What does dying look like
This handout is to give you some basic information about what physical signs and symptoms that happen for a child who is dying.
• Going in and out of levels of consciousness.
• Decreased senses, blurred vision.
• Nearing death awareness*
*Nearing death awareness is a special knowledge that a dying person has that death is near. It can sometimes be confused with hallucinations.
Things to do to help: Remind children of where they are and who is with them. Keep personal things close (blankets, stuffed animals, favorite toys or books). Keep the setting calm and peaceful. Remember likes and dislikes; around touch, music, TV, cartoons and movies. Always believe children can hear everything. Even if the child is not answering, keep talking. Talk softly and try not to ask questions that need answers if the child is not able to talk. Medicines like lorazepam can be helpful.
• Hands, feet, or legs cool or cold to touch
• Underside of the child’s body may look darker
• Blood pressure slowly decreases
• Heart rate may increase and become weak and irregular
• Fingers earlobes, lips and nail beds may look bluish or light gray
• Mottling on knees or feet (a sign that death is very near)
• Bleeding, depending on the disease (leukemia)
• The child may or may not have a fever
Things to do to help: use light covers; prepare for the child’s skin to feel cold; gently turn the child every 2 hours for comfort. Heating pads or electric blankets should not be used as children can’t tell if they are too hot. If there is bleeding use dark sheets.
• Increased secretions and congestion-which may cause a rattling sound
• Irregular rate of breathing. A pattern may be to stop breathing for 5-30
seconds; then breathe slow and shallow, then faster and deeper, and then
• Some children look as if they can’t get enough air. This is called air hunger.
Things to do to help: Use pillows or elevate head of bed. Position the child on their side. A fan blowing may help air hunger. The rattling sound of breathing does not typically bother the child, but sounds like it does. Medicines to help dry secretions like-scopalamine patch or atropine may help. Oxygen and suctioning do not help.
• Decreased appetite
• Decreased thirst.
• Full feeling.
• Loss of interest in eating
• Fewer bowel movements
• Loss of bowel control.
Things to do to help: Offer sips of liquid or ice chips or small bites of food. Do not force food or drink. Swab mouth frequently and use lip balm to keep lips from drying and cracking. For loss of bowel function use pads or diapers. A bowel schedule can be helpful and prevent discomfort of constipation.
• Less urine
• More concentrated urine
• Loss of bladder control.
Things to do to help: Diapers or foley catheter.
Pain: Different with each disease and can get worse or drop off as death gets closer.
Things to do to help: Opioid pain medicine (such as morphine, oxycodone, fentanyl, and dilaudid) and comfort cares. Do not be afraid of the doses prescribed by the child’s doctor. The amounts may seem large, but it is important to keep the child comfortable.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 07/30/2013
Copyright © 07/30/2013 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7532
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