End-of-life symptoms vary from person to person. For some, death may approach suddenly, whereas for others, end-of-life symptoms may linger for days, weeks, or even months.
Symptoms also vary. Some people become physically weak, even though their cognitive functions are strong, and for others vice versa. For still others, all functions decline at the same time.
What are typical end-of-life symptoms?
1-3 months before death
- Reduced appetite
- Feeling tired
- Talking less
- Isolating from people and family
- Losing interest in activities that they used to enjoy once
1-2 weeks before death
- Feeling tired and drained all the time
- Little appetite and thirst
- Limited bowel movements and urine
- More pain
- Different sleep-wake patterns
- Changes in blood pressure, breathing, and heart rate
- Temperature fluctuations, leaving their skin cool, warm, moist, and pale
- Confusion or being in a shock
- Congested breathing
- Hallucinations and visions of long-gone loved ones
Within days or hours
- No appetite or thirst
- No urinating and bowel movements
- Groaning or scowling from pain
- Dropping of body temperature
- Irregular heartbeat and pulse
- Teary or glazed eyes
- Mottled bluish purple skin on the knees, feet, and hands
- Gasping breathing that slows down and stops completely
Last hour
- Restless and confused
- Upsetting hallucinations, causing them to cry out or strike out
- No measurable pulse
- Pale and waxy skin
- Dilated pupils
- Tears falling from the eyes
- Small movements of the arms, legs, or larynx
| Type | Physiological changes | Symptoms | Intervention |
|---|---|---|---|
| Cardiac and circulation | |||
| Decreased blood flow |
|
|
|
| Decreased blood flow to the brain |
|
|
|
| Decrease in the cardiac output and blood volume in the vessels |
|
|
|
| Urinary function | |||
| Decreased urine output |
|
Keep the person clean and dry. Place a Foley’s tube in the following conditions:
|
|
| Food and fluids | |||
| Decreased appetite and thirst |
|
|
|
| Swallowing issues |
|
|
|
| Skin | |||
| Skin may become spotted or discolored | Purplish or dark pinkish patches on the back and arms/legs |
|
|
|
Bedsores may develop due to the pressure of being bed bound. |
|
|
|
| Respiratory | |||
| Collection of secretions in the pharynx and upper respiratory tract | Noisy respiration—usually no cough or weak cough |
|
|
| Dyspnea | Shortness of breath | Supplementing 2-3 liters of oxygen may support the person’s breathing | |
| Cheyne-Stokes respiration (breathing rate changes from rapid breathing to periods of no breathing) | Notable changes in breathing |
|
|
| General changes | |||
| Profound weakness and fatigue |
|
Normal part of the dying process | |
| Disoriented to time and a severely limited attention span |
|
Normal part of the dying process | |
| People may speak to long-gone loved ones or see places others cannot see | The family may assume these are hallucinations or a drug reaction | If a person appears frightened, they may need to be treated with medication |
Medically Reviewed on 1/13/2022
References
Image Source: iStock Images
https://www.webmd.com/palliative-care/journeys-end-active-dying
https://palliative.stanford.edu/transition-to-death/signs-of-impending-death/
https://www.webmd.com/palliative-care/journeys-end-active-dying
https://palliative.stanford.edu/transition-to-death/signs-of-impending-death/
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