A common question many family members of hospice care patients have is how long their loved one has left. There is no definitive answer to this. Just as your loved one is unique, so is their condition. How they are being treated and how their body and mind respond to their health care, emotional care, spiritual care, and pain medications impacts time left. However, it is possible to recognize when death may be near. There are certain common physical signs of this that many patients display.

Physical Activity Declines

Most hospice patients significantly decrease their level of activity in the weeks, days and hours leading up to death. Your loved one might sleep more. They may have difficulty holding a conversation or responding to simple questions. They may move less, and they may be less inclined to try to participate in activities of daily living.

Pre-Death Signs: Body Temperature and Other Vitals

Body temperature can decrease when a senior is nearing death. Their hands might feel cold or clammy. Blood pressure can also decrease, and blood flow to the outer extremities (hands and feet) can decrease as well.

Breathing Changes and Imminent Death

Cheyne-Stokes breathing is also very common. This is when your loved one’s normally rhythmic breathing will change to a pattern where they take several quick breaths and then stop breathing for a period of time. Coughing and raspy sounding breathing, or a “death rattle,”  is also sometimes noticeable as body fluids begin to build in the lungs or throat.

This can be very distressing to listen to, but it is usually not an indication of pain. Sometimes, a dehumidifier, cough medication or simply repositioning the patient will temporarily change breathing back to a more normal sounding, rhythmic pattern. The dying person also appreciates comfort, so don’t be afraid to hold their hand or offer soothing words and loving gestures.

Hallucinations Are Signs of Dying

Many dying individuals report seeing or hearing things which are not there. Your loved one may look directly at a shadow in the corner and insist a person is standing there. They might also hear a thunder clap outside but recognize it as a baby crying. These illusions are caused by sensory changes as the brain begins to shut down and move toward death.

Skin Color and Signs of Impending Death

Signs of death within hours or signs that death is near include changes in skin color. Tinges of purple, grey or other pale tones are often most noticeable on the feet, knees, hands and lips. After death, the skin tone will change again to a more waxen pallor. This is caused by the blood settling in the body.

Impacts of Dying on the Nervous System

The dying process directly affects the central nervous system. Because of this, your loved one may move, even very quickly, from being fully awake to completely non-responsive. If the dying person lapses into a coma, it is often a sign of impending death. Your hospice care provider will ensure a hospice nurse, hospice chaplain or other support person remains with you, often even around the clock, if there are indicators that your loved one is actively dying.

The sequence of events leading up to death is uncertain. That is part of what makes the time leading up to the moment of death so complex and difficult to come to terms with. However, some signs of dying let you know the end is near. During this time, it is perhaps more important than ever to surround yourself with the right support system as you prepare for what’s to come.

Salus Homecare San Diego is here to help. Our hospice professionals provide compassionate, empathetic assistance in watching for and recognizing signs of impending death. We ensure dignity and respect for dying patients and the right level of support for family members too. Contact us, and let us know if we can help you.

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