Death symptoms. Increase and decrease in body temperature. What are the signs of death

If you are dying or caring for a dying person, you may have questions about how the process of dying will be physically and emotionally. The following information will help you answer some questions.

Signs of approaching death

The process of dying is as diverse (individual) as the process of birth. Impossible to predict exact time death, and how the person will die. But people who are on the verge of death experience a lot similar symptoms regardless of the type of disease.

As death approaches, a person may experience some physical and emotional changes, such as:

A dying person may experience other symptoms, depending on the disease. Talk to your doctor about what to expect. You can also contact the Terminally Ill Assistance Program, where they will answer all your questions regarding the process of dying. The more you and your loved ones know, the more prepared you will be for this moment.

• Excessive sleepiness and weakness associated with approaching death

As death approaches, a person sleeps more, and it becomes more and more difficult to wake up. The periods of wakefulness become shorter and shorter.

As death approaches, the people who care for you will notice that you are unresponsive and that you are in a very deep sleep. This state is called a coma. If you are in a coma, then you will be tied to the bed, and all your physiological needs(bathing, turning, eating and urinating) will need to be controlled by someone else.

General weakness is a very common phenomenon with the approach of death. It is normal for a person to need help with walking, bathing, and going to the toilet. Over time, you may need help to roll over in bed. Medical equipment, such as wheelchairs, walkers or hospital bed can be very helpful during this period. This equipment can be rented from a hospital or terminally ill center.

• Respiratory changes as death approaches

With the approach of death periods rapid breathing may be interspersed with periods of restlessness.

Your breath may become wet and stagnant. This is called "death rattle". Changes in breathing usually happen when you are weak and normal discharge from your airways and lungs cannot go out.

Although noisy breathing may be a signal to your loved ones, you will most likely not feel pain and notice congestion. Since the fluid is deep in the lungs, it is difficult to remove it from there. Your doctor may prescribe oral tablets(atropines) or patches (scopolamine) to relieve congestion.

Your loved ones may turn you on the other side so that the discharge comes out of the mouth. They can also wipe these secretions with a damp cloth or special swabs (you can ask at the help center for the terminally ill or buy them at pharmacies).

Your doctor may prescribe oxygen therapy to help relieve your shortness of breath. Oxygen therapy will make you feel better, but will not prolong your life.

• Changes in vision and hearing as death approaches

Visual impairment is very common in the last weeks of life. You may notice that you have trouble seeing. You may see or hear things that no one else notices (hallucinations). visual hallucinations- a common occurrence before death.

If you are caring for a dying person who is hallucinating, you need to cheer him up. Recognize what the person sees. Denial of hallucinations can upset the dying person. Talk to the person, even if he or she is in a coma. It is known that dying people can hear even when they are in a deep coma. People who came out of a coma said that they could hear all the time while they were in a coma.

• hallucinations

Hallucinations are the perception of something that is not really there. Hallucinations can involve all of the senses: hearing, sight, smell, taste, or touch.

The most common hallucinations are visual and auditory. For example, a person may hear voices or see objects that the other person cannot see.

Other types of hallucinations include gustatory, olfactory, and tactile hallucinations.

Treatment for hallucinations depends on their cause.

• ChangesappetiteWithapproachof death

As death approaches, you are likely to eat and drink less. This is due to a general feeling of weakness and a slower metabolism.

Since nutrition is so important in society, it will be difficult for your family and friends to watch you not eat anything. However, metabolic changes mean you don't need the same amount of food and fluids as you used to.

You can eat small meals and liquids while you are active and able to swallow. If swallowing is a problem for you, thirst can be prevented by moistening your mouth with a damp cloth or a special swab (available at a pharmacy) dipped in water.

• Changes in the urinary and gastrointestinal systems as death approaches

Often the kidneys gradually stop producing urine as death approaches. As a result, your urine turns dark brown or dark red. This is due to the inability of the kidneys to properly filter urine. As a result, urine becomes very concentrated. Also, its number is decreasing.

As appetite decreases, some changes also occur in the intestines. The stool becomes harder and more difficult to pass (constipation) as the person takes in less fluid and becomes weaker.

You should tell your doctor if you have bowel movements less than once every three days, or if bowel movements are uncomfortable. Stool softeners may be recommended to prevent constipation. You can also use an enema to cleanse the colon.

