End-of-life dreams and visions (ELDVs) are not uncommon and are experienced by many near the time of death. These visions can occur months, weeks, days or hours before death.
A conscious dying person can know if they are on the verge of dying. Some feel immense pain for hours before dying, while others die in seconds. This awareness of approaching death is most pronounced in people with terminal conditions such as cancer.
Since ancient times, people have recorded dreams and visions experienced by individuals at the end of their lives. Often during these dreams, the dying individual experiences deceased family, friends or religious figures (Fenwick and Brayne, 2011; Kellehear et al, 2011; Houran and Lange, 1997).
What are ELEs? ELEs are significant, subjective experiences within the dying process that occur while asleep (dreams) or awake (visions). They can happen hours, weeks or even months before a person passes and may increase in frequency as a patient approaches death.
Terminal agitation is typically seen during the hours or days before death and can be distressing and overwhelming for caregivers.
People are considered to be approaching the end of life when they are likely to die within the next 12 months, although this is not always possible to predict. This includes people whose death is imminent, as well as people who: have an advanced incurable illness, such as cancer, dementia or motor neurone disease.
People often become more drowsy and sleep more towards the end of life. This is one of many signs that a person may have when they are in their last few days and hours of life, but not everyone will experience this.
You might be unable to stop crying and worrying. Or you might feel that there is no point in doing anything. You might also find it difficult to see life going on as normal for most people. It can feel very strange to watch people go about their daily lives, do shopping, drive, and work.
Dying may take hours or days. No one can predict the time of death, even if the person is exhibiting typical end-of-life signs and symptoms. This can sometimes cause fatigue and confusion; and although you may be prepared for the dying process, you may not be prepared for the actual death moment.
Your heart stops beating. Your brain stops. Other vital organs, including your kidneys and liver, stop. All your body systems powered by these organs shut down, too, so that they're no longer capable of carrying on the ongoing processes understood as, simply, living.
Hallucinations – They may hear voices that you cannot hear, see things that you cannot see, or feel things that you are unable to touch or feel. These hallucinations may be frightening or comforting to the dying person depending on their content.
This typically lasts no more than a few hours, but each patient is different and it can continue for as long as 24-48 hours. While the sound is difficult for family members to hear, it does not cause the patient pain or distress.
He said, “When the soul leaves the body, it can take a long time or it can happen very quickly. No matter how, it is painful. It is painful for the one who is dying, and it is painful for those who are left behind. The separation of the soul from the body, that is the ending of life.
In time, the heart stops and they stop breathing. Within a few minutes, their brain stops functioning entirely and their skin starts to cool. At this point, they have died.
You might be worried that going to sleep means you might not wake up again. Dr Mannix has found this a common concern among her patients but she reassures them that “becoming unconscious doesn't feel like going to sleep.”
Fear of death is a natural human response. Faced with a terminal diagnosis, many patients struggle with how to overcome fear of death to find peace and acceptance.
Causes of Confusion at End of Life
Secondary issues such as a terminal tumor placing pressure on the brain or even simple fear, anger, or emotional turmoil can also contribute to the type of mental agitation that can lead to confusion.
Pain is common in terminal illnesses -- more than 70% of patients with advanced cancer experience severe pain. A conservative estimate is that over 300,000 cancer patients suffer pain daily. It has been estimated that at least 25% of all cancer patients die without adequate pain relief (AHCPR).
The “whimpers” are part of the sounds of dying, no more, no less. Sighs, moans, gurgles, and soundless cries are all part of the normal, natural way a person dies. We, with our fear and deep sadness of the moment, react and hold on to every expression as if it has meaning.
So what do dying people want? In short: truth, touch and time. They want others — family, friends and physicians — to be truthful with them in all respects, whether discussing the disease process, treatment options or personal relationships. They want truth but not at the expense of reassurance and hope.
Even if someone is unconscious, they may still be able to hear or feel you. If you are worried that they are distressed or in pain, speak to their doctor or nurse. They may be able to prescribe medicines or look at other ways to make them more comfortable.
Is palliative care the same as end of life care? No. Although it can include end of life care, palliative care is much broader and can last for longer. Having palliative care doesn't necessarily mean that you're likely to die soon – some people have palliative care for years.
Terminal care will comprise of extensive physical and medical care within the loved one's own home or hospital setting. During this stage of their palliative care journey, individuals may experience the following physical symptoms: Becoming bedridden. Experiencing severe mobility issues.