Eyes of a dying person

Eyes of a dying person


  • Natural death: Practical information for this phase of life
  • What Are The 3 Stages Of Dying?
  • End-of-Life Signs: What to Expect as a Loved One Nears Death
  • The Dying Process
  • How Can We Recognise Death is Approaching?
  • Natural death: Practical information for this phase of life

    Blog: Stories and Insight End-of-Life Signs: What to Expect as a Loved One Nears Death As end of life approaches for your family member or friend, it is understandable that you may feel apprehensive and have many questions.

    In some cases, these changes may occur over a period of weeks; for others, the process lasts just a few days or hours. Common changes include: Less interest in eating and drinking. Not passing fluids regularly. Speaking and moving less, difficulty communicating. Sleeping more than usual. The person may only need enough liquid to keep their mouth moist. Read more about what hospice patients can eat and drink. Another common end-of-life change is that people may not respond to questions and may also show little interest in their surroundings.

    Let your loved one sleep and remain peaceful. At this point, it is more important to be with, rather than to do for, your relative. This can cause gurgling, coughing, choking, or even vomiting. To help ease this gurgling, use a cool-mist vaporizer to moisten the air in the room and contact your hospice nurse for additional advice. When breathing becomes irregular or seems difficult, with periods of no breathing lasting 20 to 30 seconds, the person may moan with each breath.

    This sound is typically caused by air passing over very relaxed vocal cords, and not due to pain or distress. Your loved one may become restless and pull on bed linens or clothing, hallucinate, or even try to get out of bed, due to less oxygen reaching their brain. Play soft music, talk in a calm voice, or read to your loved one. Contact your hospice nurse for additional advice.

    Final End-of-life Signs Some final end-of-life signs you may see in your loved one include: Becoming very cold, then hot; developing a blueish skin tone. Skin of knees, feet, and hands turn purplish, pale, gray, and blotchy. Loss of bodily functions. Becoming unresponsive or lapsing into a coma. In addition, blood pressure gradually falls, and less blood flows to the hands and feet. Arms and legs become cold and bluish in color as circulation slows.

    The underside of the body may darken, and it may become impossible to find a pulse at the wrist. To help, provide blankets to warm, and cool, wet washcloths to cool. As the skin of the feet and hands turn purplish and pale, this end-of-life change usually signals that death will occur within hours to days, and may be followed by the person becoming unresponsive.

    End-of-life changes at the time of death People sometimes think that the moment of death will be dramatic, difficult or painful. That is not usually the case, especially when a person dies while receiving hospice care.

    Read more: What is hospice care? In fact, the signs of death are often subtle. It may take a few minutes to realize the person has died, rather than just being asleep or unresponsive. When someone dies, you many notice the following end-of-life changes: Breathing ceases. The person cannot be roused. Their eyelids may be partially open, with their eyes in a fixed stare. Their mouth may fall open slightly, as the jaw relaxes.

    Their body may release any waste matter in their bladder or rectum. The skin turns pale and waxen as the blood settles. What to do when death occurs: If the patient is receiving hospice care at home, call the hospice organization.

    Do not call or any other local emergency number. The hospice nurse will help you with any calls to the physician and funeral home of your choice.

    If the patient is receiving care at an inpatient hospice center or other facility, notify a staff member. To learn more about end-of-life signs and about caring for your loved one who is terminally ill, call Samaritan at Related Posts.

    What Are The 3 Stages Of Dying?

    This is also a time of change and transition, both physically and emotionally, and no two people experience the end of life in the same way. Consider the following questions about this sometimes-traumatic time, when the goal is to keep the patient as comfortable as possible: What physical changes can I expect to see? Sleeping A person nearing death may stop talking or responding and begin sleeping more and more as the body changes the way it uses energy. Always assume that your loved one can hear even if he or she seems unconscious and no longer communicates.

    Keep talking to your loved one and touch him or her if that provides comfort. Loss of Interest in Food and Fluids As the body begins to shut down, it loses its ability to process food and fluids.

    So the person may have little interest in eating or drinking. Urine production will decline and the urine may be the color of tea. The question of whether to begin providing fluids often arises. If food or fluids are given artificially at this point, the person may feel discomfort.