As you become more and more weak, it is natural that you find it difficult to control bladder and intestines. Your bladder may be placed urinary catheter as a means of prolonged drainage of urine. The terminally ill program can also provide toilet paper or underwear (these can also be purchased at a pharmacy).

• Changes in body temperature as death approaches

As death approaches, the part of the brain responsible for regulating body temperature begins to malfunction. You may have a high temperature, and in a minute you will be cold. Your hands and feet may feel very cold to the touch and may even turn pale and blotchy. Changes in skin color are called patchy skin lesions and are very common in last days or hours of life.

Your caregiver can control your temperature by wiping your skin with a damp, slightly warm washcloth or by giving you medications such as:

• Acetaminophen (Tylenol)
• Ibuprofen (Advil)
• Naproxen (Alev).
• Aspirin.

Many of these medicines are available in the form rectal suppository if you have difficulty swallowing.

• Emotional changes as death approaches

Just as your body prepares physically for death, you must also prepare emotionally and mentally for it.

As death approaches, you may lose interest in the world around you and certain details of everyday life, such as the date or time. You can close in on yourself and communicate less with people. You may want to communicate with only a few people. This introspection can be a way of saying goodbye to everything you knew.

In the days leading up to death, you may enter a state of unique conscious awareness and communication that may be misinterpreted by your loved ones. You can say that you need to go somewhere - "go home" or "go somewhere". The meaning of such conversations is unknown, but some people think that such conversations help prepare for death.

Events from your recent past can mix with distant events. You can remember very old events in great detail, but not remember what happened an hour ago.

You can think of people who have already died. You may say that you have heard or seen someone who has already died. Your loved ones can hear you talking to the deceased person.

If you are caring for a dying person, you may be upset or frightened by this. strange behavior. You may want to return your loved one to reality. If this kind of communication is bothering you, talk to your doctor to better understand what's going on. Your loved one may fall into a state of psychosis, and it may be scary for you to watch it. Psychosis occurs in many people before death. It may have a single cause or be the result of several factors. Reasons may include:

• Medications such as morphine, sedatives and pain relievers, or taking too many medications that don't work well together.
• metabolic changes associated with high temperature or dehydration.
• Metastasis.
• Deep depression.

Symptoms may include:

• Revival.
• hallucinations.
• Unconscious state, which is replaced by revival.

Sometimes delirium tremens can be prevented through alternative medicine, such as relaxation and breathing techniques, and other methods that reduce the need for sedatives.

Pain

Palliative care can help you relieve physical symptoms associated with your condition, such as nausea or difficulty breathing. Control of pain and other symptoms is important part your treatment and improve your quality of life.

How often a person feels pain depends on their condition. Some deadly diseases, such as bone cancer or pancreatic cancer, can be accompanied by severe physical pain.

A person can be so afraid of pain and others physical symptoms that he may be thinking of committing suicide with the assistance of a doctor. But death pain can be effectively dealt with. You should tell your doctor and loved ones about any pain. There are many medications and alternative methods (such as massage) that can help you deal with the pain of death. Be sure to ask for help. Ask a loved one to report your pain to the doctor if you are unable to do so yourself.

You may want your family not to see you suffer. But it is very important to tell them about your pain, if you cannot stand it, so that they immediately consult a doctor.

Spirituality

Spirituality means a person's awareness of the purpose and meaning of his life. It also denotes the relationship of a person with higher powers or the energy that gives meaning to life.

Some people don't often think about spirituality. For others, it's part of everyday life. As you approach the end of your life, you may be faced with your own spiritual questions and challenges. Being associated with religion often helps some people achieve comfort before death. Other people find solace in nature, in social work, strengthening relationships with loved ones or in creating new relationships. Think of things that can give you peace and support. What questions concern you? Seek support from friends, family, relevant programs, and spiritual guides.

Caring for a dying relative

Pain and symptom control at the end of life

At the end of life, pain and other symptoms can be effectively managed. Talk to your doctor and loved ones about the symptoms you are experiencing. The family is an important link between you and your doctor. If you yourself cannot communicate with the doctor, your loved one can do this for you. There is always something you can do to ease your pain and symptoms so that you feel comfortable.

physical pain

There are many pain relievers available. Your doctor will choose the easiest and most non-traumatic drug for pain relief. Usually applied first oral preparations because they are easier to take and less expensive. If your pain is not acute, pain medications can be bought without a doctor's prescription. These are drugs such as acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen. It is important to stay ahead of your pain and take your medications on schedule. Irregular use medication is often the cause of ineffective treatment.

