What Are the 6 Signs of Impending Death?

Medically Reviewed on 10/27/2021
Physical signs of impending death
Understanding the following 6 signs of impending death can better help you care for a person going through the dying process.

All death is sudden, no matter how gradual the dying process may be. There is, perhaps, no certain way to prepare yourself to see a loved one dying. Nonetheless, knowing the signs of impending death may help you take care of your loved one more compassionately and appropriately.

The 6 signs of impending death include

  1. Decreased energy
  2. Loss of appetite
  3. Reduced interest in surrounds
  4. Change in breathing
  5. Change in consciousness
  6. Changes in bowel and bladder functions

You must not necessarily just be a passive spectator when these signs appear. If you think that you need a doctor’s advice, you should certainly go ahead with it. This may, especially, be done if you feel that the dying person appears too troubled or in pain.

Understanding the 6 signs of impending death to care for the person

The six signs of impending death and tips to take care of the dying person are described below.

Decreased energy

A person nearing death appears to have considerable weakness and reduced stamina, which is possibly due to changes occurring in their body during the dying process, the effect of medications, or a reduced appetite.

The person may wish to not move or even sit up, and they may prefer sleeping for long hours or just lying in their bed. Simple tasks such as changing clothes or eating may make them feel exhausted.

  • How to deal with it:
    • A change in the physical activities of your loved one may make you anxious. This, however, occurs normally while nearing death.
    • You must not force them to be active or be angry with them when they appear tired doing the simplest tasks.
    • You may need to help them eat, drink, and even turn in bed.
    • They may need frequent breaks even during personal care.
    • Make sure that all tasks, such as personal hygiene and feeding, are no longer than 10 to 15 minutes.

Loss of appetite

Many people express a reduced interest in food when they are nearing death. Reduced appetite may be due to various reasons such as weakness, metabolic, or biochemical changes in the body, and medications.

  • How to deal with it:
    • Seeing your loved one cease eating can be emotionally burdening for you. You must, however, not try to force-feed them because it may cause them harm and make them more uncomfortable.
    • You may provide them with small spoonfuls of soft foods or help them have a few sips of water. This will relieve any dryness or irritation in the mouth, improve urine output, improve digestive functions, and relieve coughing and chest congestion.

Reduced interest in surroundings

People nearing death lose interest in socializing or even talking to people around them. They may appear withdrawn in themselves.

  • How to deal with it:
    • Respect their wish for space. You may ask them if they want to meet a friend or relative or want to talk.
    • If they refuse to participate in conversations, respect their decision with calmness and compassion.

Change in breathing

Toward the end of life, breathing becomes rapid and shallow and may be interspersed with pauses. Due to increased airway secretions, breathing may have a crackling or rattling sound, also known as the death rattle.

  • How to deal with it:
    • Episodes of shallow breathing may make you think that your loved one is choking or breathless. This is, however, a natural part of the dying process.
    • Increased secretions and reduced swallowing may cause drooling. You may wipe these secretions gently with a soft cloth.
    • You may raise their head or gently turn them to make their breathing easier. Moreover, using a cool-mist humidifier may help.
    • You may contact a doctor or nurse to provide any medications that may help with their breathing and secretions.
    • Do not try suctioning out the secretions because it may cause a reflex increase in secretions.

Change in consciousness

Because the dying process affects the brain, the person dying may have reduced consciousness. They may appear in deep sleep and find it difficult to wake up, and they may feel pain and touch but not express it. Some may even go into a coma.

The person may have altered sensory perceptions such as delusions, illusions, and hallucinations. A delusion is when a person has a false and unshakeable belief. Generally, delusions of persecution (the person feels that people want to harm them) and grandeur (the person feels that they have immense authority or power) are seen. They may hear, see or feel what does not exist (hallucinations) or wrongly perceive sounds or objects (illusions).

  • How to deal with it:
    • Although the dying person may appear to be unconscious, you can still talk to them and express your love and care toward them because the sense of hearing is one of the last to go before death.
    • Make sure they are comfortable in their bed because they may be unable to express themselves.
    • Altered sensations such as delusions and hallucinations may appear unnerving, but you must act with patience and compassion.
    • You may calm a confused or agitated person by gently telling them that you are there for them or holding their hand.
    • Remember that although your loved one appears to be sleeping, they can still feel, hear, and acknowledge your care.

Changes in bowel and bladder functions

There may be a loss of bowel and bladder control. Some people may develop urinary retention or have minimal urine output. Some individuals nearing death have diarrhea, whereas others may have constipation.

  • How to deal with it:
    • It is often stressful for the caregiver to manage incontinence or involuntary passage of urine or stools.
    • If the urine output is minimal, you may use absorbent pads or diapers. 
    • Catheterization may be done in some people. In people with excessive diarrhea, the healthcare provider may recommend rectal tube insertion.

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Medically Reviewed on 10/27/2021
References
Image Source: KatarzynaBialasiewicz / Getty Images

https://www.uptodate.com/contents/palliative-care-the-last-hours-and-days-of-life?source=related_link#H40111015

https://crhcf.org/insights/five-physical-signs-that-death-is-nearing/

https://hospicefoundation.org/Hospice-Care/Signs-of-Approaching-Death