Dying: A Guide to Crossing Death's Doorstep
How to Know Your Loved One is Dying
This hub offers a breath-by-breath-to-last-breath guide to help you recognize and participate in each stage of your loved one's last weeks, days, hours and minutes of life.
Like fingerprints, each person's exit from this earth is unique and highly individual. However, there are certain universal harbingers that signal the Grim Reaper's entrance. As one might hover over a loved one's sickbed watching for signs of recovery, those of us in hospice wait and watch for behavorial death omens (bdo's for short).
Death be not proud (Holy Sonnet 10)
Death, be not proud (Holy Sonnet 10) by John Donne
Death, be not proud, though some have called thee Mighty and dreadful, for thou are not so; For those whom thou think'st thou dost overthrow Die not, poor Death, nor yet canst thou kill me. From rest and sleep, which but thy pictures be, Much pleasure; then from thee much more must flow, And soonest our best men with thee do go, Rest of their bones, and soul's delivery. Thou'art slave to fate, chance, kings, and desperate men, And dost with poison, war, and sickness dwell, And poppy'or charms can make us sleep as well And better than thy stroke; why swell'st thou then? One short sleep past, we wake eternally, And death shall be no more; Death, thou shalt die .
I am not a ghoulish girl, honestly
If you've read some of my hubs you might get the impression I've got some kind of death wish. Actually, nothing could be further from the truth. It's just that my life has been filled with death over the past few months. As a result, it has risen to the top of my topics list.
I'm reminded of the line in "Silence of the Lambs" when Dr. Hannibal Lecter says to FBI Agent Clarice Starling (in reference to serial killer Buffalo Bill): "What is it he does, Clarice?" She says something to the effect, "He hunts women." "No. He COVETS." He then asks her, "And what is it we covet?" The answer: "We covet what we see." Lightbulb-over-head moment for Clarice: "He knew her!"
So have I come to see and know death -- in a much more intimate way than I ever expected to. Death has become an integral part of my life, whether I want it to be or not. As such, it has risen to the top of my list of hub topics. We write what we know.
My dear father died November 24, 2008. This morning, a mere 3 months and 2 days later, my beloved father-in-law joined him in heaven.
MM's Dad and Father-in-Law
The Dying Experience
The hospice social worker gave us a booklet titled "Gone From My Sight, the dying experience" (by Barbara Karnes). The information in this booklet is incredibly useful for famiies of terminally ill patients. Even if your loved one is not terminally ill it can be equally useful. It can help you interpret behaviors that otherwise make no sense. Basically, what you're seeing means your loved one is preparing for death.
1-3 Months Prior to Death
Withdrawal -- Beginning of separation from the world. Decreased interest in newspapers, TV, then from people (refuses visitors) and finally from children, grandchildren and even spouse.
Sleeping More -- During this phase the person is going inside self, sorting things out and evaluating one's self and life. This is typically done with the eyes closed. More and longer periods of sleep occur.
Communication -- Words lose importance. Touch and wordless communication become more prominent.
Food -- When the body is preparing to die it's natural that eating decreases or stops. Meats go first, followed by vegetables and other hard-to-digest foods. Eventually only liquids are taken. The body no longer needs fuel. From this point forward, spiritual energy, not physical energy, will be needed.
1-2 Weeks Prior to Death
Disorientation -- Person is sleeping mos tof the time now. S/he often becomes confused, talking to people and about places and events that make sense only in their head. Conversing with loved ones who are already dead is common.
Agitation -- Picking at the bedclothes and agitated arm movements, restlessness occur.
Physical changes -- several changes signal that the body is losing its ability to maintain itself.
* Blood pressure may lower
*Pulse beat may increase to upwards of 150 or decreasing down as low as 0.
*Body temperature fluctuates between fever and cold. There is increased perspiration and clamminess.
*Skin color changes. It's flushed with fever, then bluish with cold. A pale yellowish palor washes over the complexion.
*Nailbeds, hands and feet are often pale and bluish because the heart can no longer circulate blod throughout the body.
*Breathing changes. Respiration may increase from a normal 16-20 to 40-50 breaths per minue. Or it may decrease to 9 or even 6 breaths per minute. You may notics a puffing or blowing of the lips upon exhaling. Rhythmic breathing may stop then restart.
*Congestion causes a rattly sound in the lungs and upper throat. Non-productive coughing may occur. The breathing and congestion symptoms come and go.
1-2 Days or Hours Before Death
*Energy Surge. It's common to experience a final surge of energy. Person may be alert and talking instead of disoriented. S/he may request a favorite meal. Visitors may be asked for (or at least tolerated). The person may move about wanting to move furniture or other activities requiring energy.
This means that the spiritual energy for the transition from this world into the next has arrived. It is used for a brief time in physical expressions.
*The 1-2 week signs (above) become more intense as death approaches.
*Restlessness may increase due to lack of oxygen in the blood.
*Breathing patterns become more irregular and slower. Breathing may stop for 10, 15, up to 30 seconds before resuming.
*Congestion may become very loud, still intermittent.
*The eyes have a glassy look, often tearing. They may be open or semi-open but not seeing.
*Hands and feet become purplish. Knees, ankles and elbows, underside of arms, legs, back and buttockscan be blotchy.
*Person becomes generally non-responsive.
Final Minutes of Life
*Cannot be wakened
*Gasping for air/fish-out-of-water breathing
*Final separation occurs when breathing stops. What appears to be last breath is often followed by 1-2 long-spaced breaths.
*Mouth remains open, unable to close.
*The physical body is now empty. Its owner has moved into the spiritual realm.