Sometimes pain cannot be controlled with over-the-counter medications. In this case, more effective forms treatment. The doctor may prescribe pain medications such as codeine, morphine, or fentanyl. These drugs can be combined with others, such as antidepressants, to help you get rid of the pain.

If you cannot take pills, there are other forms of treatment. If you have trouble swallowing, you can use liquid medicines. Also, drugs can be in the form of:

• Rectal suppositories. Suppositories can be taken if you have trouble swallowing or feel sick.
• Drops under the tongue. As well as nitroglycerin tablets or heartache sprays, liquid forms some substances, such as morphine or fentanyl, may be absorbed blood vessels under the tongue. These drugs are given in a very small amount– usually only a few drops – and are effective way pain management for people with swallowing problems.
• Patches applied to the skin (transdermal patches). These patches allow pain medications, such as fentanyl, to pass through the skin. The advantage of patches is that you instantly receive the required dose of medication. These patches are better at controlling pain than pills. In addition, a new patch must be applied every 48-72 hours, and tablets must be taken several times a day.
• Intravenous injections (droppers). Your doctor may prescribe treatment with a needle inserted into a vein in your arm or chest if you have very severe pain that cannot be controlled by oral, rectal, or transdermal means. The drugs may be given as a single injection several times a day, or continuously in small amounts. Just because you're hooked up to a drip doesn't mean your activity will be restricted. Some people carry small portable pumps that provide them with small doses of medication throughout the day.
• Injections into the area spinal nerves(epidural) or under the tissue of the spine (intrathecal). At acute pain strong painkillers such as morphine or fentanyl are injected into the spinal area.

Many people who suffer from severe pain fear that they will become addicted to pain medications. However, addiction rarely occurs in terminally ill people. If your condition improves, you can slowly stop taking the medicine so that dependence does not develop.

Painkillers can be used to manage the pain and help keep it tolerable. But sometimes painkillers cause drowsiness. You can only accept a small amount of medicines and, accordingly, endure a little pain to stay active. On the other hand, maybe weakness doesn't matter to you of great importance and you are not disturbed by drowsiness caused by certain medications.

The main thing is to take medicines on a certain schedule, and not just when the need arises. But even if you take medication regularly, sometimes you may feel severe pain. This is called "pain breakouts". Talk to your doctor about what medications should be on hand to help manage breakouts. And always tell your doctor if you stop taking a medicine. Sudden termination may cause serious side effects and severe pain. Talk to your doctor about ways to manage pain without medication. Alternative medical therapy may help some people relax and relieve pain. You can combine traditional treatment With alternative methods, such as:

• Acupuncture
• aromatherapy
• Biofeedback
• Chiropractic
• Pointing images
• Healing Touch
• Homeopathy
• Hydrotherapy
• Hypnosis
• Magnetotherapy
• Massage
• Meditation

For more information, see the Chronic Pain section.

emotional stress

During the period when you are learning to cope with your illness, a short emotional stress is normal. Non-depression that lasts more than 2 weeks is no longer normal and should be reported to your doctor. Depression can be cured even if you have fatal disease. Antidepressants combined with psychological counseling will help you cope with emotional distress.

Talk to your doctor and family about your emotional stress. Although grief is a natural part of the process of dying, it does not mean that you have to endure serious emotional pain. Emotional suffering can intensify physical pain. They can also reflect badly on your relationships with loved ones and prevent you from saying goodbye to them properly.

Other symptoms

As death approaches, you may experience other symptoms as well. Talk to your doctor about any symptoms you may have. Symptoms such as nausea, fatigue, constipation, or shortness of breath can be managed with medication, special diets, and oxygen therapy. Have a friend or family member describe all of your symptoms to a doctor or terminally ill worker. It is helpful to keep a journal and write down all your symptoms there.

Cancer before death: what you need to be prepared for?

The period of the end of life is individual for each patient with oncology. so spreads in the body that it becomes uncontrollable. In this case, health care professionals often decide that further treatment is useless. However, patient care continues further, but with an emphasis on improving the quality of life. the main task- to facilitate the last days of the patient as much as possible.

