This list may appear frightening, but knowing
what to expect may reduce some of your anxiety about the approaching death.
Each person approaches death in their own way,
bringing to this last experience their own uniqueness. Our list is a map
to the goal of a peaceful death. Like all maps, there are many different
routes to the same destination.
You may see all of these symptoms or none.
Death will come in its own time and its own way to each of us. It
is important to remember that dying is a natural process.
S.
Withdrawal
- Physical and emotional; increased sleep
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There
is decreased need because the body will naturally begin to conserve
energy that is expended on these tasks. Dehydration is a natural
comfort measure requiring the body to handle less fluid in all
the systems. At no time should food or fluids be forced.
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Talk
calmly and assuredly, keep lights on and use times when patient
is alert for meaningful conversation. Music can be very calming.
Medication is often used to control this symptom.
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S.
Changes in Breathing Pattern
This
is common. You may see irregular breathing: very rapid,
very slow, or 10 to 30 seconds of no breathing at all
(this is called apnea). These symptoms are very common
and indicative of a decrease in circulation. It does
not mean that your loved one is uncomfortable or struggling.
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S.
Collection of oral
secretions in the back of the throat, causing noisy
respiration
The
swallowing reflex may be absent. The patient may
be breathing through secretions. Which can be
more uncomfortable for us as observers than the
patient experiencing it. Elevate the head of bed
or turn the patient on his or her side.
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S.
Incontinence of urine
or stool
Reduced
intake results in reduced output with darker
color. Bed pads and briefs can be used to
protect bed linens. Cleanse the patient
and change linens frequently to maintain
comfort and protect skin.
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S.
Changes
in skin temperature and color
Decreased
circulation can cause coolness and
discoloration of skin. Use light covers,
turn side to side frequently to maintain
comfort and prevent skin breakdown
(bedsores). Heating pads and electric
blankets are not recommended.
Hearing is the
last sense to be lost, so the patient
can hear all that is being said. This
is a good time to say good-bye and
reassure them that you will be all
right even though you will miss them
greatly. (You may tell them its okay
to "let go"). This
permission is often helpful for a
peaceful death.
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S.
How do you
know death has occurred?
- No
breathing
- No
heartbeat or pulse
S.
Confusion
or agitation can vary from mild confusion to end-stage agitation,
which may include trying to get out of bed, picking at
covers and seeing things not apparent to us
S.
Reduced Food and Fluid Intake
There is a natural
process of withdrawing from everything outside of one's self, looking
inward, and reviewing one's self and one's life. Your loved one may turn
inward, withdraw physically and emotionally. This occurs in an attempt
to cope with the many changes that are occurring.