    However, small amounts of ice chips or a Popsicle may be welcome. Proper care of the mouth by keeping it moist and clean is particularly important at this time. This is because blood circulation is decreasing. The patient may not be able to tell you if the blanket overheats. Changes in Skin Color The skin, especially on the hands and feet, may look blotchy.

    Skin of light complexions may look blue, and skin of dark complexions may appear darker. This is called mottling and is caused by slow blood circulation. The underside of the body may become darker. You may notice a bluish-gray color around the mouth, paleness around the mouth or paleness in the face. Rattling Sounds in the Lungs and Throat Rattling sounds, which can be quite loud, may occur when a person is taking fewer fluids and loses the ability to cough up secretions.

    This rattling does not signal additional pain or discomfort. Suctioning generally is not recommended because that can increase secretions and discomfort.

    Turning may help lessen or stop the rattling. Bladder and Bowel Changes The ill person may lose the ability to control urine and stool as the muscles in that area begin to relax. Check with your doctor about whether a catheter is needed.

    Disposable bed pads or adult disposable briefs also may help. Disorientation and Restlessness A person nearing death may seem confused about the time or place and may not recognize familiar faces. Restless behaviors such as pulling at bedding or clothing may occur as a result of less oxygen to the brain, chemical changes in the body and medications.

    If disorientation occurs, identify yourself by name and speak softly but clearly. Surge of Energy Occasionally, someone close to death will have a temporary increase in energy and alertness. The person may become talkative after a period of sleepiness, ask for a favorite food or want visitors after a period of withdrawal. Take advantage of this time because it can be one of special closeness and a chance to express your love and support. Breathing Pattern Changes Breathing patterns often change as the body continues to shut down.

    You may notice periods of rapid, shallow breathing. Or you may see shallow breathing with a space of five to sixty seconds between breaths. This is called Cheyne-Stokes breathing. Maintaining Comfort as Death Nears It is important for patients to receive their medications as scheduled to help ensure their comfort.

    Some family members worry that giving pain medication may hasten the death. Family members also sometimes worry that the final dose of pain medication caused the death even if the patient had been given this same dose before without problems. What emotional changes and needs can I expect to see? Withdrawal Your loved one may focus less and less energy on the world around him or her and may appear to lose interest in surroundings, favorite pastimes and visitors.

    Energy may be limited, and the patient may want to be with only one or two people. Respect this period of withdrawal. It can be a sad time for family and friends, but it also can be a peaceful time for your loved one. Your presence is the most important gift you can offer during this period. Vision-like Experiences Your loved one may speak to someone you cannot see or describe people and places not visible to you. These experiences are common in the transition from life to death. Do not argue or try to explain away the experience.

    Most often, these visions are comforting and full of profound meaning to the dying person. The Need for Permission to Let Go As difficult as it can be, giving permission to let go may be an important final gift. A dying person may try to hold on, despite prolonged discomfort, to be sure loved ones will be all right.

    They are, after all, a natural expression of your love. The Need to Say Goodbye You may wish to call friends and family members who want to share their thoughts and expressions of love with your dying loved one.

    Remember, hearing is among the last of the senses to fade. These are sincere offers, so if you need some practical assistance, such as picking up a prescription, picking up a relative at the airport or delivering dry cleaning, let friends and family feel useful. They will be grateful to you for letting them help. Choosing the Setting Even during the dying process, a person continues to protect and nurture those he or she loves.

    For many, death is a very private act, so they wait for the few brief minutes they can be alone to slip away. Others wait to let go until they are alone with one or two special people. Still others leave amid a circle of loving faces around their bedsides. However death occurs, trust that it may well have been the way your loved one chose it to be. When Death Occurs Even though you have been present during the dying process, the moment of death will be powerful. Each person will experience it differently.

    Here are the indications that death has occurred: No breathing for a prolonged period of time. No heartbeat. Eyes are fixed and slightly open, with enlarged pupils. Jaw relaxed, with the mouth slightly open. Whether death occurs at home, a hospital or a nursing home, family and friends may want to sit with the body for a time.

    There is no need to rush things, and sitting with the body, praying or reminiscing may be comforting. If death occurs in a health care facility, the nurses will help with procedures.

    If death occurs at home without hospice, the physician should be notified. In some counties, the police may come to the home. It is important that they know the death was expected. Many people find it helpful to make careful notes about just what has happened and how it took place so they can share it with others and think through the process in an accurate way later.

