As your loved one reaches the final stages of his or her illness, it’s understandable that you may have many questions and concerns.
The active phase of dying is the final stage of the natural process of bodily functions slowing down and/or ceasing. It’s important to understand what to expect and to learn the signs of active dying, but it’s also important to keep in mind that predicting when your loved one will pass away is still difficult. Just being present may be more valuable than any action you take.
What are the Signs that Someone is Actively Dying?
Knowing what to expect when your loved one is actively dying, and what you can do, can make a difference in the care you provide and bring you peace of mind. Keep in mind that everyone is different and don’t always exhibit all the signs. Here are some signs that someone is actively dying.
Seven+ Days Before Death
Your loved one may not want food or drink and swallowing may become difficult. There may only be a need for enough liquid to keep the mouth from becoming dry. Offer, but do not force food, liquids, or medications.
They may be confused. It is also a common experience for patients to speak about the presence of loved ones who have previously passed.
They may speak/communicate less.
Four-Six Days Before Death
Your loved one may sleep a lot more and be in an unresponsive state without the ability to be aroused (coma/semi-coma). This is very natural and it’s important to let your loved one sleep. At this point, it’s important for you to be with them rather than do for them.
As the oxygen supply to the brain decreases, they may experience severe agitation or hallucinations that are inconsistent with their normal manner or personality, such as pulling on bed linens or clothing. You can talk to them in a calm voice and reassure your loved one that you are there. You can play calm music or give them a back rub.
Your loved one may pass less fluids. As bodily functions slowly decline and the intake of food and drink decrease, the output of fluids will also decrease. This is natural.
Two-Three Days Before Death
Your loved one may experience a bluish discoloration of their extremities. The skin of their legs and arms may feel cold to the touch. As the end draws near, the body loses the ability to control its temperature. Arms and legs will become cold and bluish in color as circulation slows down. The underside of the body may darken and it may become impossible to find a pulse at the wrist. You can provide blankets to warm them or a cool wash cloth to cool them.
Your loved one will respond even less to verbal cues.
Less Than Two Days Before Death
Breathing may become irregular with periods of no breathing lasting for 20 to 30 seconds. Raising the head of your loved one’s bed will make breathing easier for them.
A gurgling sound may be produced when your loved one inhales and exhales When they breathe through their mouth, secretions collect in the back of the throat and can cause a gurgling sound, coughing, choking or even vomiting. These same secretions may coat the inside of the mouth or drain if the patient is on his or her side supported by pillows. Use a cool-mist vaporizer to moisten the air in the room. If this does not help, contact your Samaritan nurse for advice.
Your loved one may have a fever greater than 100 degrees. You can place a cool wash cloth on their forehead, remove blankets, and/or get a fan.
At the time of your loved one’s death
Breathing ceases.
Heartbeat ceases.
Your loved one cannot be aroused.
Your loved one’s eyelids may be partially open with eyes in a fixed stare.
Your loved one’s mouth may fall open slightly as the jaw relaxes.
Any waste matter in the bladder or rectum may be released.
When Should Hospice Be Contacted?
If you are in the South New Jersey area and believe your loved one could benefit from hospice care, contact Samaritan 24 hours a day, 7 days a week for more information on how our services can help: (856) 596-1600. Remember, hospice is not a place, but instead a type of care. Our hospice team comes to you to provide help to your loved one and their family.
When you think your loved one passes away and you’re already receiving hospice care, call the hospice organization caring for him or her immediately. For patients and families receiving Samaritan’s hospice care at home, please call Samaritan at (856) 596-1600 and a nurse will be contacted immediately and will respond promptly.
When your loved one passes away at an inpatient facility such as The Samaritan Centers at Voorhees or Mount Holly, please notify a staff member.
Do not call the police, emergency squad, or 911, if a hospice organization is caring for you and your loved one.
As part of the hospice program, the nurse will help you with any calls to the physician and funeral home of your choice. Additionally, if you have more questions regarding “what is active dying” or any other related subjects, please don’t hesitate to contact Samaritan: (856) 596-1600.
