called Cheyne-Stokes respirations, is common in people who are dying. In this pattern, breathing is very deep and rapid, followed by short breaths, and then a period of not breathing.
Mucus can pool in the back of the person’s throat, causing a rattling or gurgling sound while breathing. This noise can be very upsetting to family members and visitors, but the person is usually not aware of the sound.
The following can sometimes make breathing easier:
As people get closer to dying, they may sleep more, become drowsy or be difficult to wake. They may fall asleep while talking. A person may slowly lose consciousness in the days or hours before death.
When visiting someone with advanced cancer, it’s helpful to remember:
Sometimes, a person who is dying may become restless, anxious or confused. This confusion and disorientation is also called delirium.
People with delirium may not know loved ones or friends, what day or time it is, or where they are. Some people may see and speak to things that others can’t see (hallucinations), or start to worry about things. They may try to get out of bed or shift around in bed more. They may turn their sleeping cycle around so that they sleep during the day and are awake at night. A person with delirium may make jerking movements with their legs and arms, which they cannot control. They may also lose control of their bladder or bowels.
Delirium has many possible causes, including drugs, disease, brain metastases, changes in metabolismmetabolismThe chemical processes in the body that create and use energy. It includes breaking down food and transforming it into energy, eliminating wastes and toxins, breathing, circulating blood and regulating temperature. and infections. Delirium can develop quickly over a number of hours or days. If the underlying cause of the delirium can be found, the healthcare team will treat it.
Delirium can upset family members and caregivers, especially if the loved one becomes aggressive or unkind. Try to remember that people who have delirium aren’t aware of how they’re acting and their actions do not reflect their true feelings or beliefs.
It’s normal to feel uncomfortable or nervous around someone with delirium. Following these tips can help keep the person calm and safe.
The healthcare team may suggest medicines that can help reduce anxiety and make the person more comfortable.
As death nears, the body slows down. People don’t need as much food or fluids as before, so they don’t feel hungry or thirsty. It may go against your instincts, but try to let the person decide when and what they want to eat or drink.
A person nearing death may also have problems swallowing. Don’t force them to eat or drink if this is the case. Forcing them to eat or drink could cause choking or may increase their risk of a lung infection.
To keep your loved one comfortable, you can:
Some people may lose control of their bladder or bowels because muscles in the pelvis relax. Sometimes a tube (called a catheter) that drains urine is used. Urine may become darker and they may urinate less.
To keep your loved one comfortable, you can:
As death nears, the skin can change. It may look pale, blotchy or bluish. It may become thin, dry and flaky. There may be reddened areas over the joints of the hands and legs. Hands or feet may feel cool to the touch.
To keep your loved one comfortable:
Sometimes people who are near death have a brief and unexpected improvement. They are more alert and can interact with those around them. Family members might hope that this temporary improvement means that the person is going to get better, and that the prognosis was wrong. As hard as it is, it’s important to remember that these changes are only temporary and the person will get worse again.
This time could be used to share important feelings or thoughts with the dying person, and make a deeper connection in the final days or hours before death.
Within about 12 hours of being at Camp Goodtime, everything started to change, and that week was cathartic, transformative. It was the first time I got to know myself.
The Canadian Cancer Society is actively lobbying the federal government to establish a national caregivers strategy to ensure there is more financial support for this important group of people.