What happens during someone's last days
Tuesday 31 October 2017
Despite the best advances in medical science and technology, we will all die one day.
For some, this will be the result of a serious accident or medical emergency, and dying will be very quick. But for many of us, dying will be a longer process, bought about by illness, age, or a combination of the two.
Dying isn’t something everyone feels comfortable talking about, but it is something we will all go through. Many of us will also care for or be with a family member or friend while they are dying, before we reach that stage of life ourselves.
It makes sense that we might wonder what dying is like. If you’ve never seen someone die, you might be scared or curious about what will happen. Read on to learn more about the body’s dying process.
What can family and friends expect when someone is dying?
Just like all things in life, no two people will experience dying and death in exactly the same way. But there are some common physical processes that people who are dying will experience, though they won’t always experience all of them and they won’t always happen in a particular order.
As the body begins to wind down, various reflexes and functions will begin to slow. Signs of this can include:
Appetite and thirst – in the days before a person dies, their appetite and thirst might decrease. This doesn’t cause them discomfort, and they don’t need to be fed or given large amounts of water.
Circulation – the circulation of blood around the body will begin to slow, which can cause fluctuations in their temperature. They might feel cool to touch at one point, and then their skin may feel hot later on.
Changes in urine and continence – if the person has stopped drinking a lot of fluid, their urine might become stronger and darker in colour.
Many people worry that incontinence (losing control of bladder and bowels) will make dying an undignified process. This doesn’t happen to all people, but if it does, there is special equipment to help make things sanitary and dignified, like absorbent pads and sheets.
Breathing – breathing patterns might change, from rapid to slow, constant or with pauses between breaths. This isn’t uncomfortable for the person, and is part of the slowing of blood circulation. You might find their breathing noisy or very shallow at times.
Coughing and swallowing – these reflexes can also begin to slow. If saliva or mucus gathers at the back of the throat, their breathing can become noisy. This might sound concerning, but isn’t usually distressing to the person.
It’s important to remember that these changes usually do not mean that the person is in pain or distressed, but are just part of the body’s natural dying process.
How can family, friends and carers help and support someone who is dying?
Just being with a person who is dying can be comforting for them. Your presence when sitting with someone and talking to them, even if they aren’t responding, can be very valuable.
Dying can be an emotional or spiritual process. As a person prepares to die, they may want to spend time looking back on their life, saying goodbyes and voicing gratitude, concerns or regrets. Some people may want to take part in religious or cultural practices. Some people may not want to, or be able to, do these things. Take your cues from the dying person and be prepared to listen, share and find meaningful ways to be with the person and say goodbye.
There are some things that carers can do to help physically care for the dying person, to help make them comfortable, whether in hospital, a hospice or at home. Palliative care staff can assist with medical needs and questions of carers.
If their mouth becomes dry and causes discomfort, little sips of water or moistening the mouth with a damp swab can help.
Cover them with light layers of blankets if cold, and make sure air circulates through the room. If hot, damp clothes can be used to cool them.
Keep the room quiet and lights low and the environment comforting. You might want to softly play music that is special to the person.
The moment of death
The moment of death is usually very peaceful and not painful for the person, completing the slow winding down process of the body.
As the body has been gradually dying, death might not occur suddenly or obviously. Signs that death has occurred include:
- breathing has completely stopped
- there is no heartbeat or pulse
- eyelids may remain open
- pupils are fixed (don’t expand or contract with changes to light)
- mouth might be open
- the person cannot be woken up.
Once the person has died, there’s no need to take any action immediately. Those who are there might want to sit with the person, call people to come, or fulfil any religious or cultural wishes of the person.
You can read more about the dying process, palliative care, and advance care planning at the links below.