Every person’s journey through life is unique, and so is their experience with dying. The process varies greatly from one individual to another – for some, it may last a few weeks, while for others, it could be just a matter of hours. Various factors, including underlying illness and medications, can shape the experience, but there are certain common signs and symptoms that often appear as the end of life approaches.
If hospice care starts early, patients may not show these signs for several months. However, as time progresses and the body begins to slow down, loved ones may start to notice some common changes.
As energy wanes, talking and movement usually decrease significantly. Your loved one may spend more time resting and be less responsive.
How to Help: Gentle repositioning can reduce stiffness and prevent pressure injuries. If movement causes discomfort, consult the hospice team to manage pain appropriately.
It’s natural for interest in food and drink to lessen, often due to the body’s declining ability to process sustenance. Swallowing can also become challenging.
How to Help: Avoid pushing food or fluids. Focus on comfort by keeping the mouth and lips moist, and ask the hospice team about alternative ways to administer medications.
Reduced intake can lead to constipation and loss of bladder control.
How to Help: Stool softeners may be useful, and if needed, a Foley catheter can provide comfort and reduce the need for frequent repositioning.
A slight fever or cold extremities can be common as circulation slows.
How to Help: Provide a warm blanket for comfort but avoid heating pads. Use cool compresses if your loved one feels warm.
Near the end, blood pressure and heart rate may become erratic or slow.
How to Help: These changes are normal but should be communicated to the hospice nurse for guidance and support.
Skin may appear purplish, pale, or blotchy in certain areas as circulation diminishes.
How to Help: Prioritize gentle, pain-free care for any open wounds. The hospice team can guide you on how to keep the skin clean and comfortable.
Pain may intensify as the body weakens and chronic conditions worsen.
How to Help: If your loved one seems uncomfortable, notify the hospice team to adjust pain management as needed.
Breathing may become slower, shallower, or interrupted by pauses.
How to Help: Though these changes can be distressing to observe, they do not indicate pain. Gentle repositioning or elevating the head can ease noisy breathing, and the hospice team may offer treatments to manage any excess secretions.
The dying person may gradually detach from their surroundings, appearing less responsive or interested.
How to Help: Maintain a calm environment and continue speaking gently; hearing often remains even when responses fade.
Sensory changes can cause illusions or hallucinations, which may be comforting or unsettling.
How to Help: Be supportive, understanding, and speak to the hospice team if these changes seem distressing for your loved one. Some people find comfort in visions of loved ones or in religious experiences as they near the end.
In the final days, many people become unresponsive, as if in a deep sleep.
How to Help: Continue to offer gentle words and physical comfort, knowing that even in this state, your loved one may still hear and sense your presence.
As the journey nears its end, remember that the hospice team is there to support both the patient and family, helping to create as much comfort as possible during this natural process.