This surge of energy is usually short, lasting anywhere from a few minutes to several hours, and may occur one to two days prior to death. This is unique to each person, and not everyone will experience such a noticeable burst of energy. The dying person may experience increased: Appetite.
This difficult time may be complicated by a phenomenon known as the surge before death, or terminal lucidity, which can happen days, hours, or even minutes before a person's passing. Often occurring abruptly, this period of increased energy and alertness may give families false hope that their loved ones will recover.
Palliative care experts say it is not uncommon for people in hospice care to perk up briefly before they die, sometimes speaking clearly or asking for food.
Some argue that a rise of neurotransmitters could be released from the brain in response to deteriorating health. Others suggest that the body might be attempting to prepare for the final stages of life or that the surge is connected to the patient's emotional state.
Most people who are dying feel tired. They may want to sleep more often, or for longer periods. They may want to talk less, although some may want to talk more. They may want to eat less or eat different foods since their stomach and digestive system are slowing down.
This surge of energy is usually short, lasting anywhere from a few minutes to several hours, and may occur one to two days prior to death. This is unique to each person, and not everyone will experience such a noticeable burst of energy. The dying person may experience increased: Appetite.
Terminal lucidity is not an official medical term, but it refers to people with dementia unexpectedly returning to a clear mental state shortly before death. Experts do not know exactly why a person may experience this lucidity, and more research on the neurological mechanisms involved is necessary.
Terminal lucidity, also known as paradoxical lucidity, rallying or the rally, is an unexpected return of mental clarity and memory, or suddenly regained consciousness that occurs in the time shortly before death in patients with severe psychiatric or neurological disorders.
Changes in Muscle Function
Sudden, involuntary muscle movements called myoclonic jerks and the loss of reflexes in the legs and arms are additional signs that death is near. Myoclonus is not painful, but the abrupt onset of these uncontrollable muscle spasms can be distressing.
Mental changes
As death nears, you may start to see or hear things that no one else does. You may also become agitated, or be more or less alert at different times. This is known as delirium. Your caregiver will tell a doctor or hospice palliative care worker if you're having delirium.
What happens at the moment of death or in the hours before death, is generally just normal body actions. A tear is natural -- the eyes are partially open and have been for days or even weeks. There is a drying out of the eyes and the body is trying very hard to produce moisture.
Periods of rapid breathing, and no breathing for brief periods of time, coughing or noisy breaths, or increasingly shallow respirations, especially in final hours or days of life.
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.
A death grip is an extremely tight grip, such as that exerted by people in a panic for fear for their life. This was commonly thought to be a risk when rescuing drowning people—that they would cling to their rescuer with a death grip which would cause them both to perish.
End-of-life rallies are not fully understood, and no one can predict just how long a rally will last. In rare instances, it can last a week or more, but in most cases it's a very brief window to connect with your loved one. Families who understand this can spend that time chatting and making a final connection.
Terminal agitation is typically seen during the hours or days before death and can be distressing and overwhelming for caregivers.
The first stage, known as clinical death, occurs when a person's heart stops beating. About four to six minutes later, brain cells start to die from the loss of oxygen and biological death occurs.
Shock: During this phase, people are often in a state of shock. Their feelings go back and forth between agony and disbelief. They often feel that they are in a state of misery that isolates them from the world. Dealing with the bad news takes up most of their physical and emotional energy.
Agonal breathing or agonal gasps are the last reflexes of the dying brain. They are generally viewed as a sign of death, and can happen after the heart has stopped beating.
Pulse and heartbeat are irregular or hard to feel or hear. Body temperature drops. Skin on their knees, feet, and hands turns a mottled bluish-purple (often in the last 24 hours) Breathing is interrupted by gasping and slows until it stops entirely.
You breathe your last breath. Your heart stops beating. Your brain stops. Other vital organs, including your kidneys and liver, stop.