Treatments and medications are aimed at controlling pain and other end-of-life symptoms. Patients and their families often want to know how long a person will live. This question is difficult to answer. In cancer before death, life expectancy depends on a number of factors, including the type of malignant process, its location, accompanying illnesses and their ability to influence the situation.

It's important to know :

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Cancer before death: symptoms, signs, sensations

People who care for a dying person should be aware of the physical difficulties their ward is experiencing. The caregiver should be alert to the occurrence of unusual cancer symptoms prior to death so that they can seek immediate medical attention. medical care and alleviate the suffering of the patient. Emergency situations include:

• the patient experiencing new symptoms such as nausea, vomiting, uncontrollable states ( severe anxiety or anxiety)
• increased pain that does not go away even after taking prescribed medications;
• the presence of breathing problems, discomfort expressed by grimaces of pain or a strong groan;
• inability to urinate or have a bowel movement;
• depressed state of the patient, which even comes to topics about suicide.

How do cancer patients feel before they die?

Some symptoms of the patient's condition may clearly indicate the approach of death, namely:

1. People often focus on the last weeks of life, supposedly forgetting the previous one. This does not necessarily mean that patients become depressed. This situation may indicate a decrease in blood flow or oxygen levels in the brain, as well as psychological preparation to death.
2. Loss of interest in things that previously occupied them (TV shows, talking with friends, pets, hobbies, etc.).
3. Some patients may have increased drowsiness, confusion after waking up, which is associated with a decrease in the functioning of the brain system.

Signs of cancer before death, for which relatives or caregivers should be prepared

1. Extreme restlessness, unwillingness to be alone. It is better for a person caring for a sick person to be near the dying person in order to help in the next bouts of panic or despair.
2. The pain can get so intense that it becomes difficult to control. In this case, massage or other methods of relaxation, as well as properly selected medications, can help.
3. Weakness and fatigue increase with time.
4. Once the body is affected malignant process, the patient's body needs less food. Loss of appetite is caused by the body's need to conserve energy expended on the use of food and liquid, as well as the inability to normal operation digestive system.
5. Toward the end of life, people often have episodes of confusion or daydreams. They can get confused in time, place, loved ones.
6. Sometimes patients report seeing or talking to loved ones who have died. People with cancer often talk about an exciting ride, radiant light, butterflies and other symbols that are hidden from prying eyes before they die.

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Symptoms that indicate the process of dying

• Loss of control bladder or intestines by relaxing the pelvic muscles. Therefore, a person needs to change linen and personal hygiene products. You can place disposable diapers under the patient or wear diapers for adults.
• have reduced kidney function, and therefore consume less fluid. It leads to infrequent urination and strong odour.
• The intervals between breaths shorten, become faster, or become cyclical. As a result, there may be different sounds, which indicates the collection of saliva and other fluids in the upper respiratory tract. This condition may disturb the caregiver, but it does not bring suffering to the patient. To alleviate the situation, you can use a pillow under your head or a roller, which allows a person to stay in an elevated position.
• The skin may take on a bluish tint. The dying person often feels cool because the blood flow slows down. This condition is not painful. However, the caregiver must warm the patient with a heating pad or electric blanket.

For acquaintance:

No one can stop the approach of death, but close people are able to do everything so that the dying person does not feel lonely in the last days of his life.

The one who faced serious illness, feels in difficult situation. His friends and family also have a hard time. Of course, modern medicine is located on high level, however, some situations can be changed by means of pills, operations, etc. already unrealistic.

It happens that a cancer patient anticipates his death, thinks, perhaps dreams, and can accurately determine the time period when the irreparable will happen, without telling anyone so as not to upset them even more.

In order to be able to personally monitor the condition, it is useful for relatives and friends to know not only, but also what is hidden behind the ornate statements of the attending staff.

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Signs of imminent death of a cancer patient - what are they?

Professional medical staff know that even with seemingly successful treatment, which is not accompanied by frequent, the patient dies. Even innovative anti-cancer drugs, which are produced and released in countries with developed medicine, become useless in resisting a cruel disease.

Deterioration of the condition, as well as possibly approaching fatal outcome a seriously ill person can be traced by such factors (most often they are observed in combination):

• loss of appetite;
• fatigue;
• incredible apathy (moral and physical);
• nervous breakdowns;
• complicated breathing;
• sharp fluctuations in weight;
• ensuring their own isolation;
• difficulty urinating;
• violation of the activity of blood vessels;
• fast freezing.

