When a person is in the final stage of life, the body gradually begins to slow down. Families may notice changes in breathing, alertness, eating and drinking, circulation, and other normal body functions.
These changes can be difficult to recognize, especially when a family has never experienced the dying process before. Angel Palliative Care & Hospice, Inc. helps patients and families understand these changes and provides comfort-focused hospice care based on the patient’s individual needs and plan of care.
What Does Actively Dying Mean?
The term actively dying generally refers to the period when a person is approaching death and noticeable changes are occurring as the body begins to shut down.
The timing is different for every person. Some changes may develop over several days, while others may occur more quickly. Not every patient will experience every change.
The hospice team can assess the patient’s condition, explain what the family is observing, and provide guidance about comfort and care.
Changes Families May Notice
As death approaches, families may notice changes in several areas of the patient’s condition.
These may include:
- Sleeping more and spending more time resting
- Becoming less responsive or difficult to awaken
- Eating and drinking less
- Having less interest in conversation or surroundings
- Becoming weaker and requiring more assistance with personal care
- Changes in breathing, including irregular breathing or periods of paused breathing
- Cooler hands, feet, or other changes in circulation
- Changes in skin color or appearance
- Changes in bladder or bowel function
- Increased difficulty communicating
These changes are not necessarily a sign that the patient is experiencing pain or distress. The hospice team can assess the patient’s condition and help determine what comfort measures may be appropriate.
Changes in Eating and Drinking
A decrease in appetite and fluid intake is common as the body becomes weaker near the end of life. A patient may eat only small amounts or may eventually stop eating and drinking.
This can be especially difficult for families because providing food and fluids is often an important way of caring for someone they love.
At this stage, families should discuss changes in eating and drinking with the hospice team. The team can explain what is happening and provide guidance on appropriate comfort measures based on the patient’s condition and plan of care.
Families should not feel that they have to manage these changes on their own.
Changes in Breathing
Breathing patterns can change as a person approaches death. Breathing may become slower or irregular, with periods of deeper breathing followed by pauses.
Families may also notice changes in the sounds of breathing or increased secretions in the throat.
These changes can be difficult to hear or watch. The hospice team can explain what the family is seeing and assess the patient for signs of discomfort or distress. Comfort-focused interventions can then be provided as appropriate.
If you notice a significant change in your loved one’s breathing, contact the hospice team for guidance.
Changes in Alertness and Communication
A person who is approaching death may sleep for longer periods and become increasingly difficult to awaken. They may speak less, respond less often, or eventually become unable to communicate.
Even when a person does not respond, families may continue to talk to them, hold their hand, play familiar music, or simply remain nearby.
The hospice team can help families understand changes in responsiveness and provide guidance about how to remain involved in their loved one’s care.
How Can Families Provide Comfort?
Families can support their loved one by helping create a calm, comfortable environment.
Depending on the patient’s needs and hospice plan of care, comfort measures may include:
- Speaking calmly and reassuringly
- Keeping the room comfortable and peaceful
- Providing gentle personal care
- Assisting with repositioning as directed by the care team
- Providing mouth and lip care as instructed
- Playing familiar music
- Sitting with the patient or holding their hand
- Allowing the patient to rest without expecting them to communicate
The hospice team can demonstrate appropriate comfort measures and answer questions as the patient’s condition changes.
What Happens During the Final Hours?
During the final hours of life, a patient may become increasingly sleepy or unresponsive. Breathing may become more irregular, and other physical changes may become more noticeable.
There is no single pattern that every patient follows, and it is not possible to predict the exact timing of death based only on these changes.
For this reason, families should communicate with the hospice team when they notice significant changes or believe their loved one may be nearing death. The hospice team can help explain what is happening and provide support based on the patient’s individual condition.
How Hospice Supports Patients and Families
Hospice care focuses on the patient’s comfort and quality of life while also supporting the people involved in their care.
At Angel Palliative Care & Hospice, Inc., the hospice team works with patients, families, and caregivers throughout the end-of-life process. Depending on the patient’s needs and plan of care, the team may provide nursing care, aide support, social work, spiritual care, medications, medical equipment and supplies, and other hospice services.
APCH also provides 24/7 on-call support, including nights, weekends, and holidays, so families have a hospice resource to contact when questions or changes arise.
When Should You Contact the Hospice Team?
Contact the hospice team when you notice a significant change in your loved one’s condition, have concerns about their comfort, or are unsure what a particular change means.
You do not need to wait until you are certain that your loved one is actively dying. The hospice team can help assess the situation, explain what may be happening, and provide guidance about the patient’s care.
If you or your loved one is not currently receiving hospice care and you have questions about whether hospice may be appropriate, APCH can also explain the hospice evaluation process.
Talk With the APCH Care Team
Watching a loved one approach the end of life can be difficult, and families often have questions about what they are seeing.
Angel Palliative Care & Hospice, Inc. is available to answer questions about changes at the end of life, comfort-focused care, and hospice services.
Phone: 650-590-2530
