What to expect when someone is dying – Death usually comes gradually and peacefully.

While the dying process is unique to each person there are many common changes that indicate life is coming to an end.

Many families have questions about what happens in the final days of life.

In this article, you will learn about the signs we usually see before death. Some of these signs start to appear a few hours before but some can appear many days before a person dies.

We hope by knowing what to expect, you will be comfortable to continue providing the care and support which has helped your loved one during their illness.

The dying process is unique to each person, but in most cases, there are common signs or changes that can indicate a person is dying.

Death usually comes gradually and peacefully and there are many changes that indicate life is coming to an end.

Most changes that occur at this time are normal and often don't need special treatment, hospitalisation or professional help.

Please talk to a doctor or nurse if you are unsure or concerned about anything.

Here are some of the changes that may occur when a person is dying:

Not eating and drinking

Eventually there will come a time when food and drink are neither wanted or needed. This can be hard to accept but a loss of appetite is a signal that the person is not going to get better.

The swallowing reflex may become slow and eating and drinking can become difficult.

Don't pressure the person to eat or drink but be guided by their wishes.

Caring can be continued in other ways. Moisteingn the mouth (using mouth swabs moistened with cool water) may be all that is needed.

Changes in awareness

As weakness increases, the person may spend more time in bed and have less interest in their surroundings. From a very sleepy state they may lapse into a coma or unconsciousness. This may last for a very short time or for several days.

Breathing

It is very common for the breathing patterns to change. There may be gaps of seconds or minutes between breathes, with the gaps getting longer. There may be periods of shallow rapid panting.

In the last hours of life there may be a noisy rattle to the breathing. It is caused by a build up of mucus in the chest that the person is unable to cough or clear. This is not usually distressing for the person who is dying but it might be for you. Medication and/or a change of position may help.

Incontinence

There may be a loss of control of the bowel and bladder. Absorbent pads and wet wipes will be useful to keep the person clean and comfortable.

Increased confusion and restlessness

You may notice increased restlessness. The person may pull at the bed clothes, or try to get out of bed when they are too weak to stand, or be muddled in their thinking and conversation.

Try to reassure the person by talking calmly, saying who you are, and holding their hand. Keep the environment calm and peaceful and allow the person to sleep if they can.

Sometimes medication may be needed to calm and soothe restlessness.

Changing colour/temperature

The body temperature can change. You may notice the person's arms and legs feel cool and clammy and possibly look mottled and dark in colour. This does not necessarily mean they are feeling cold. Occasionally the person's skin can feel hot.

How will you know the person has died?

- no breathing or heartbeat

- the person cannot be roused

- eyes are fixed on a certain spot, pupils are enlarged, and eyelids may be open

- jaw relaxes and mouth stays open

- possible loss of control of bladder and bowel movement.

What do you do when someone has died?

You do not have to do anything straight away. You can take your time and collect your thoughts.

The person may be washed and dressed in fresh clothing. There may be certain clothing and possessions that you wish to stay with them.

You may want the help of your spiritual support person at this time. You could call him or her for assistance. Or you may want family/whanau or friends to be with you to give you support.

When you are ready, you will need to call a funeral director who will guide you through what you need to do and the funeral arrangements.

Your Doctor will sign the Death Certificate. You may have been given a phone number to contact hem if it is after hours. Otherwise the funeral director will help make arrangements to contact the doctor to prepare the death certificate.

Although one journey may be finishing the journey for you will continue.

There are a range of bereavement and counselling support services available to support you:

- Mary Potter Hospice staff on (04) 801 0006

- Skylight (Wellington) on 0800 299 100

- Your General Practitioner.

- Counsellors or psychotherapists in private practice.

- Maori heath organisations.

- Counselling services provided by your employer.

- Literature – there are many good books and information available through counsellors, chaplains, bookshops, libraries and the internet.

Mary Potter Hospice acknowledges the original work of the previous National (NZ) LCP Office which information the information in this article.

For more information on Support Services or further Articles and Resources see the links below.

Go to Support Services       Go to Articles and Resources