It’s never easy when a loved one approaches the end of life. Because it’s an experience that most of us have seldom, if ever, gone through before — and a subject rarely talked about — it can be hard to tell what’s normal and why certain things are happening, and when the end is truly near.
Although most laypeople are unaware of the markers of the closing of life, hospice and palliative care workers know there are indicators that the natural process of dying is underway, and death is imminent. These symptoms have to do with dying itself and are independent of other symptoms the loved one may be experiencing because of a disease or other condition.
When I wrote 10 Signs Death is Near for Caring.com, they clearly struck a chord. Readers responded in some the highest numbers for any article on the site with their own stories and corroborations.
Knowing what happens at the very end of life can help families focus on providing comfort, experts say, rather than on reacting to “fixing” behaviors that can’t really be fixed. That eases stress for the dying person and for the grieving family members as well.
Obviously these changes don’t apply to a sudden death, and they may not be the exact experience of everyone at the end of life. Still, the following physical signals are quite common:
Changes in appetite: The person may show a marked disinterest in eating, or even drinking, beyond a gradual loss of appetite that may have led up to this change. Even favorite foods register little response.
Changes in sleep habits: As metabolism slows, sleepiness increases. Total hours of sleep go up, and the person becomes harder and harder to rouse.
Changes in breathing: Breaths become more ragged and irregular. You may hear a particular breathing pattern called Chene-Stokes — there’s a sharp intake of breath followed by a long pause that can last up to a minute before loud deep breathing resumes and then again fades.
Changes in urination: Because the person is consuming little, there’s little to excrete. The kidneys are also shutting down as blood pressure drops as part of the dying process. What little urine there is tends to be concentrated, and brownish, reddish, or tea-colored.