For many people, death is an unfamiliar process. Terminally ill patients and their caregivers may wonder what to expect during this stage and how to make this time more comfortable. Having a better understanding of what happens during this process can help everyone involved to better prepare for this transition and each of the stages of dying.
Three Main Stages of Dying
There are three main stages of dying: the early stage, the middle stage, and the last stage. These are marked by various changes in responsiveness and functioning. However, it is important to keep in mind that the timing of each stage and the symptoms experienced can vary from person to person. Outlined below is a general look at what to expect during each stage.
Early Stage of Dying
In the early stage of dying, a patient will begin eating and drinking markedly less. This period can last anywhere from a few days to several weeks.
What You Will See
The first sign of this stage of dying will be a noticeable drop in interest in food. For many patients, eating becomes more of a burden than a joy at this point. They may also occasionally choke on their fluids and will start to feel full rather quickly.
What Is Actually Happening
During this stage, the body starts conserving energy and does not need as much nourishment as it did in the past. Although it may be troubling to witness, it does not cause the patient any pain or suffering. This is a natural process where the body shuts down hunger, and artificial feeding at this time does not prevent death and can even lead to physical distress.
To provide comfort, loved ones can offer patients bits of food, sips of fluid, or ice chips, but it is important to respect the patient’s wishes when it comes to eating and drinking.
Middle Stage of Dying
The middle stage of dying is marked by changes in the patient’s physical appearance that could last a few hours or several days.
Signs You Will Notice
The person will become increasingly less responsive to their surroundings and those around them, to the point where they will eventually become unable to speak or move at all. This is typically seen during the last days of life.
What Is Occurring In Stage Two
As the body’s circulation slows down, blood is reserved for helping major internal organs function. The patient’s hands and feet might feel cold and could become darker in appearance.
During this stage, loved ones can offer blankets to increase comfort as the patient’s circulation changes. However, heating pads and electric blankets are not advised because the patient will be unable to judge if they are becoming too hot.
The detachment from their surroundings and relationships is the body’s physical and spiritual response to the process of dying and is perfectly normal.
Loved ones should assume the patient can hear everything they say. Experts suggest speaking softly to the patient and touching them gently only if they normally like being touched. This is a good time for prayer or meditation. It is not recommended to ask the patient questions that require answers.
Last Stage of Dying
During the final stage of dying, disorientation and restlessness will grow. There will be significant changes in the patient’s breathing and continence.
What You Will Notice
The patient’s bowel movements may stop entirely, or they may become incontinent. Their breathing may become shallow and irregular, with long pauses that grow frequent as death approaches. There may also be sounds of chest congestion and throat rattling in the last hours.
What Their Bodies Are Doing
The restlessness noted in this stage is attributed to changes in metabolism, while the kidney and bowel functions are affected by decreasing circulation. Relaxing muscles can lead to incontinence. The slowing of blood circulation to internal organs causes the lungs to lose their power to clear out fluids as well as the relaxation of the throat muscles.
When a patient enters the final stage of dying, it is helpful to talk to them reassuringly. Again, gentle touch is acceptable if the patient likes being touched. Even when they are not responsive, the patient might be able to hear those around them, so it is important to speak respectfully. Although this can be a distressing time for loved ones, it is best to try to stay calm.
Some patients may need medication for restlessness, diapers, a catheter, or underbody pads. At this point, administering oxygen will not help. However, it may be useful to elevate the head of the patient’s bed or use pillows to help lift their head; turning the patient on their side may also increase comfort.
Talk With Hospice Care About the Stages Of Dying
If your loved one has a life-limiting illness, hospice care can help improve their quality of life during their final months. Complete the Request Care form to speak with a Traditions Health representative to find out how we can help your family and your loved one physically, emotionally, and spiritually each step of the way.
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