The term agony, deriving from the Greek ἀγωνία that means “fight”, defines the last moments of the living organism's existence before the encounter with death, and its phenomenology is still to be explored. One of the most problematic issues related to agony is its length.
ES, also coined as premortem surge, terminal lucidity, or terminal rally, is a deathbed experience reported as a sudden, inexplicable period of increased energy and enhanced mental clarity that can occur hours to days before death, varying in intensity and duration (Schreiber and Bennett Reference Schreiber and Bennett ...
Most people do not die in pain. With the right treatment, care and support, the vast majority of people we see are comfortable and not in pain at the end of life.
Pain is a part of life and may also be a part of death. Similar to how you experience different types of pain sensations in life (from the type of sensation to how intense it feels), you may experience various pain sensations in death. Much depends on your cause of death and whether you have access to pain medications.
Gasping is a brainstem reflex; it is the last respiratory pattern prior to terminal apnoea. Gasping is also referred to as agonal respiration and the name is appropriate because the gasping respirations appear uncomfortable, causing concern that the patient is dyspnoeic and in agony.
This stage is also one of reflection. The dying person often thinks back over their life and revisits old memories.4 They might also be going over the things they regret.
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.
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.
Putrefaction (4-10 days after death) – Autolysis occurs and gases (odor) and discoloration starts. Black putrefaction (10-20 days after death) – exposed skin turns black, bloating collapses and fluids are released from the body.
Technically, there is no such thing as dying from old age, but it is a term that is often used to generalize someone's death, which may be down to a number of causes and factors.
Terminal agitation is typically seen during the hours or days before death and can be distressing and overwhelming for caregivers.
Many people living with a terminal illness experience pain, but not everyone does. It could be caused by your illness, or by a treatment or operation you've had. It could also be caused by a condition you've had for a while, such as arthritis.
In the hours before death, most people fade as the blood supply to their body declines further. They sleep a lot, their breathing becomes very irregular, and their skin becomes cool to the touch. Those who do not lose consciousness in the days before death usually do so in the hours before.
Your loved one may become restless and pull on bed linens or clothing, hallucinate, or even try to get out of bed, due to less oxygen reaching their brain. Repetitive, restless movements may also indicate something is unresolved or unfinished in the person's mind.
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.
Phase 1: Hypostasis
This occurs within an hour to several hours after death. The blood vessels collapse. Pooling of blood due to gravity can occur but will leave white gaps at pressure areas. Regurgitation of gastric contents can occur, as can the emission of semen.
Here is a brief summary of the changes that happen in the body in the hours and days after death: One hour: Relaxation of muscles (primary flaccidity) starts right away, followed by the skin becoming pale. Two to six hours: Muscles begin to stiffen (rigor mortis)
By 50 years in, your tissues will have liquefied and disappeared, leaving behind mummified skin and tendons. Eventually these too will disintegrate, and after 80 years in that coffin, your bones will crack as the soft collagen inside them deteriorates, leaving nothing but the brittle mineral frame behind.
The first organ system to “close down” is the digestive system. Digestion is a lot of work! In the last few weeks, there is really no need to process food to build new cells. That energy needs to go elsewhere.
“Our data shows that a dying brain can respond to sound, even in an unconscious state, up to the last hours of life.”
'Peaceful' refers to the dying person having finished all business and made peace with others before his/her death and implies being at peace with his/her own death. It further refers to the manner of dying: not by violence, an accident or a fearsome disease, not by foul means and without much pain.
So, what does it feel like to die? As these studies record, death by cardiac arrest seems to feel either like nothing, or something pleasant and perhaps slightly mystical. The moments before death were not felt to be painful. We don't know if this would extend to other causes of death, but still, it is reassuring.
Particularly in the last few minutes, the person's face muscles may relax and they may become very pale. Their jaw may drop and their eyes may become less clear. The person's breathing will eventually stop. Often, the person's body will completely relax.
The immediate aftermath of dying can be surprisingly lively. For the first few minutes of the postmortem period, brain cells may survive. The heart can keep beating without its blood supply. A healthy liver continues breaking down alcohol.