Hospice Signs of Dying

The hospice signs of dying are certain indicators that hospice workers use to determine that death is imminent. The actual process of dying is also known as “active dying.” Although some family caregivers are uncomfortable acknowledging that the dying process is starting, knowing these signs can help family members to remain calm and keep the dying person comfortable.

A person who is actively dying increasingly withdraws from his or her surroundings. The dying person will probably not move or speak very much, if at all. The person will become increasingly unresponsive, and may fall into very deep sleep or even a coma as death approaches. The dying person may hallucinate, seeing things that aren't really there, and may be disoriented and confused. Agitation and restlessness sometimes occur, and doctors can prescribe mild sedatives to reduce anxiety or increase medications for pain.

During active dying the rhythm of breathing changes. Long pauses in breathing, from 5 to 30 seconds, alternate with light, rapid breaths. Fluid build-up in the lungs causes breathing to be very noisy with rattling sounds. This noisy breathing is usually not painful for the dying person, but it can be stressful for family members to hear. Light suction of the mouth will not get rid of the noise, but it may make the dying person more comfortable. Doctors can prescribe medications such as atropine to reduce fluid build-up, which may ease the noisy breathing somewhat. Sometimes a gently blowing fan can help make the patient more comfortable, or a humidifier. As the time of death approaches, the jaw moves during each breath and the mouth stays open. When this jaw movement occurs, death is usually only hours away.

In active dying, blood pressure drops dramatically and the pulse becomes both faster and weaker. Feet and hands may feel cool to the touch, and appear mottled, grayish, or pale. Nail beds, lips, and earlobes take on a bluish color as less oxygen circulates through the body. The patient can be kept warm with light sheets and blankets; however, if the person continually throws off sheets and blankets, they may be feeling too warm, even if the feet and hands feel very cool.

A person who is actively dying may show little interest in food or liquids, and may actually refuse any food or drink. Swallowing becomes very difficult as death approaches, and dehydration may set in. Since dryness in the mouth can be uncomfortable, caregivers may use wet swabs or ice chips to keep the dying person's mouth moist. Lip balm prevents and eases painful cracking and dryness.

Urine may take on a dark color and will be less as the dying process progresses, and bowel movements may be infrequent or absent. The dying person will probably experience both bowel and bladder incontinence, and caregivers should be careful to keep the skin clean and dry to avoid discomfort for the person who is dying.

Caregivers should try their hardest to keep the dying person comfortable. If the person refuses food or water, caregivers shouldn't force the issue. Pain medication should be given if the dying person is moaning, grimacing, or is showing other signs of pain. Caregivers need to remain quietly supportive throughout the dying process, and not argue with the dying person if they begin to hallucinate or become confused. Caregivers can talk to the dying person to offer comfort, as he or she may be able to hear even if unable to respond. The room should be quiet and peaceful, and the dying person treated gently and respectfully at all times. A hospice nurse is usually on call around the clock, so caregivers should call if a certain symptom becomes overwhelming or death seems to be very close. It's always okay to ask for help, especially during the process of active dying.

Seeing the hospice signs of dying may make the approaching loss feel very real and very frightening. Family members may find it very difficult to be present as their loved one dies, and may want the symptoms to stop or the doctor to do everything possible to keep the person alive. The hospice approach to care attempts to give patients as comfortable and peaceful a death as possible, but does not allow for life-prolonging attempts. Be aware that if paramedics are called instead of hospice workers, they may try to resuscitate the dying person. The process of resuscitation can be very violent and uncomfortable, and may only prolong the dying process for hours or days.

The best thing to do for the dying person is simply to be present. Hold the dying person's hand, or gently put a comforting hand on the person's shoulder. Talk to your loved one, and tell your loved one how much you care for him or her. If it fits in with your beliefs, pray for the person or with the dying person if they are able. Talk with the dying person about the afterlife if they want you to, and reassure your loved one as much as you are able.

Keeping vigil with someone who is dying can be exhausting, so caregivers need to remember to care for themselves too. Enlist family members to help with any arrangements, and give everyone time and space to grieve. If it helps, caregivers can share feelings with the hospice social worker, clergy, or family and friends. Grief takes a long time to get through and each person grieves in unique ways. Supporting a loved one as they die is a huge gift to that person, and can be an amazing way to show the dying person how very much you love him or her.

• Dying Celebrities
• Books on Grief for a Stillborn Child
• Children's Books About Death

• Free Funeral Program Template
• Sample Funeral Program
• Poems Related to Grief
• Bereavement Poems by Unknown Authors
• Poem about Death of a Dog

• Sample Grief Group Session
• Category:Coping With Grief
• Physical Stages of Dying
• Signs that a Pet May be Dying
• What Is the Definition of Hospice