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:
- Appetite 
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.
- Fatigue 
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.
- Weakness 
Simple tasks like raising a head or shifting in bed may be difficult for the person. Try and keep the person comfortable.
- Disorientation 
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.
- Breathing 
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.
- Social 
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.
- Urination  
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.
- Kidney Functions 
Kidney failure is common and can increase blood toxins and contribute to a peaceful coma before death.
- Blood Pressure 
The person may experience a drop in blood pressure. This is normal.
- Swelling 
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.
- Skin temperature 
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.
- Bowel Movements 
The person may lose control of bowel movements as the muscles begin to relax.
- Skin Color 
Decrease in blood circulation may cause a change in skin color as well as blotches. This is normal.
- Pain 
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/
-Written by Valerie Michel Buck
Imagine this, your father is very ill and in the hospital, your father’s doctor makes it seem like he isn’t going to last the week. Naturally most children and grandchildren want to say their last goodbyes and spend the last moments cherishing what little time with him that he has left. Now imagine your step mother/ guardian of your father says no. In 49 out of 50 states, NO MEANS NO! However, one state is leading the way: IOWA.
This started with the famous radio personality Casey Kasem, who was ill and his daughter Kerri Kasem wanted to see her father. A year after the children sought court action to see their father, Iowa law ensures that adult children can see their sick parents. 
If other states adopt the same or a very similar law, no one can keep you from your parents when they are ill. As sad at it may be, it happens all the time. Below are some links to get involved or for assistance if you are having a similar issue.
Read the law in it’s entirety: http://coolice.legis.iowa.gov/Cool-ICE/default.asp?Category=billinfo&Service=Billbook&menu=false&hbill=sf306
To learn more about the Kasem Cares foundation and to help further legislation of bill across the entire United States: http://www.kasemcares.com/
If you are having similar issues, contact an Elder Law Attorney in your state: http://www.longtermcarelink.net/a2cfindattorney.htm
-Written by Valerie Michel Buck