Sleep – As the end of life approaches, the dying person will gradually spend more and more time sleeping, and at times will be difficult to rouse. The person may become increasingly confused about time, where they are and the identity of family and friends who are normally familiar to them.
Nutrition – There will probably be a decreased need for food and drink. It can be hard to accept the person’s lack of appetite and thirst. Many of us equate food and drink with basic care. As the physical body dies, however, the vital organs shut down and no longer need nourishment to keep them functioning. This is the wisdom of the body, which knows exactly what it needs. In the last stages of dying, forcing food or fluids when the body says “no”may cause the dying person acute discomfort and should be avoided.
Circulation – As a result of blood circulation slowing down, the limbs of the body may become cool to the touch and darker in colour.
Breathing – As the person’s cough or swallowing reflex diminishes, saliva and mucus may increase and collect in the back of the throat. This can cause noisy breathing, which may be distressing for loved ones even though it is not causing distress to the resident. Talk to the staff about this, as there are medications and procedures which can sometimes assist. Breathing patterns may eventually become irregular, with 10 seconds to several minutes where no breathing occurs.
Hearing and touch – Never assume that the person can’t hear you. Hearing and touch are the last senses to be lost, even if the dying person is not lucid or is in a coma.
What you can do:
- Do not give liquids or food unless requested.
- Wet the lips and mouth with a small amount of water, ice chips or a spray bottle.
- Protect lips from dryness with a protective lip balm.
- Always speak gently, and identify yourself before speaking.
- Use gently reassuring touch.
- Be comfortable with silence and remember you are supporting the person to ‘let go’.
- Never speak about the dying person as if they are not in the room.
- Let relatives and close friends know what is happening.