The signs and symptoms of active dying include: Long pauses in breathing; patient's breathing patterns may also be very irregular. Blood pressure drops significantly. Patient's skin changes color (mottling) and their extremities may feel cold to the touch.
For some people, the dying process may last weeks; for others, it may last a few days or hours.
All of the signs described are ways the body prepares itself for the final stages of life. Your loved one may sleep more and might be more difficult to awaken. Hearing and vision may decrease. There may be a gradual decrease in the need for food and drink.
But when the principles are properly applied, the medical examiner can often estimate the physiologic time of death with some degree of accuracy. The most important and most commonly used of these are body temperature, rigor mortis, and lividity.
The end-of-life period—when body systems shut down and death is imminent—typically lasts from a matter of days to a couple of weeks. Some patients die gently and tranquilly, while others seem to fight the inevitable.
Transitioning is the first stage of dying. It describes a patient's decline as they get closer to actively dying. Generally, when one is transitioning, they likely have days — or even weeks — to live. I have seen some patients completely skip the transitioning phase and some stay in it for weeks.
Visions and Hallucinations
Visual or auditory hallucinations are often part of the dying experience. The appearance of family members or loved ones who have died is common. These visions are considered normal. The dying may turn their focus to “another world” and talk to people or see things that others do not see.
They Know They're Dying
Dying is a natural process that the body has to work at. Just as a woman in labor knows a baby is coming, a dying person may instinctively know death is near. Even if your loved one doesn't discuss their death, they most likely know it is coming.
Hospice has a program that says that no one should have to die alone, and yet this hospice nurse is telling me to take a break? Some patients want to die when no one else is there. Hospice professionals know that companionship while dying is a personal preference.
Terminal agitation is typically seen during the hours or days before death and can be distressing and overwhelming for caregivers.
Cardiac arrest is the hallmark of death. It's the moment when the heart stops effectively pumping blood around to the muscles and tissues of the body, especially the brain. This is the moment when every patient dies.
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.
[1] The other changes in the eyes, in the immediate post-mortem phase, include loss of intraocular pressure and the clouding of the cornea. The intraocular pressure decreases drastically after death and reaches 4 mmHg or less within 6 hours after death.
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.
If the body feels warm and no rigor is present, death occurred under 3 hours before. If the body feels warm and stiff, death occurred 3-8 hours earlier. If the body feels cold and stiff, death occurred 8-36 hours earlier. If the body is cold and not stiff, death occurred more than 36 hours earlier.
According to a research most hospital deaths occur between 3am to 4am. This is the time in a day when the body tries to prepare for the activities of the next day while the brain tries to dispose some information to give space to the future happenings of the next day.
Physical signs
Facial muscles may relax and the jaw can drop. Skin can become very pale. Breathing can alternate between loud rasping breaths and quiet breathing. Towards the end, dying people will often only breathe periodically, with an intake of breath followed by no breath for several seconds.
The dying person will feel weak and sleep a lot. When death is very near, you might notice some physical changes such as changes in breathing, loss of bladder and bowel control and unconsciousness. It can be emotionally very difficult to watch someone go through these physical changes.