Even if you've had months to prepare, it's natural to feel anxious and afraid when someone you love is dying. Will it be painful for him? Will she be scared? Will you be able to handle watching your loved one die? And how will you know when death is near?
If you're the caregiver, knowing the signs to look for as your loved one enters the final days of life will help prepare you for what's to come.
- Decreased activity and socializing. Your loved one will become less active and may not want more than a few visitors at once. He may have trouble talking and will probably speak less frequently.
- Restlessness. She may pull at sheets or kick off covers. She may see people or things that aren't there. Listen to her and don't argue with or contradict her.
- Less interest in food and water. Let him eat whatever he wants. Don't force food or fluids. Swallowing may become hard to do, so offer him ice chips or ice pops. Apply lip balm or petroleum jelly to his lips. Although dehydration will begin, this will not cause pain.
- Sleeping. Your loved one will sleep often and may be difficult to awaken. Never assume that she can't hear you. Hearing is the last sense she'll lose, so hold her hand and speak softly. Never say anything in front of her that you wouldn't say if she were awake. Play soft music, read to her or hold her hand.
- Confusion. Your loved one may become confused. Tell him who is in the room with him and what day or time it is.
- Incontinence. As muscles begin to relax, your loved one may lose control of her urine and bowels. Disposable underwear and bed pads can help keep her clean and comfortable.
- Decreased urination. Drinking less causes poor kidney circulation. Your loved one will urinate less and his urine will become darker.
- Change in skin color. The arms and legs can become cold and turn blue because blood will be circulating mostly to the most vital organs. Keep your loved one warm, but don't use electric blankets.
- Abnormal breathing patterns. Your loved one may breathe abnormally fast or more slowly than normal. At times, she may seem to stop breathing. Air passing over her relaxed vocal cords may cause a moaning sound. Although this may sound disturbing, the person isn't suffering.
- Congestion. As your loved one becomes unable to cough up secretions, you may hear loud gurgling sounds. Lift up the head of the bed to help drain the secretions.
- Drop in body temperature. Your loved one's body temperature may drop by a degree or more.
Coma and death
Once your loved one is in a coma, death can occur in minutes or hours. It's important that family members let him know he no longer needs to hold on. Having them say their personal goodbyes will reassure him that it's OK to let go. You will know this has occurred when his heartbeat and breathing cease, his eyes become fixed and his jaw relaxes.
Although your loss will be extremely difficult, you can find comfort in knowing that you provided the very best of care in your loved one's final days.
Created on 05/29/2007
Updated on 08/04/2010
- Hospice Foundation of America. End of life info.
- National Cancer Institute. End of life care: questions and answers.