Each of them is discussed separately. Priority is occupied difficulty eating. Rejection or extremely unexpected loss of habits. Now he likes fish, and a day later he turns away from it completely.

This is explained by the fact that the need to eat disappears, and an ever smaller proportion of energy is spent, which a healthy person is used to getting from food. Meat is removed from the diet. The fact is that it is difficult for the body, weakened by a serious illness, to digest it. Because of this, many doctors transfer to cereals and increase the consumption of an increased amount of liquid: juices, broths, compotes. At the moment when the patient is no longer able to independently swallow what is in his mouth, relatives, unfortunately, can prepare for the worst ending.

Fatigue, weakness and breakdowns can be added and assembled into a single aspect, since their formation is simultaneous, which is quite natural. Caused by nothing more than exhaustion. On the basis of this, the rest develops. It is difficult for the patient to move even for short distances. The defining stage in the development of the above is a disorder of the central nervous system. There is a loss in space, when the dying person forgets the people and the place where he was located more than once.

The dying man gives up and decides himself that there is no reason and strength to cope. FROM specified point a neurologist and a psychologist are involved, whose work is aimed at motivating and further fighting the disease. If you do not take these actions, then the seriously ill person will definitely give up.

If speech about breathing problems, then you need to study the Cheyne-Stokes syndrome. So, they indicate that they mean intermittent and superficial inhalations and exhalations, which deepen and then return to their original character. This cycle is repeated more than once. Then it is complicated by developing wheezing and acquires a permanent appearance.

Changes in weight are characteristic and quite logical just because of the difficulties that arise. Therefore, this point is rarely stopped. Commendable are the efforts of others, their installation to provide drinking. But there must be an understanding that all the signs of the death of a cancer patient are interconnected.

The closer the inevitable denouement, the more the patient seeks to be alone and get as much sleep as possible. This may be considered normal. This is due to psychological and physical reasons. He doesn't want his family to see him as weak. There is no desire to provoke someone's pity or indignation at the fact that it will be necessary to arrange care.

Urine acquires strange color - red or dark brown. This is due to the fact that the liquid practically does not enter the body, and the kidneys, which serve as a filter, slow down their functioning.

Vascular problems are reflected in regular edema and blue spots, which are commonly called venous. The skin turns pale, which leads to a slight display of veins and even small capillaries. Edema also appears due to the fact that the body is deprived of natural filtration.

The last messenger is decrease in body temperature. Blood begins to strive for the heart and vital important bodies to add a lifetime. When legs and fingers get cold in a second, the end is near.

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What do we have to do?

Of course, relatives do not agree to accept such an outcome. Although medicines can not always completely cope with the tragedy, there are still ways.

As for the loss of interest in food, the caregiver will need to be patient. It is forbidden to use the force of coercion, to show irritability and hostility - even more so. You can occasionally offer water, fruit drinks, fresh juices, etc. That's what it is wise to follow, so that the lips do not dry out. While a person refuses to drink, it is required at least to lubricate them with balm or with a damp cloth.

The advice for fatigue is about the same. It is impossible to disturb sleep, force the patient to wake up, or artificially prolong the period of wakefulness.

Fatigue is also not amenable to violent influence. Don't needlessly disturb the person. Still, there is no reason for this. All that can be done is to increase comfort and try to give him a rest, increase the dose of joyful emotions and organize a good environment around.

Hypersensitivity nervous system needs a special approach. It makes sense to invite an experienced psychologist. He must be friendly. Indicative for him will be meetings with those people who. The main thing is to be able to motivate to continue the struggle, which will certainly end in success. And with disorientation, you can solve it this way - when visiting a caring person, you need to repeat your name, not show aggression and try to express yourself too softly. The same applies to the desire for isolation - not to interfere and introduce additional negative. Gentle and calm intonations will help to gradually return the patient to the social environment.

Breath will be restored special exercises. They are performed under the supervision of a professional support worker. Rational change of position. Turning sideways is the best solution to the problem.

Violation of the work of blood vessels, swelling and rapid freezing can be included in one list. They are fought against with a massage or a warm blanket.

But relatives should know that all of the above is, unfortunately, signs of an imminent death of a cancer patient and in the battle with them it is not always possible to win.

