When Death Occurs at Home
As a person is dying, their body will go through a number of physical changes as it slows down and moves toward the final stages of life. Many of these changes are normal and to be expected. Please remember that each person is different; all of these signs and symptoms won’t occur for everyone. Although the following changes are presented in the order in which they usually appear, some variation is common.
When you notice changes, report them to your home care nurse or family doctor, who can make any needed adjustments in medications and offer practical suggestions. If you have questions or concerns at any time, please talk to the home care nurse, family doctor or one of the Yukon Palliative care team members.
We hope that this information will help you prepare for changes that are likely to happen. We include some practical advice and comfort measures to help you in your role as caregiver and advocate.
A dying person may…sleep longer
A dying person may sleep for longer periods and sometimes have difficulty waking. Times of increased activity and communication may be followed by hours or days of deep sleep and unresponsiveness. In the moments before death occurs, many people appear to be sleeping or comatose.
A dying person may…eat and drink less
It is normal at end of life for people to have very little appetite or thirst. A dying person may not be interested in food or drink. This is a natural part of their body preparing for death.
A dying person may…become confused and/or restless
A dying person may be unable to recognize familiar people or surroundings, may see things that you cannot see, pull at their sheets and clothing or reach into the air.
A dying person may…experience emotional and spiritual changes
A dying person may talk about going somewhere, ask to go home, or see and speak to people you don’t see. Strong emotions such as fear or anger may be expressed near end of life. Although not everyone will experience these responses, they are considered normal and expected.
A dying person may… have difficulty swallowing
A dying person may forget to swallow or have difficulty swallowing as weakness increases. Foods and fluids with the consistency of yogurt are easier to swallow than thin water-like fluids.
A dying person may… have irregular or shallow breathing
Rapid shallow breathing is common. There may be pauses between breaths of 10-30 seconds or longer. Changing breathing patterns are normal, and usually the dying person is unaware of and untroubled by these changes.
A dying person may… develop wet-sounding breathing or moaning
As the body weakens, saliva may collect at the back of the throat and cause wet-sounding breathing. This wet sound may also be caused by congestion deeper in the lungs. Moaning as the person breaths in or out may or may not be an indication of discomfort.
A dying person may… become unresponsive
The person may no longer respond to voices, being touched or may seem to be sleeping with their eyes open.
A dying person may… lose control of bladder or bowels
If the person has stopped eating and drinks very little, loss of bowel and bladder control may not be an issue. Decreased urine output and bowel movements are normal at the end of life.
A dying person may… have a change in body temperature
The person may feel unusually hot or cool to the touch. If the temperature-regulating part of the brain is not working or a fever has developed, the person will feel hot to the touch. Conversely as circulation slows, the person’s arms, legs, hands and feet may feel cool, and the skin may look patchy or bluish in colour. These changes are a normal part of the dying process. Typically, the person will not be feeling cold as this natural cooling occurs.
For many people, saying goodbye is an important part of the dying process. The person who is dying, as well as friends and family members, may wish to find ways to express their love, gratitude and sorrow to each other. Some people may choose to say goodbye through conversations, letters, trips and rituals, or simply by being together. Some dying people seem most comfortable with loved ones around, while others may be more at ease with quiet and privacy. Usually the amount of stimulation and contact with others that people preferred when they were well is similar to what they desire near the end of life. A dying person may seem to choose the time to die, perhaps when particular people are present or when they are alone.
You may wish to:
At the time of death
You will notice that the person’s:
When death has occurred at home
After the death...
This final leave-taking can be a difficult time. Before the funeral home attendants arrive, you may want to bathe and/or dress the person or gather special objects or notes to send with him or her. You may prefer to choose the clothes you want the person to wear and give them to the attendants, or you can bring them to your meeting at the funeral home.
When the funeral home attendants arrive, they will move the body to a stretcher in preparation for leaving. Consider whether or not you wish to be present when the person’s body is removed. You may wish to remain with the body or you may want to leave, go into another room or go for a walk while the stretcher is taken out. Memorial or funeral plans can be made or confirmed at an appointment with the funeral home the next day.