Dying – What happens to the body beforehand?
WE WILL ALL DIE. For us dying should be surrounded by care (treating the person) and not treating only the illness. We believe strongly in what the Hospice organization do, but also that Death should openly be talked about.
Yet the complicated truth is that we all fear dying. We fear it in different ways, according to our individual circumstances and life experiences, and yet dying is a bodily process in the same way that pregnancy and birth are. Dying has identifiable stages of progression. With life-limiting illness’s medical staff and ourselves can recognise this progression. Less reliably early on, but with increasing accuracy closer to death.
Symptoms in the last few months of life (most common first)
- loss of appetite
- insomnia
- immobility
- fatigue
- mouth infections (e.g. thrush)
- cough
- breathlessness
- pain
- nausea
- pressure sores
- non-healing wounds
- swollen legs
- confusion
- incontinence
- vomiting
Whilst these symptoms are compiled from studies predominately based on cancer patients, many symptoms are commonly seen in patients dying from other illnesses. As with any illness, the progression will not be in a straight line, with symptoms only getting worst. Also don’t assume that the symptoms cannot be relieved or reduced or by your GP or palliative care nurse.
In the last few days
According to the Natural Death Centre – “In the last few days of life the body is slowly winding down, the organs fail, and the dying person is withdrawing from the world. lts not possible to predict exactly when someone will die, but there are often signs that death is close. It is a very natural and normal process, and the final stages of dying are usually peaceful.
- Consciousness – In the last few days most people slip in and out of a coma and become increasingly drowsy, often sleeping for most of the day and night.
- Restlessness and agitation may increase in the Iast few days of life. aim for comfort and symptom control rather than investigating me causes. The exception is urinary retention, which the nurse should assess to see if a ca meter is needed. Sometimes just sitting with the person will ease agitation but a mild sedative
- Eating and drinking will have stopped In me last few days of life for many as the body no longer needs fuel. Lips and mouth will be dry so sponges and lip balm here.
- Breathing/death rattle – As me body becomes weaker, fluid can build up in the air passages, breathing becomes shallower and me person might sound chesty
- People who are dying occasionally have vision-like experiences which may take the form of mumbling in their sleep as if talking to their ancestors.
For those working in palliative care the feedback is that the process of dying is made less frightening and more peaceful the better prepared we are. Knowing what to expect and knowing what our loved ones will see as we die, helps people to plan, to speak to each other openly and honestly, and to relax. In this way it’s usually possible to gather the right people in time, and help them to prepare, because for most of us, dying affects not only the dying person but also their dear ones. Whether or not we are related to the people we hold most dear, dying is a ‘family affair.’ This can avoid the situation where dying people and their families remain unprepared because our fear about death has become a fear about even mentioning dying.
Those working in the hospital environment (where most people die) can get stuck in the combative and stressful world of healing the sick. In many ways to have a better death requires a sea change in attitude, and a reinterpretation of the meaning of the Hippocratic oath, that uncompromising promise to wage war against illness and to fight for life at all cost, into a more subtle holistic approach, one which lets go of the idea of death as the enemy and instead seeks to pull a blanket of comfort around the shoulders of the dying.”