9 Signs to Look for at the End of Life

How to help your loved one cope

Ideally, an individual at the end of life should be comfortable and free of any distressing symptoms and signs. But the transition to death, like the beginning of life, is hard work. 

Just as a woman's body knows how to give birth, the human body knows instinctively how to die, but it doesn't always do so without pain or discomfort.  

There are nine common signs that often occur at the end of life, and if you can recognize and manage them early on, your loved one will be better able to do the important work of dying.



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Pain is probably the most feared symptom at the end of life. Not every illness that leads to death causes pain, but other underlying conditions may still exist. An example is an individual dying of heart failure who also has arthritis. Other diseases, like cancer, usually do cause pain. Whatever the illness is, the ability to recognize and help manage pain for your loved one is essential.


Shortness of Breath

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Shortness of breath occurs more frequently than pain at the end of life and can be even more troubling. Some degree of breathlessness is common in most individuals as they near death. Luckily, there are a few simple and effective treatments that can bring quick relief, such as deep-breathing exercises, relaxation techniques, oxygen, and, if needed, medications.



Anxiety & Depression in Old Age
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Anxiety is perfectly normal and quite common at the end of life. Though it's normal to feel some level of anxiety while experiencing pain or shortness of breath, anxiety can occur at any time in the dying process, even without another distressing symptom.


Decreased Appetite

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Unfortunately, there isn't much you can do about a decreased appetite at the end of life. As your loved one's body naturally shuts down and prepares for death, it no longer needs the calories and nutrition that food provides. If you're concerned about hunger or thirst, you can read more about decreased appetite, increase food intake, and artificial feedings.


Nausea or Vomiting

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Illnesses, medications, and other treatments can often lead to nausea with or without vomiting. This can be an extremely troubling symptom for your loved one, as well as for you. Fresh air, small meals, limiting odors, and nausea medications are among the treatments you can try to help your loved one manage nausea and/or vomiting. 



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If you've ever been constipated, you know how horribly uncomfortable it can be. It's definitely not something anyone wants to experience in their final weeks or days. Medications used to treat pain and shortness of breath can cause constipation, as can lack activity, decreased fiber and fluid intake, and disease processes. Constipation is a symptom you have to stay on top of to prevent it from becoming severe.


Delirium and Terminal Restlessness

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Confusion, agitation, and sleeplessness can occur in some individuals at the end of life. Delirium can be caused by disease processes, decreased oxygen in the brain, medications, and a host of other reasons. Be sure to let your healthcare provider know if your loved one is acting confused or agitated.


The "Death Rattle"

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As undesirable as it is to call this symptom the "death rattle," it's a pretty accurate description of the symptom. End-stage wet respirations is the medical term for secretions that build up in the airway when an individual becomes too weak to clear those secretions out. The accumulation of mucus and fluids causes a rattling sound with breathing, which can be distressing for loved ones. 


Decreased Intimacy

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Intimacy is deeply important to many people at the end of life. The need to feel close to the one you love doesn't vanish just because death is near. However, it isn't uncommon at the end of life for your loved one to become increasingly focused inward rather than socializing with others.

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