A Personal Journey: What to Expect In the Final Days of Life

Many people wonder if they will recognize that a loved one is dying.

Each person’s journey to death is unique and nothing is set in stone. Some people fade quickly while others experience a gradual decline. There are many paths one can take on this journey but they all lead to the same destination. Knowing what to expect and how to respond in ways that will help your loved one will allow him or her to accomplish this final stage of life in the best way possible.

Physically, the body begins the final process of shutting down through a series of progressive changes that include:

• Increased sleeping: Due to changes in body metabolism, your loved one may spend more time sleeping and may be difficult to rouse in the final days of life. Speak to him or her directly as you normally would, in a soft tone, even though there may be no response. Never assume the person cannot hear, as hearing is the last of the senses to be lost.
• Reduced intake of food and drink: The person may have a decrease in appetite and thirst, as the body begins to conserve the energy it expends. Do not try to force food or drink, as it will only add to his or her discomfort.
• Coolness: The hands and arms, feet and then legs may be increasingly cool to the touch and the color of the skin may look more pale or purplish. This indicates that blood circulation is decreasing and is being reserved for the most vital organs.
• Disorientation: The person may seem to be confused about the time, place and identity of the people surrounding him or her, including family members and other familiar people. This is also due in part to the metabolism changes.
• Breathing pattern changes: You may notice a different, irregular breathing pace. A particular pattern of shallow breaths followed by periods of not breathing for up to a full minute, known as Cheyne-Stokes breathing, is not uncommon. You may also see periods of rapid, shallow breathing that’s similar to panting. These common patterns indicate a decrease in circulation in the internal organs. Elevating the head and turning the person onto his or her side may bring comfort.
• Restlessness: The dying person may make agitated and repetitive motions such as pulling at bed linens, IVs or clothing. This common occurrence is again due to the decrease in oxygen circulation to the brain. Don’t try to restrain these motions. To have a calming effect, speak in a quiet, soothing way. Other things which may be helpful are recalling fond memories and favorite places, reading something comforting, playing music or lightly massaging the forehead.

Emotionally, the spirit of the one who is dying begins the final process of release from the body and its environment. This emotional release follows its own priorities, which may include the resolution of any unfinished business and the family’s permission to ‘let go’. The most appropriate kinds of responses to these emotional-spiritual changes are those that support and encourage this release. You may encounter:

• Withdrawal: Your loved one may seem unresponsive or in a comatose-like state. This indicates preparation for release, a detaching from surroundings and relationships, and the beginning of letting go.
• Visions: The person may speak or claim to have spoken to persons who have already died. He or she is beginning to detach from this life and is preparing for death, so it will not be so frightening. Do not contradict, belittle or argue about what your love one claims to have seen or heard.
• Decreased socialization: In the final hours or days, the person may only want to be with a very few or just one individual. This indicates from whom support is most needed in order to prepare for death. If you are part of the final inner circle of support, the person needs your affirmation and permission to leave.

When the person is ready to pass and you are able to let go, it’s time to say goodbye. Saying goodbye is your final gift of love, as it achieves closure and makes the final release possible. It may be as simple as saying I love you. Or it may include recounting favorite memories, places and activities you shared. Like the dying process, saying goodbye is also a very personal experience. It’s important to keep in mind that there’s no right or wrong way to go about it.

Do you need more information or additional help? Families, friends and caregivers of someone who is dying can turn to the Family Caregiver Alliance and the National Hospice and Palliative Care Organization for support. Our caring, compassionate funeral directors are always happy to assist you, as well. We invite you to reach out to us anytime.

About Vaughn Greene Funeral Services: For more than 20 years, Vaughn Greene Funeral Services has been providing a ministry of care to Baltimore’s African American community. As a leading local, minority- and family-owned provider, we promise to provide our highest level of service and respect to families who entrust us to honor their loved one. For more information, please call us at 410.655.0015 or visit us online at https://vaughncgreene.com/.