The thought of death nearing can be very frightening. Although death is a normal process, it’s natural to worry about what will happen.
You may want to have a religious or spiritual adviser present and may want to carry out particular religious practices. It’s important to do whatever you feel is right.
For many people, dying is very peaceful. You’ll usually slip slowly into unconsciousness and find that it’s difficult to wake up.
Generally, people eventually become completely unconscious. They can’t be woken at all, but may still be able to hear and be aware of the people around them. Some people have phases where they are awake and can talk, and then slip back into unconsciousness.
If you’re at home and anything happens that worries your carers, for example, if you have pain or other symptoms that are difficult to control, your carers can contact your district nurse, specialist nurse or GP. They can give you medicines to control your symptoms, either as an injection or through a syringe driver. They can also discuss any concerns that you or your carers have and reassure you.
Information for relatives and friends
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Even if your relative or friend is unable to respond, they may still be able to hear you and know you’re there.
So it can help to speak to them and let them know what you’re doing, especially if you’re giving them medicines or moving them. This may feel strange as they can’t respond, but it can be comforting for both of you. You may need to move them regularly to keep them comfortable. There may be times where not much needs to be done and you can just sit with them and be close to them.
It’s fine to call your relative or friend’s GP or specialist nurse to let them know what’s happening and to ask for advice if you need it.
Your relative or friend won’t usually feel thirsty at this stage but their mouth may be dry and need to be moistened. If they feel sick, anti-sickness medicines (anti-emetics) can be given by a syringe driver.
Skin and sensation changes
In the last few hours, your relative’s or friend’s hands, feet and skin may feel very cold and possibly moist. Sometimes the skin changes colour and becomes slightly more blue, grey or white. Their skin may also be very sensitive to touch. So if you move them, be very gentle and tell them what you’re doing.
Several layers of light, warm clothing and bedding can help to keep them at a comfortable temperature.
As your relative or friend gets closer to death, their breathing pattern will probably change. Their breathing may become irregular, with longer gaps between the breaths. It may also become very noisy, due to a build-up of fluid in their air passages as they are lying flat. This may be distressing for you and any other people around, but it isn’t usually distressing for the person who is dying.
If fluid does build up in the air passages, drugs can be given by injection or through a syringe driver to reduce the build-up of these secretions.
Marie Curie have produced a video about how breathing patterns change towards the end of a person's life. You might find it helpful to watch this video.
If your relative or friend is drifting in and out of consciousness, there may be times when they don’t seem to recognise you or other people around them. You may find this distressing. They may also talk to people who they knew in the past or who died long ago, probably because they are thinking of these people. If they seem restless or agitated, this can be eased by giving sedatives by injection or through a syringe driver.
For most people, their final moments are very peaceful. Their breathing may become even slower and more irregular with very long pauses between each breath. Their tummy (abdominal) muscles may take over control of the breathing from the chest muscles, so that their tummy rises and falls with each breath.
Finally, they will stop breathing altogether. This may seem to take a long time for some people. For others, it will only be a few minutes. Sometimes it can be difficult to pinpoint the exact moment of death. Often, the person’s body will relax completely and they may look very peaceful. Some people feel they can sense when the person has died.
In some cultures, there’s a belief that the person’s consciousness (mind or soul) stays around the body for some time after death. Other people feel that their consciousness moves on quickly to another place. Some people believe that life just ends and nothing is left of the person’s mind or consciousness.