End-stage cancer is a sentence. The moment when doctors shrug their shoulders and admit defeat becomes the most terrible for loved ones. And here a dilemma arises - whether to inform the patient himself that there is no hope left? How to behave? Where to find strength for support? And how to help the patient to live the remaining time?

• The very first thing worth remembering is freedom of choice. When we try to decide, even for a very close and beloved person, how he will react to this or that event, we take on more responsibility than we can afford. Everyone lives their own life. Therefore, if you are asking yourself whether it is worth reporting how much time is left, it is better to report. A person must decide for himself how he will spend this time. Perhaps he has plans and deeds that he put off until the last moment. Do not forget that a person himself knows that he is suffering from an illness that can be fatal. So he was already considering the possibility that he could die.
• Second, be sincere in your emotions. There is nothing more frightening for a dying person than the cowardice of loved ones. If you understand that you cannot cope with emotions, connect a psychotherapist. The presence of a figure that is not included emotionally helps to maintain balance for everyone.
• Third, don't avoid talking about death. If your loved one wants to talk - be there, talk to him about it. Death scares everyone. For a man who understands that he has left to live limited quantity time, the thought of death haunts. Attempts by loved ones to distract only lead to the fact that the dying person withdraws into himself and plunges into his fear alone. Speaking from time to time his thoughts and feelings, he makes attempts to accept the inevitable.
• Fourth, help him keep his dignity. If he does not want to see anyone, then do not insist. Death is rarely beautiful. Death from cancer is also painful. If your loved one asks to protect him from contacts - let him do it, take care of him.
• Fifth, take care of yourself. If your loved one dies, you do not have to sit next to him around the clock. It is difficult to understand and comprehend. This phrase can cause anger, but being constantly around, you deprive yourself of the strength to support it. You “fall” into pity for yourself and for him. Periodically absenting yourself, allowing yourself to continue living, you save yourself and the patient from feelings of self-pity, feelings of guilt.
• Sixth - if your loved one is ready, invite him to discuss his funeral and his disposal of property. Listen to all wishes. Give him the opportunity to feel that he can control something else and manage something. The funeral ceremony is a symbol. A symbol of transition to another existence, a symbol of farewell. Say goodbye to him the way he likes it.
• Seventh - invite your loved one to write letters to those with whom he would like to say goodbye. Not just letters, but parting words that can remain even after death. Which will keep it in the memory of people.
• Eighth - if it allows physical state patient, try to fulfill his cherished desire.
• Ninth - if you are believers, then let your loved one confess and take communion. Communicating with a confessor can help to cope with the fear of death and gain hope for the immortality of the soul.
• Tenth - draw up for yourself a clear action plan for the time of the funeral and be sure after. The time after the funeral is the hardest. When you have a clear plan of action, at first you can just stick to its points. This creates a sense of control and security. The death of a loved one inevitably confronts us with the thought of our own vulnerability and mortality.

A person's life path ends with his death. You need to be prepared for this, especially if there is a bed patient in the family. Signs before death will be different for each person. However, observational practice shows that it is still possible to distinguish a number of common symptoms which portend the nearness of death. What are these signs and what should be prepared for?

How does a dying person feel?

A bedridden patient before death, as a rule, experiences mental anguish. In sound consciousness there is an understanding of what is to be experienced. The body goes through certain physical changes, this cannot be overlooked. On the other hand, the emotional background also changes: mood, mental and psychological balance.

Some lose interest in life, others completely close in on themselves, others may fall into a state of psychosis. Sooner or later, the condition worsens, the person feels that he is losing his own dignity, more often he thinks about a quick and easy death, asks for euthanasia. These changes are hard to observe, remaining indifferent. But you will have to come to terms with this or try to alleviate the situation with drugs.

With the approach of death, the patient sleeps more and more, showing apathy towards the outside world. In the last moments, a sharp improvement in the condition may occur, reaching the point that the recumbent for a long time the patient wants to get out of bed. This phase is replaced by the subsequent relaxation of the body with an irreversible decrease in the activity of all body systems and the attenuation of its vital functions.

Bedridden patient: ten signs that death is near

In conclusion life cycle old man or the bedridden patient feels more and more weak and tired from lack of energy. As a result, he is increasingly in a state of sleep. It can be deep or drowsy, through which voices are heard and the surrounding reality is perceived.

