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Recognizing the Signs That Death Is Near

What to Do When Death Is Near

As you start to recognize the signs that death is near, you may not know how to respond. Not only can it be emotionally difficult, but it can also be difficult to know how to physically respond. If you are a caregiver to your friend or loved one, there are some ways you can physically help when you start to see the signs that death is approaching.
One of the signs that death is near is changes in body function, such as significant weakness, reduced appetite, more drowsiness, and limited ability to cooperate with caregivers. When you start to recognize these signs, some of the ways you can help include:
  • Talking in a calm, quiet voice
  • Avoiding sudden noises or movements so as not to startle your loved one
  • Turning the person and changing his or her position every couple of hours
  • Applying a cool, moist washcloth to head, face, and body for comfort
  • Talking to the doctor or hospice nurse about other options for medications if your loved one is having problems swallowing pills.
If your loved one is experiencing changes in consciousness, such as sleeping more during the day, restlessness and anxiety at night, confusion about time and place, or an inability to recognize people, some of the things you can do include:
  • Planning your times with your loved one when he or she is most alert or during the night when just your presence may be comforting
  • Reminding your loved one gently who you are, what day it is, and where they are
  • Continuing pain medications until the end of life, as some of the restlessness may be due to pain
  • Using a calm, gentle tone to reduce chances of agitating your loved one
  • Using gentle touch and holding their hand to provide comfort and let them know they are not alone.
Changes in metabolism are another sign that death is near. These changes can include less need for food and drink, dry mouth, and no more need for certain vitamins or other medications, unless they help your loved one feel more comfortable. When these changes occur, you can help your loved one by:
  • Applying Vaseline® to their lips to help prevent drying
  • Feeding them ice chips with a spoon or giving them sips of water or juice with a straw
  • Checking with the doctor or hospice nurse about any medications, vitamins, or supplements that may be stopped.
Some signs of death may include changes in secretions, such as mucus collecting in the back of the throat, which can make a rattling sound that is distressing to hear but isn't usually uncomfortable for your loved one, or secretions becoming thicker because the person cannot cough. If these changes occur, you can help by:
  • Adding humidity to the room using a cool mist humidifier
  • Giving your loved one ice chips or sips of liquid through a straw to help thin secretions
  • Changing the person's position, such as turning them on their side (this may help drain the secretions from the mouth) or raising their head to give some relief
  • Using pillows to prop up the person's head and chest at an angle
  • Finding a position that helps make breathing easier, even holding them in your arms if you can
  • Cleaning their teeth using a soft toothbrush or foam mouth swabs
  • Asking the doctor or hospice nurse about any medications that may help.
Changes in temperature and circulation are other signs that death is near. This can include arms and legs that feel cool to the touch and skin that becomes darker and possibly even looks blue or blotchy. The heart rate can become irregular, and blood pressure may become low. When these changes occur, you can help by:
  • Keeping your loved one warm using blankets (don't use heating pads or electric blankets)
  • Putting compression stockings on your loved one's legs to help keep circulation going
  • Keeping the room warm.
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