Miya Pearson
As a person approaches death, they may experience an increase in sleep and a decrease in appetite. This is because their body's metabolism falls, and they need less energy to carry out daily tasks. This can happen several months before death, and is a normal part of the dying process. In addition to sleeping more, a person who is dying may also experience changes in breathing, a decrease in social interests, and confusion or delirium. They may also withdraw from activities and people they love. It's important for caregivers to make the person comfortable, encourage them to eat high-protein foods in small quantities, and provide gentle care and reassurance.
| Characteristics | Values |
|---|---|
| Increased sleep | Several months before death, a dying person may begin to [sleep more than usual] |
| Decreased appetite | A dying person may [stop eating or drinking entirely a few days before death], or [gradually reduce their appetite over a few months] |
| Less interest in activities | A dying person may [withdraw from the activities and people they love] |
| Confusion | A dying person may experience [confusion or delirium] |
| Restlessness | A dying person may become [restless or agitated] |
| Changes in breathing | A dying person's breathing may become [shallower, faster or slower, with longer pauses between breaths] |
| Changes in heart rate | A dying person's heartbeat may become [irregular and difficult to detect] |
| Changes in skin | A dying person's skin may become [cool to the touch] |
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What You'll Learn
It's normal for a dying person to sleep more
It's perfectly normal for a dying person to sleep more. In fact, increased sleep is one of the most common signs that death is approaching. This could start months or even years before death, with the person taking afternoon naps, which progress to morning and afternoon naps, and then sleeping in front of the TV in the evening. Eventually, they may be in bed all day.
As a person nears death, their body's metabolism slows down, and they need less energy. This means they feel more tired and sleep more. Their body is also shutting down, and their vital organs are receiving less oxygen, so they may lose interest in what's going on around them and have less energy.
It's important to make a dying person who is sleeping a lot comfortable and allow them to sleep. Their hearing is often the last sense that they will lose, so you can continue to speak to them in a calm, quiet voice, and they may still be able to hear you. They may even be able to hear you after they are no longer able to speak.
However, it's also common for people to be restless in their final days, and they may become confused or delirious, drifting in and out of sleep. They may need to pass urine or move their bowels, or they may be hot or uncomfortable. If they are distressed, it's a good idea to ask for help from a doctor or nurse, who may be able to prescribe medication to help them settle.
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Dying people may become less interested in their surroundings
While sleeping a lot is not a definitive sign that someone is dying, it can be an indication that the end is near. As people approach the end of their life, they may experience a decrease in energy and become less interested in their surroundings. This can lead to increased sleep and a gradual decline in social interests.
It is important to note that everyone's journey towards death is unique, and there is no one-size-fits-all approach to determining when someone is dying. However, there are some common signs and changes that often occur as death approaches. In addition to increased sleep, a person's appetite may decrease, and they may lose interest in their favourite foods. They may also experience restlessness and confusion, especially those with conditions affecting their brain, such as dementia or certain types of cancer.
As the body's metabolism slows down, energy needs decrease, and food and drinks may seem less necessary. This can lead to a natural withdrawal from activities and people, as the individual protects their final days and hours. However, this does not necessarily mean that they are no longer hearing what is being said around them. Even when a person appears to be sleeping or resting, they may still be able to hear and may take comfort in the presence and voices of their loved ones.
Breathing changes are also common in the days and hours before death. A person's breathing may become shallower, faster or slower, with longer pauses between breaths. These changes are a normal part of the dying process and are not usually distressing to the individual.
If you are caring for someone who is approaching the end of their life, it is important to seek support from palliative care professionals, who can provide guidance and assistance with issues as they arise.
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Confusion or delirium may be part of the illness
Delirium and confusion affect how a person thinks and behaves. A person experiencing delirium or confusion may not be able to think clearly, and may have trouble focusing and understanding what is happening around them. They may also behave differently than usual. For example, they may become agitated, restless, or anxious, or they may show signs of cognitive decline. In some cases, they may even have disturbing hallucinations.
There are many causes of confusion and delirium in dying patients. One cause may be the disease itself. For example, brain cancer can cause confusion due to the location of the tumour. Lung disease can also lead to confusion because it limits the brain's oxygen supply. End-stage liver disease can cause confusion if the liver cannot adequately remove toxins from the blood. Renal disease can have the same effect, as the kidneys are not functioning optimally, leading to a build-up of toxins in the blood.
