As a loved one draws closer to the end of their life, it’s not uncommon for friends and family members to question just how long they have left. While it can be difficult to predict exactly when someone will pass, the Palliative Care Network of Wisconsin notes that most people will go through the same pattern of signs when they are in their final days, which is often referred to as “actively dying” or “imminent death.” They state that recognizing when active death is occurring can help physicians determine the best steps for the dying patient and their family.
Crossroads Hospice & Palliative Care adds that active dying happens after the pre-active stage of death. The pre-active stage can last for a few weeks to a few months. During this period, the dying person may begin to spend more time sleeping. They may also become less alert. Their desire for food and drink may wane. Also, their pulse rate may change and their eye and skin may look discolored or not as bright. When death is imminent, however, certain tell-tale warning signs of approaching death will emerge.
Signs of imminent death
Active dying generally lasts about three days (per Crossroads Hospice & Palliative Care). Hospice of the Golden Isles notes, however, that the process could go on for a week or more, depending on a person’s unique situation.
During active dying, people will completely lose interest in eating and drinking. As their digestive tract shuts down, their bowel movements and urination also slow. They will also retreat inward and may spend most of their time asleep or unaware of their surroundings. They may also seem confused or delirious. Their blood pressure may drop, too, and their body temperature may fluctuate. As their circulation becomes more sluggish, their skin may become cold or develop mottling or a blue or gray color. Finally, as death becomes very near, they may experience what is known as the “death rattle” due to their inability to clear fluids from their lungs (Hospice of the Golden Isles). They can also have what is known as “Cheyne-Stokes” breathing, in which their breathing alternates between deep, heavy breaths; shallow breaths; or periods of no breaths (per National Institute on Aging).
Comforting a person who is facing imminent death
When a patient is likely to have less than six months to live, they may be referred to hospice care. Hospice care is aimed at helping the dying person remain comfortable and emotionally supported rather than treating their underlying illness.
During active dying, a patient who is in hospice may receive a medication such as morphine. Morphine does not speed up death at the end of life as people sometimes might mistakenly think. It can help control their pain as well as ease their breathing. Anti-anxiety medications like lorazepam can be administered to calm their anxiety or treat symptoms such as seizures or nausea. Additionally, drugs like atropine may be given to reduce the death rattle.
Some other steps that caregivers can take to assist a person who is actively dying include using a sponge to wet their lips and mouth, applying lotion to their itchy skin, and covering the person with warm blankets. Additionally, experts suggest talking to the person instead of about them since it is thought that they can still hear you even when they don’t appear to be awake (per National Insitute on Aging).