Approaching Death: Signs of Body Shut Down

It may be hard to tell the difference between other life happenings and the actual approach of death. Families may not necessary want to go through an unnecessary emotional toll of preparing for death if it’s not actually approaching. Here are some ways to tell the body is shutting down:

1. Appetite [1]

The person may resist meals and liquids. If they do eat it may be small amounts and may be bland foods that are simple to digest. Do not force feed the person however offer them water, and maybe popsicles to help keep them as hydrated as possible. Even apply balm to the lips to keep them moist.

2. Fatigue [1]

Metabolism slows and with the decline in food and water, the person may be dehydrated and may have a lack of energy. Fatigue is so pronounced, awareness may be limited. It’s best to let the person sleep, waking them may not result in awareness.

3. Weakness [1]

Simple tasks like raising a head or shifting in bed may be difficult for the person. Try and keep the person comfortable.

4. Disorientation [1]

The person may not be aware of where he or she is or who else is in the room. The person may speak or reply less often, may respond to people who aren’t there. Sentences may not make sense. Also the person may randomly act restless. Try to remain calm and reassuring. Speak softly and calmly and identify yourself when you approach the person.

5. Breathing [1]

Breathing may be irregular and labored. This breathing by the person may also be noisy and cause some alarm. The person is generally unaware of the change in breathing, changing positions such as slightly elevating the head or tilting to the side slightly may help. Consider there may be phlegm and allow it to drain from the mouth. A vaporizer and oxygen may help.

6. Social [1]

For many reasons, including those listed above, social withdrawal is common. It is also common that a person may withdraw then later become unexpectedly alert which may last for an hour or several hours. This is a natural part of the dying process and may not reflect the relationship of the person. Maintaining a physical presence and touching the person gently without expecting anything from the person is the best course of action. Treasure the unexpected alert moments if they happen as these are often brief.

7. Urination [1] [2]

With little intake, the person may not urinate frequently, the urination can be a darker color. The person may lose bladder control. Hospital staff can add a catheter if necessary. You can add a bed pad when placing fresh sheets.

8. Kidney Functions [1]

Kidney failure is common and can increase blood toxins and contribute to a peaceful coma before death.

9. Blood Pressure [1]

The person may experience a drop in blood pressure. This is normal.

10. Swelling [1]

As the kidneys are less able to process bodily fluids, fluids can accumulate and get deposited in areas of the body away from the heart, which may include hands, feet or the face. This swelling is natural and no treatment is needed.

11. Skin temperature [1][3]

Minutes or even hours before death, blood circulation draws back to help the vital organs. Extremities such as the hands and feet become cooler and nail beds may look pale or even bluish. The person may also have a fever. If the person is cold, a warm blanket can help keep the person comfortable but keep them loose as to not weight the person down. If the person is warm, a cool damn wash cloth on the forehead may help the person feel cooler.

12. Bowel Movements [2]

The person may lose control of bowel movements as the muscles begin to relax.

13. Skin Color [3]

Decrease in blood circulation may cause a change in skin color as well as blotches. This is normal.

14. Pain [4]

Pain may be present in the person, consult a doctor, nurse or hospice caregiver for pain management.

Some tips in helping the person feel more comfortable:

Playing soft music that may be familiar to the person.

Soft touching such as stroking of the hand or art may be comforting to the person.

Talking softly to the person.

Hospice care in your area: http://www.longtermcarelink.net/a7hospicecare.htm

Please read our other blog article “When Death Comes Knocking.” https://longtermcarelink.wordpress.com/tag/body-shutting-down/

[1] https://www.caring.com/articles/signs-of-death

[2] http://www.hospicenet.org/html/preparing_for.html

[3] http://kokuamau.org/resources/last-stages-life

[4] http://dying.lovetoknow.com/signs-approaching-death

-Written by Valerie Michel Buck

Facing Death (What to Say to a Loved One Near Death)

Pala was lying on the couch in the small room that consisted of the majority of her home inside the assisted living facility. She’d lost a lot of weight, and her hands shook as she tried to lift them. It was easier for her to keep her eyes closed and her body still, silently contemplating what could be the last moments of her life. Her great-granddaughter entered the room, having just been woken up and told this might be the last time she would get to speak to her great-grandmother. The young girl had never been so close to death before. Seeing her great-grandmother in that weakened state made her want to cry, but she didn’t know if she should. She wanted to say something, anything, but what could she say? She was confused and sad and uncertain, so she said nothing. Pala passed away three days later.

