Care at the End of Life - The Dying Process
If you are dying or are caring for
a dying loved one, you may have questions and concerns about what will happen
physically and emotionally as death approaches. The following information may
help answer some of these questions.
Signs of approaching death
The dying process is as
variable as the birthing process. The exact time of death cannot be predicted,
nor can the exact manner in which a person will die. But people in advanced
stages of a terminal illness experience many similar symptoms as they approach
the end of life, regardless of their illness.
Several physical and
emotional changes occur as death approaches, including:
- Excessive sleepiness and weakness as
periods of wakefulness become shorter and overall energy
- Breathing changes, such as periods of rapid breathing
alternating with short episodes when breathing stops.
- Visual and hearing changes, such as seeing people or scenes that others do not
- Decreased appetite as your metabolism
slows and you no longer have the same interest in food.
- Urinary and bowel changes, such as dark or red urine and hard stools that are
difficult to pass (constipation).
- Temperature changes,
such as running a high temperature or feeling very cold.
- Emotional changes, such as becoming less interested in the outside world and being
less socially involved with others.
Dying people may also experience symptoms specific to
their illness. Talk to your doctor about what to expect. Also, if you have
chosen to receive
hospice care, the hospice team is available to answer
any questions you may have about the dying process. The more you and your loved
ones know, the better prepared you will be to cope with what is
Palliative care can help you to feel
relief from physical symptoms related to your illness, such as nausea or
Pain control and symptom control are important parts of managing your illness
and improving the quality of your life.
Whether a person suffers
from physical pain in the days before death often depends on the illness. Some
terminal illnesses, such as bone or pancreatic cancer, are more likely to be
accompanied by physical pain than others.
Pain and other symptoms
can be so feared that a person considers
physician-assisted death. But pain associated with the
dying process can be managed effectively.
Any pain should be reported to your family and your
doctor. Many medicines and alternative methods (such as massage) are available
to treat the pain associated with dying. Do not hesitate to ask for help. Have
a loved one report your pain if your illness prevents you from communicating
with your doctor.
You may want to protect your family from your
suffering. But it is important to tell them if your pain level is not tolerable
so they can tell your doctor right away.
If you and your doctor are not able to control your pain, ask about seeing a pain management specialist. This is a doctor who finds ways to treat pain that won't go away.