Drop in Body Temperature and Blood Pressure
Body temperature can go down by a degree or more as death nears. Blood pressure will also decrease, contributing to reduced blood flow to the hands, feet, nose, and lips. You may notice the patient's skin turning pale, bluish, or mottled.
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.
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.
The active stage of dying generally only lasts for about 3 days. The active stage is preceded by an approximately 3-week period of the pre-active dying stage. Though the active stage can be different for everyone, common symptoms include unresponsiveness and a significant drop in blood pressure.
End-of-life transition refers to a person's journey to death, especially in those with a terminal diagnosis. This process occurs differently for everyone. For some, it takes days or weeks; for others, it occurs rapidly. Partnering with a trusted medical team during this time can limit pain.
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.
Gasping respiration in the dying patient is the last respiratory pattern prior to terminal apnoea. The duration of the gasping respiration phase varies; it may be as brief as one or two breaths to a prolonged period of gasping lasting minutes or even hours.
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.
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.
Fear, anxiety and anger are all commonly seen characteristics of patients with terminal illnesses. As your loved one's health declines, you may notice them develop bitterness or anger. This is called terminal agitation. Along with this, terminal delirium and terminal restlessness may also present themselves.
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.
There are three main stages of dying: the early stage, the middle stage, and the last stage. These are marked by various changes in responsiveness and functioning. However, it is important to keep mind that the timing of each stage and the symptoms experienced can vary from person to person.
Terminal agitation is typically seen during the hours or days before death and can be distressing and overwhelming for caregivers.
The Danger of Death Sign is a hazard warning sign. Depicted by a yellow triangle, with a black surround, a pictogram of an immobile figure and a downward pointing flash. These signs are used on building sites, industry and workshops to alert employees and visitors of significant danger.
Absence of respiratory sounds and movements, heartbeats, brain stem reflexes, ECG, and EEG activity signifies death and are noted as the signs observed immediately after death.
You breathe your last breath. Your heart stops beating. Your brain stops. Other vital organs, including your kidneys and liver, stop.
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.
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.
Decomposition can divide into five stages – fresh, early decomposition, advanced decomposition, skeletonization, and extreme decomposition. The early decomposition phase begins with the onset of skin slippage and hair loss. These changes usually begin from the first day after death to up to five days post-mortem.