As our loved ones age, we know that death will be the inevitable end to our relationship with them. However, this knowledge does not make us any more prepared for the moment when we must let our loved ones go. We may feel sad, depressed, even confused, but most of us will feel uncertain. Just as Pala’s great-granddaughter, we may not have a lot of experience with loved ones near death, and we might question what we should do or, more importantly, what we should say.

When in doubt, we should always allow our loved ones to guide our conversations and actions. Sometimes it may be appropriate and best for them if we say nothing and simply allow our presence and love to be felt. Sometimes bringing up the past could lend to a few very sentimental and precious hours in which you can cry, talk, and laugh about your relationship.

If it is a disease or illness that is slowly taking your loved ones life, don’t focus on that. Michelle Colon-Johnson, diagnosed with stage four cancer, said “If I wanted to talk about the cancer, it felt good to know I could talk to others, but I never wanted to be treated differently.” Let your loved ones know that you are there for them, that you love them, and that if they want to talk, you are always willing to listen. Then if they wish to talk about the illness or disease, allow them to bring up the subject, otherwise focus on the important moments of your relationship – both past and present – and enjoy every minute you have left with your loved one.

Another topic you should always avoid in the presence of someone near death is clichés and platitudes. Psychiatrist Marcia Sirota said “Saying things like, ‘Everything happens for a reason,’ and ‘It’s God’s will,’ can make the person feel like the fact that they’re dying is their fault. Trying to reassure a patient they’ll be o.k. can be hurtful because they know it isn’t true. Saying things like ‘You’re strong’ or ‘You’ll get through the illness’ is equally problematic. Maybe they don’t feel strong and need to feel like they can be afraid. You need to give them the space for their fears.”

Sometimes in our ‘do it yourself’ society we feel that we shouldn’t cry, and we shouldn’t show fear. We feel like it is almost a social requirement to ‘be strong’ in the face of death. This is not true and the sooner you can get this type of thinking out of your head and out of the head of your loved one, the easier their last moments will be for the both of you. Fear is natural. Sadness and tears are natural. Allow you and your loved ones to experience these emotions. Bottling them up will only end up putting a strain on your relationship with your loved one during their last few days or weeks and will make the grieving process much more difficult to endure.

Mercia Tapping’s husband was diagnosed with terminal brain cancer and subsequently died. She advised the best thing you can do for you and your loved one in the face of impending death is to be completely open with each other and make sure nothing is left unsaid. Tapping said, “We faced this disease head on and squeezed the last out of his life together. We discussed all aspects of his burial and funeral. He wanted me to deliver his eulogy and I did. Because we faced this so openly together I have no regrets and nothing was left unsaid or undone, which makes his death still painful but complete.”

End-of-life care and funeral arrangements are not the typical topics you think of discussing when facing the inevitable death of a loved one, but these topics are essential. In the Complete Guide to Caring for Aging Loved Ones, it is advised to “approach these discussions gently, focusing on the desire to know [your loved one’s] wishes in order to follow them.” Though these topics need to be discussed, you don’t want the focus of conversation in the last moments of your loved one’s life to be legal and financial matters. Take the time to discuss these matters when you and your loved one are healthy enough to discuss them thoroughly and have everything taken care of so that there are no extra burdens or stressors upon your shoulders near or after your loved one’s passing.

Your loved one’s last moments may be full of sadness, confusion, fear, and regret, but they should also be full of thankfulness and love. Hold their hand, laugh with them, cry with them, hold them close, and, when the time comes, let them go. Leave nothing unsaid, nothing undone, and take the time to create some final memories that will stay with you for a lifetime.

Various quotations taken from Candace Rotolo’s article “Words of Comfort: What to Say When Someone is Dying.”

Quote from the Complete Guide to Caring for Aging Loved Ones taken from a response article to the question “How do we prepare for the death of an elderly loved one?”