    So take at least mental notes of what time it was as well as the number and names of people present, final words and any other conditions or circumstances you want to remember. It will help you tell the story both of life and of death, and telling the story is an important way to process the grief you inevitably will feel.

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    End-of-Life Signs: What to Expect as a Loved One Nears Death

    Restless behaviors such as pulling at bedding or clothing may occur as a result of less oxygen to the brain, chemical changes in the body and medications. If disorientation occurs, identify yourself by name and speak softly but clearly. Surge of Energy Occasionally, someone close to death will have a temporary increase in energy and alertness.

    The person may become talkative after a period of sleepiness, ask for a favorite food or want visitors after a period of withdrawal.

    Take advantage of this time because it can be one of special closeness and a chance to express your love and support. Breathing Pattern Changes Breathing patterns often change as the body continues to shut down. You may notice periods of rapid, shallow breathing.

    Or you may see shallow breathing with a space of five to sixty seconds between breaths.

    The Dying Process

    This is called Cheyne-Stokes breathing. Maintaining Comfort as Death Nears It is important for patients to receive their medications as scheduled to help ensure their comfort. Some family members worry that giving pain medication may hasten the death. Family members also sometimes worry that the final dose of pain medication caused the death even if the patient had been given this same dose before without problems. What emotional changes and needs can I expect to see? Withdrawal Your loved one may focus less and less energy on the world around him or her and may appear to lose interest in surroundings, favorite pastimes and visitors.

    Energy may be limited, and the patient may want to be with only one or two people. Respect this period of withdrawal. It can be a sad time for family and friends, but it also can be a peaceful time for your loved one. Your presence is the most important gift you can offer during this period.

    Vision-like Experiences Your loved one may speak to someone you cannot see or describe people and places not visible to you. These experiences are common in the transition from life to death. Do not argue or try to explain away the experience. Most often, these visions are comforting and full of profound meaning to the dying person.

    The Need for Permission to Let Go As difficult as it can be, giving permission to let go may be an important final gift. A dying person may try to hold on, despite prolonged discomfort, to be sure loved ones will be all right. They are, after all, a natural expression of your love. Experts suggest speaking softly to the patient and touching them gently only if they normally like being touched.

    This is a good time for prayer or meditation. It is not recommended to ask the patient questions that require answers. Last Stage Of Dying During the final stage of dying, disorientation and restlessness will grow.

    Their breathing may become shallow and irregular, with long pauses that grow frequent as death approaches. There may also be sounds of chest congestion and throat rattling in the last hours. What Their Bodies Are Doing The restlessness noted in this stage is attributed to changes in metabolism, while the kidney and bowel functions are affected by decreasing circulation.

    Relaxing muscles can lead to incontinence. The slowing of blood circulation to internal organs causes the lungs to lose their power to clear out fluids as well as the relaxation of the throat muscles. When a patient enters the final stage of dying, it is helpful to talk to them reassuringly. Again, gentle touch is acceptable if the patient likes being touched.

    With this withdrawal comes less of a need to communicate with others, even with close family. Food: The patient will have a decreased need for food and drink as the body is preparing to die. This is one of the hardest things for some family to accept. There is a gradual decrease in interest in eating and appetite—even for their favorite foods. Interest may come and go. The patient is not starving to death—this reflects the underlying disease. Sleep: The patient will spend more and more time sleeping; it may be difficult for them to keep their eyes open.

    Sometimes patients describe welcoming or beckoning. While the patient may not be distressed, it is frequently distressing to family or health care professionals. Gently orient the patient if he or she asks.

    Restlessness: The patient may become restless and pull at the bed linens. Talk calmly and assuredly with the patient so as not to startle or frighten them.

    How Can We Recognise Death is Approaching?

    If the patient is a danger to himself or others, you may prescribe sedating neuroleptics e. Decreased Senses: Clarity of hearing and vision may decrease. Soft lights in the room may prevent visual misinterpretations.

    Never assume that the patient cannot hear you, as hearing is the last of the five senses to be lost. Incontinence of urine and bowel movements is often not a problem until death is very near. Invite family to participate in direct care; the nurse can help place absorbent pads under the patient for more comfort and cleanliness, or a urinary catheter may be used. The amount of urine will decrease and the urine become darker as death becomes near. Physical Changes as death approaches: The blood pressure decreases; the pulse may increase or decrease.


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