Approaching death

• Appetite decreases, the patient no longer has the energy to eat or drink.

• The patient mostly stays in bed and sleeps a lot.

• The patient’s interest in their surroundings decreases, as does their level of consciousness.

• Secretions (urination and bowel movements) decrease.

• There may be swelling (oedema), mainly in the lower parts of the body and the legs.

• The patient may have a fever.

• Symptoms, such as pain, may increase.

• Breathing may become heavier, superficial, or gasping, there may be rattling or pauses (apnoea) in breathing.

• Circulation becomes weaker.

  • Hands and feet turn cold.

  • The heartbeat becomes weaker.

At the end of life, most people also experience changes in their psychological state. These may include decreased level of consciousness, delirium, and anxiety.

As death approaches, the patient often lacks the energy to talk much, but may still find the presence of another human being soothing. Being touched, like by having someone hold the patient’s hand, may have a similar effect. Sometimes, reading and playing relaxing music are good options too.

When the patient is no longer able to express how they’re feeling, their symptoms are monitored by paying attention to things such as facial expressions, gestures, body movements, and sounds. Symptoms can be relieved both with and without medication.

Death is a natural event and a part of every life. The moment of death is usually peaceful.

Death means the cessation of vital functions, such as breathing, brain activity, heartbeat, and circulation. To those present, the moment of death usually appears as cessation of breathing and relaxation of the body.

Sometimes the moment of death is accompanied by changes in breathing, noises, muscle twitches, or the patient reaching for the air with their hands. These are usually a part of the normal dying process.

Following death, the body gradually grows colder, and the joints stiffen over the next few hours. The skin develops a purplish discolouration in the lower parts of the body, such as the sides, due to gravity.

Those close to the dying patient

Supporting a loved one on their final journey may be an invaluable experience leaving precious memories. What the experience of the death of a loved one is like depends on a number of factors, such as the care received by the patient during their illness, any feelings of being left without support, personal resources for coping mentally, and the support received by both the patient and their loved ones.

It’s important to bring up any questions or concerns regarding the dying patient’s condition or care with the care staff. The moment of death is often an emotional experience for those close to the patient. It’s perfectly natural to feel frightened or distressed. As a personal experience, death is completely unique, and therefore new and unfamiliar every time.

Even after the patient’s death, it’s important to bring up any negative experiences or things left unclear regarding the patient’s care or death with the unit responsible for the patient’s care.