The changes which occur
The dying process is unique to each
person but in most cases, there are
common characteristics or changes
which help to indicate that a person
Any one of these signs can be
attributed to something other than
Loved ones may find it easier to dying, so remember that the events
support each other if they know what to be described here are happening
to a person whose illness is already
may happen during this sad and
so severe that life is threatened.
The many changes which indicate that
life is coming to an end fall into three This leaflet was conceived and developed
by practicing palliative care nurses.
Irene Salmon RN, Catherine Griffiths PhD RN
and John Bridson BA (Hons) MSc RN
Coping with dying
1. Diminished need for food and drink
2. Changes in breathing Understanding the changes
which occur before death
3. Withdrawing from the world
Diminished need for Changes in breathing Withdrawing from the world
food and drink People who suffer from breathlessness ‘Withdrawal from the world’ is a gradual
are often concerned that they will die process. The person will spend more
There comes a point in most people’s Initially, as weakness develops, the
fighting for their breath. Yet towards time sleeping and will often be drowsy
effort of eating and drinking may
lives when death and dying are the end of life, as the body becomes when awake.
simply have become too much and at
contemplated. Perhaps we must face this time help with feeding might be
less active, the demand for oxygen is
This apparent lack of interest in one’s
our own death or that of someone actually reduced to a minimum.
appreciated. surroundings is part of a natural process
close to us, but we don’t know what Your relative/friend will be supported
This may be comforting to those who which may even be accompanied by
to expect. have had breathing problems, as carers feelings of tranquillity. It is certainly not
to take food and fluids by mouth for
often remark that when a loved one is a snub to loved ones.
as long as possible.
In order to reduce the anxiety which dying their breathing is easier than it
Eventually the person may lapse into
often comes from the unknown, this When someone stops eating and has been for a long time.
unconsciousness and may remain in
leaflet describes some typical features drinking it can be hard to accept,
Of course, breathing difficulties can be this state for a surprisingly long time
even when we know they are dying.
of the process of dying. It may be a physical sign that they are
made worse by feelings of anxiety. But (in extreme cases many days) although
the knowledge that someone is close for others it is shorter.
It anticipates questions you may want not going to get better. Your
at hand is not only reassuring; it can be
relative/friend may neither want or When death is very close (within minutes
to ask and hopefully it will encourage a real help in preventing breathlessness
need food and/or drink and decisions or hours) the breathing pattern may
you to seek further help and about the use of artificial fluids (a
caused by anxiety.
change again. Sometimes there are
information. drip) will be made in the best interests Occasionally in the last hours of life long pauses between breaths, or the
of your relative/friends for this there can be a noisy rattle to the abdominal muscles (tummy) will take
moment in time. This decision will be breathing. This is due to a build up of over the work – the abdomen rises and
explained to you and reviewed mucus in the chest, which the person falls instead of the chest. If breathing
regularly. is no longer able to cough up. appears laboured, remember that this
Medication may be used to reduce this is more distressing to you than it is to
Try not to be discouraged if there is
and changes of position may also help. the person dying.
little response – this may be due to
weakness, not lack of appreciation. These measures may have limited The skin can become pale and moist
Simply being together can be a great success, but while this noisy breathing and slightly cool prior to death. Most
comfort to both of you. is upsetting to carers it doesn’t appear people do not rouse from sleep, but
to distress the dying person. die peacefully, comfortably and quietly.
Most importantly, being cared for in
this way enables people to feel that If the person is breathing through the This is a difficult and painful time for
their lives have been worthwhile and mouth, the lips and mouth become dry. you. You are leaving those you love or
that they will be remembered. Moistening the mouth with a damp losing someone you love and care for.
sponge and applying lip salve will give It is often hard to know what to say to
comfort. each other at a time like this.
Nurses, doctors and other staff are there
to help you to work through your worries
and concerns and to offer you care and