How to Recognize When a Patient is Reaching End of Life

Dealing with a death is never easy, however, caregivers should be aware of the symptoms and signs of approaching death before a natural and expected death occurs. These 7 tips will help a caregiver look for the normal changes a patient will experience as death approaches.

Reduced Intake And Lack Of Interest In Food And Fluids: Caregivers should never force food or drink into a patient’s mouth or try to use guilt to manipulate a patient into eating and drinking. As long as the patient can swallow without difficulty, small chips of frozen ice or juice can be refreshing. If the patient wants to eat frequent feedings of desired foods and fluids is more appealing and manageable than large meals.

Decreased Interest And Attention: As the body weakens a person’s involvement with family, friends, pets, or other interests may decrease. A patient may lose interest in favorite topics of conversation. They may want to be alone with only one person at a time or ask that visits be shorter than usual. Patients will weaken and tire easily. Withdrawal from life is a natural preparation for death and caregivers should remember not to feel shut out.


Reduced Strength And Mobility: Caregivers should remember it is natural for a patient to tire and weaken easily. A patient may need increased amounts of rest to handle even simple tasks. A caregiver should assist and supervise all activities to promote safety.


Changing Sleep And Rest Patterns: As a patient nears death day and night sleeping patterns may reverse. If the patient is unable to sleep for several nights, pain should be assessed and health care providers should be notified. When fatigue becomes profound patients may sleep with their eyes and mouth open and appear unresponsive. Caregivers should never try to wake the patient by speaking loudly or shaking. As the patient becomes less responsive caregivers and family members need to remember to continue to speak normally and assume that the patient can hear as hearing is usually the last of the senses to be lost.


Loss Of Control Of Bladder And Bowels: Patients will urinate less as their body weakens and urine will become darker. As the muscles begin to relax in the bladder and bowel areas patient’s will lose control of their bladder and bowels. The nurse can assess if a catheter is needed for extra comfort. The patient should be kept clean and comfortable and pads should be used to prevent frequent soiling of furniture.


Descriptions Of ‘Supernatural’ Experiences: It is common for patients who are near death to describe meetings with others who have died before. For patients who experience anxiety over their impending death this is often when they start to relax and feel at peace. Patients who describe these types of experiences generally feel calmer and have less emotional struggle.


Energy Surge: At the very end of life caregivers often see a surge of energy in the patient. The patient may become very alert after a period of deep sleep and extreme weakness. The patient may want to try things such as walking around or taking off their clothes when they haven’t done so for weeks. The patient may also have an increase in appetite and eat all their meals when before they could only manage a spoonful. Caregivers should inform families that this is not a sign of recovery rather it’s a sign that death will occur usually in the next 24 hours.


Even though a patient is nearing death caregivers should give the patient the freedom to be independent in their lives and care as much as possible. By recognizing these symptoms and signs you can begin to prepare yourself to handle the inevitable.

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