Journey's End: Active Dying
Symptoms and Signs that Death Is Near continued...
For children and teens, the signs and symptoms are more or less the same as for adults. However, the course of dying is harder to predict in children. They often remain fairly active and ask a lot of tough-to-answer questions right up until the end is near.
In the last days or hours, your loved one may experience what doctors call terminal delirium: heightened activity and confusion often accompanied by hallucinations so distressful they may cry out, strike out, or try to climb out of bed. Since your loved one could hurt him or herself, it's important to try to stop it with medications or with other non-drug interventions.
Make sure the room is well lit, but not brightly lit; also make the room as quiet and peaceful as possible and constantly assure your loved one that you are there.
Ironically, in the last days or hours, a loved one may also experience a period of clarity and lucidity.
During the journey to death, the signs and symptoms of approaching death are unique to each person and his or her condition. Some people have a very gradual decline. Others have a more rapid decline, and their signs and symptoms are usually more pronounced.
When to Say Good-bye
One of the hardest questions is when to call in family members to say good-bye and to make memories for the future.
Family should be notified as soon as it becomes evident that death is approaching. This allows the care team to provide them insight about what to expect – both in terms of their loved one's decline and their own physical and emotional reactions – and it enables family members to support one another and their loved one.
Don't assume, however, that calling the family in means they will be there at the end. It's often the case that families will sit late into the night, but the person doesn't die until they have left, as if he or she was unable to let go while they were there.
These resources may be of particular help to caregivers, families, and friends of a person who is dying: