Signs of Approaching Death

What You Can Do To Comfort and Support

Greater Need for Sleep:  The person will tend to sleep more and more and may be hard to awaken.  This is a result of changes in the

body as it is slowing down.

Watch for times when your loved one is more awake.  Plan to do things and to talk with the person when he or she is more alert.

Increased Confusion:  A dying person may seem confused about time, place, and people.  Again, this

is a result of changes in the body.

Gently remind the person of the time and day.  Let him or her know who you are and who is nearby.  You may wish to bring in a few favorite items like pictures, a blanket, or music.

Loss of Control of Bowel and Bladder: Some people lose control

of body functions as death nears.  This is because the nervous system changes and the muscles weaken.

You and/or the staff will place pads under the person and change them often.  This adds comfort and helps prevent skin breakdown.  Please ask the staff about other skin care options.  The nurses may also place a catheter into the bladder to collect urine and to help avoid skin breakdown.

Changes in Skin Temperature

and Color.   Arms and legs may become cool to touch.  The

underside of the body may also darken as circulation slows down.

Use light covers and gently turn the person side to side every few hours to maintain comfort.  Heating pads or electric blankets should not be used.

Noisy Breathing:  The person who

is dying will likely be drinking less

and may not be able to cough up mucous as well.  It can collect in the back of the throat causing noisy breathing.

Turning the person on his side or raising the head of the bed can help.  Extra pillows may also be useful.  It may be helpful to suction the mucous.

Changes in Hearing and Vision: 

A person’s senses lessen as the nervous system slows.

You may want to keep lights on in the room during wakeful hours.  Talk with your family member or friend. Never assume the person cannot hear since hearing is the last sense to go.  Explain what you are doing.  Show your feelings.  Say the things you may not have yet said.  Encourage others to do the same.  Include children and older relatives; they may want or need to say good-bye in their own way.

Restlessness and Anxiety:  The patient may seem restless and pull

at the linens.  He may have visions you cannot see.  This can happen

as the blood flow slows and less oxygen reaches the brain.

Stay calm and speak slowly.  Offer simple reminders of the time, where he is, and who you are.  Music may be calming and sometimes medicine may be used.

Changes in Pain:  As death nears, there may be an increase or

decrease in pain.

Let your nurse or doctor know if the person’s pain seems to be increasing.  Ask for pain medicines as often as needed.  People do not die from too much pain medicine.  They die because the disease takes over the body.

Decreased Desire or Need for Food and Fluids:  The person you are close to may not take or want food or fluids as the need for these becomes less and may have a dry mouth

If the person can swallow, offer ice chips or a moist cloth to the lips.  Using a wet Q-tip, wipe inside the mouth and keep the lips wet with a lip balm.

Changes in Breathing Patterns:  There may be times when the

person breathes very fast or very slow, and may not breathe for a

few seconds.  This is usual as death approaches.

Raising the head of the bed or using pillows to prop him up may be helpful.

Changes in Urine:  There may

be less urine and it may change in color.  This can happen as the

kidney function slows.

A nurse may place a catheter in the bladder if the dying person is not able to use a bedpan or get up to the bathroom.