Those final months, weeks, and days before a loved one dies can be extremely difficult. Sometimes, you know that your loved one is suffering or in pain. Maybe you haven’t been able to have a regular conversation with them in a little while, or have been mourning their departure for a period of time (even though they’ve still been physically present). But often, the hardest part about knowing a loved one will soon die, is the ‘waiting’ part.
When will it happen? How can I ensure I’m there when it happens? Or, on the contrary, How can I ensure I’m not in the room when it happens?
In this guide, we’ll dive into the 10 most common signs to look out for – these often signify that a loved one’s death is imminent.
But we’ll start by answering one, very frequently-asked question…
Can doctors and/or nurses tell me when my loved one is about to die?
While we wish that doctors and nurses held the key to all the information we’ll ever need to know about our loved ones and their health, they unfortunately don’t know (and can’t predict) everything. Of course, there are a range of signs healthcare professionals and death doulas will look out for when they know a patient is likely to pass away in the near future (due to their health condition and current state – ie. If they’re in palliative care, they’re likely preparing for their end-of-life). We’ll touch on some of these signs in this article so you, too, can look out for them.
What doctors and nurses can do, however, is give you an estimate on how long your loved one might have left. This isn’t always accurate, and sometimes their estimates can be ambiguous in nature, but these estimates can be a comforting way for family and friends to start preparing themselves for their loved one to pass. Particularly if your preparing for a loved one to die at home.
Why do changes happen near the end of someone’s life?
When a person dies, their body begins to slow down. It can no longer function in the way it once did.
However, it’s important to note that not every individual will display the same signs in their final moments before death. And while some changes are obvious and visible at surface level, others are not.
What signs of near-death can I look out for when visiting my loved one?
These signs don’t always mean, for certain, that death is near, but they can mean that it is. The significance of these signs also depend on your loved one’s condition before they start to show – and maybe they were already exhibiting these signs in the days, weeks and months prior as a result of their condition or ill health.
1. Changes to weight
As our loved ones come closer to death, it’s not uncommon for them to lose weight and muscle. They might begin to look thin and frail (regardless of their weight prior), and experience a loss of appetite. This weight loss and loss of appetite can be due to a range of circumstances; their body might be slowly shutting down, or their medication and/or illness could be causing the change.
On the other hand, some can start to swell or become ‘puffy’ (this is referred to as ‘oedema’) as a result of a build-up in fluid. This, too, can be caused by certain medicines.
2. Eating and drinking less
We mentioned above that this isn’t uncommon for someone who is about to pass away. When we’re dying, our body requires less energy, so naturally, a dying person might not feel like food. Doctors and nurses often recommend refraining from forcing your loved one to eat when they’re nearing the end of their life – often ensuring they eat and/or drink won’t extend their life expectancy.
It’s always worth offering some food to your loved one, just in case they do want some. Small portions of higher calorie yet easy-to-swallow foods can be a good option (like ice cream, yoghurt, or sucking on ice chips).
3. Sleeping more
Everyday activities can become too tiring when a person is nearing the end of their life. Sometimes even sitting in a chair for too long – or sitting in a chair at all – can feel too challenging and exhausting. As a result, your loved one might spend more time sleeping, and will likely prefer to lie down in bed than do anything else.
At this stage, it’s important to help your loved one in any way you can; do their washing, ensure they’re comfortable, call for medical help when they need it, and assist them in going to the toilet.
If your loved one is choosing to die at home and you don’t feel 100% comfortable with doing certain tasks (like taking them to the toilet, or showering them), you can always organise in-home hospice care.
4. Feeling hotter or colder than usual
When someone is nearing death, their body often can’t regulate temperature in the way it once did. As a result, they might feel hotter or colder than usual. If this happens to your loved one, you can offer to bring them a blanket, open the window, or make them something hot or cold to drink (if they have an appetite, that is).
‘Dyspnoea’ refers to a shortness of breath that occurs close to death. This shortness of breath isn’t related at all to underlying disease, and can be brought on by imminent death.
One way to minimise your loved one’s experience with breathlessness is to ensure they feel comfortable, calm and relaxed; anxiety can often worsen their breathing.
6. Issues with their bladder
Near the end of life, some people can lose control of their bowels and/or bladder. This can happen because our muscles begin to relax when we’re about to die, as our body slowly shuts down and prepares for death. This can be an extremely embarrassing sign of death for the person experiencing it.
Our recommendation is to ensure that your loved one’s dignity remains as intact as possible – and doctors and nurses can often make some helpful suggestions around this (including the use of pads and wipes).
7. Noisy breathing
We love to find noisy breathing irritating, don’t we? On the train, in the office, when our partner is sound asleep next to us and we’re struggling to catch some much-needed z’s. However, if your loved one is nearing death, they can also start breathing noisily. (Although this noise can sound pretty different to those irritating noises your partner makes).
The way we’d describe noisy breathing when someone is about to pass is like a mucous-y rattle. Some people even refer to it as the ‘death rattle’. This can occur because your loved one isn’t able to cough or clear their airways.
You can help them clear their airways (or breathe a little quieter, and more comfortably) by shifting their position or requesting medications from a doctor or nurse. Sometimes they won’t be able to provide an appropriate medication, but it’s always worth asking.
It’s important to note that although the ‘rattle’ might sound uncomfortable, your loved one likely won’t be feeling any pain. In fact, they might not be uncomfortable or distressed at all – this is a totally normal and pretty common symptom before someone passes away.
8. Body pains
Our biggest concern when a loved one is dying is often, Are they in pain? And the answer, sometimes, is yes. But the good news is that with the right treatment, care and support, their pain can be managed, and they’ll be able to die comfortably and easily.
9. Restlessness and becoming agitated
It can be difficult for your loved one to get comfortable when they’re dying, which, really, is where your help will be very much appreciated. Sometimes people who are dying will struggle to make themselves comfortable because they’re worried or nervous about death, anxious about what will happen after they’ve died, or they could be experiencing bed sores or pain.
If this happens, it’s worth touching base with a doctor or nurse so you can find a solution that’ll make your loved one more comfortable in their final days or hours. It can also be helpful to ensure your loved one feels cared for and relaxed at all times. Creating a warm and comforting environment for them can make a huge difference to their physical comfort.
10. Becoming delirious
‘Delirium’ refers to confusion that can come on suddenly over a short period of time (sometimes hours or days). The person might suddenly feel confused, and they can experience hallucinations. Often, you can provide the individual with medication that can help them combat this experience, but a great way to tackle things from your end as a loved one and carer, is to provide them with comfort and reassurance.
While these are some of the 10 most common signs that death is near, it’s important to remember that no two humans are the same. While some individuals will exhibit certain signs, others won’t. And vice versa. What’s most important – when you know a loved one is dying – is to provide them with support and comfort. Keeping them as relaxed as possible, and doing whatever you can to maintain their sense of self, is most essential.
If you are caring for a loved one at the end of their life, having a plan in place for their cremation is often a good idea. This is particularly true if a person has chosen to pass at home. Willed's dedicated team of funeral planners can assist. Call them on 1300 945 533 or go to willed.com.au to learn more.