Medications can also cause confusion or delirium. Opioids, benzodiazepines, and drugs used to reduce anxiety are known to increase the risk of delirium. If a person's organs have started to fail, the effects of these drugs may be increased. Cancer treatments, such as chemotherapy drugs, steroids, and radiation to the brain, can also cause confusion and delirium.
If your loved one is experiencing confusion or delirium, it is important to call the hospice team right away. The hospice team will work to identify the root cause of the delirium and, if possible, reverse it. Medication management may be the most effective way to resolve delirium. However, it is important to remember that it may take hours to days for the patient to return to their normal cognitive baseline. In some cases, helping the patient to orient themselves may be the best option.
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Breathing patterns change in the final moments of life
While sleeping a lot can be a sign that someone is nearing the end of their life, it is important to note that it is just one of the many signs and symptoms that indicate impending death. As the body begins to shut down, it requires less energy, which leads to decreased food and fluid intake. This can result in a gradual decline in social interests and activities, causing the person to withdraw from loved ones and activities they once enjoyed.
Breathing pattern changes are a common occurrence in the final moments of life and can be indicative of the body's transition towards death. These changes can happen very quickly or over the course of hours or days. Cheyne-Stokes respiration is a typical end-of-life breathing pattern characterised by alternating periods of deep breathing followed by gradually shallower breaths and temporary pauses in breathing. This pattern can be distressing for loved ones but is generally painless for the individual. Agonal or irregular breathing, marked by unpredictable pauses and variations in breath rate, is another common occurrence.
In the final hours or days of life, breathing may become noisy, with a gurgling sound commonly known as the "death rattle." This noise is caused by the accumulation of fluids and congestion in the throat, as the person is no longer able to swallow or clear away secretions. While this can be upsetting for caregivers, it does not indicate pain or suffering for the individual. Repositioning the person and elevating their head and shoulders may help ease noisy breathing.
As death approaches, vital signs such as blood pressure and heart rate fluctuate or decrease. The person may experience confusion, delirium, or hallucinations and may become unresponsive or unconscious for short or extended periods. Their skin may also change colour, becoming purplish, pale, grey, or blotchy, especially on the extremities. These signs can vary from person to person, and the dying process itself may last for weeks, days, or hours, influenced by the individual's illness or medications.
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Dying people may experience decreased appetite and vital sign changes
As a person gets closer to death, their body's metabolism falls, and they may experience a decreased appetite. They may stop eating or drinking as their appetite gradually reduces. They may not even be interested in their favourite foods. This is not starvation, as starvation occurs when a healthy person does not get enough food and feels intense hunger. Instead, it is a normal part of the dying process, as a person's nutritional needs change.
In addition to decreased appetite, a dying person may experience changes in their vital signs. Their circulation may reduce, resulting in cold skin that may appear pale or mottled with blue and purple patches. Their breathing patterns may also change, becoming shallower, faster or slower, with longer pauses between breaths. They may also make grunting, gurgling, or rattling noises when breathing. These breathing changes are due to the person being very sleepy or unconscious and unable to cough or swallow the normal fluids in their chest or throat.
It is important to note that each person's journey towards death is unique, and these signs may occur over months or years. As a person's body slowly shuts down, they may also experience a decrease in energy levels and become less interested in their usual activities. They may also withdraw from the people around them, preferring to isolate themselves in their final days.
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Frequently asked questions
Sleeping more can be a sign that someone is approaching the end of their life. This is because the body's metabolism falls, causing fatigue and tiredness. However, this is not always the case, as some people sleep more due to old age.
Other signs include decreased appetite, vital sign changes, weakness, and confusion. The person may also become less interested in what's going on around them and have less energy. They may also experience noisy or 'rattling' breathing due to an inability to cough or swallow fluids in their chest or throat.
It's important to make the person comfortable and let them sleep. Help them change position in bed every 1-2 hours and continue speaking to them in a calm, quiet voice as hearing is often the last sense that a person loses. If they are anxious, sit with them so they know you're there.