A dying person can see, hear, feel and perceive things that do not actually exist, sounds. In order not to upset the patient, this should not be denied. Loss of orientation and confusion are also possible. The patient is increasingly immersed in himself and loses interest in the reality around him.

Urine due to failure of the kidneys darkens to almost Brown color with a reddish tint. As a result, edema appears. The patient's breathing quickens, it becomes intermittent and unstable. Under pale skin, as a result of a violation of blood circulation, dark “walking” venous spots appear, which change their location.

They usually first appear on the feet. In the last moments, the limbs of a dying person become cold due to the fact that the blood, draining from them, is redirected to more important parts of the body.

Failure of life support systems

Distinguish primary signs appearing on initial stage in the body of a dying person, and secondary, indicating the development of irreversible processes.

Symptoms may have outward manifestation or be hidden. Disorders of the gastrointestinal tract How does a bedridden patient react to this? Signs before death, associated with loss of appetite and a change in the nature and volume of food consumed, are manifested by problems with the stool.

Most often, constipation develops against this background. A patient without a laxative or an enema finds it increasingly difficult to empty the bowels. Patients spend the last days of their lives refusing food and water altogether. You shouldn't worry too much about this. It is believed that with dehydration in the body, the synthesis of endorphins and anesthetics increases, which to some extent improve general well-being.

Functional disorders

How does the condition of patients change and how does the bed patient react to this? Signs before death, associated with the weakening of the sphincters, in the last few hours of a person's life are manifested by fecal and urinary incontinence. In such cases, it is necessary to be prepared to provide him hygiene conditions using absorbent underwear, diapers or diapers. Even in the presence of appetite, there are situations when the patient loses the ability to swallow food, and soon water and saliva. This may lead to aspiration. When severely exhausted eyeballs strongly sink, the patient is not able to completely close the eyelids. This has a depressing effect on those around you. If the eyes are constantly open, the conjunctiva needs to be moistened special ointments or saline.

Respiratory and thermoregulatory disorders

What are the symptoms of these changes if the patient is bedridden? Signs before death in a weakened person in an unconscious state are manifested by terminal tachypnea - against the background of frequent respiratory movements are heard death rattles. This is due to the movement of the mucous secretion in the large bronchi, trachea and pharynx. This condition is quite normal for a dying person and does not cause him suffering. If it is possible to lay the patient on his side, wheezing will be less pronounced.

The beginning of the death of the part of the brain responsible for thermoregulation is manifested by jumps in the patient's body temperature in a critical range. He can feel hot flashes and sudden cold. The extremities are cold, the perspiring skin changes color.

Road to death

Most patients die quietly: gradually losing consciousness, in a dream, falling into a coma. Sometimes it is said about such situations that the patient died on the “usual road”. It is generally accepted that in this case, irreversible neurological processes occur without significant deviations.

Another picture is observed in agonal delirium. The movement of the patient to death in this case will take place along the “difficult road”. Signs before death in a bedridden patient who embarked on this path: psychosis with excessive excitement, anxiety, disorientation in space and time against the background of confusion. If at the same time there is a clear inversion of the wakefulness and sleep cycles, then for the patient's family and relatives such a condition can be extremely difficult.

Delirium with agitation is complicated by a feeling of anxiety, fear, often turning into a need to go somewhere, to run. Sometimes this is speech anxiety, manifested by an unconscious flow of words. The patient in this state can perform only simple actions, not fully understanding what he is doing, how and why. The ability to reason logically is impossible for him.

These phenomena are reversible if the cause of such changes is identified in time and stopped by medical intervention.

Pain

Before death, what symptoms and signs in a bedridden patient indicate physical suffering? Usually uncontrollable pain last hours the life of a dying person is rarely enhanced. However, it is still possible.

An unconscious patient will not be able to let you know about this. Nevertheless, it is believed that pain in such cases also causes excruciating suffering. A sign of this is usually a tense forehead and deep wrinkles appearing on it.

If, during examination of an unconscious patient, there are assumptions about the presence of a developing pain syndrome, the doctor usually prescribes opiates. You should be careful, as they can accumulate and, over time, aggravate an already serious condition due to the development of excessive overexcitation and convulsions.

Giving help

A bedridden patient before death may experience significant suffering. Relief of symptoms physiological pain can be achieved drug therapy. Mental suffering and psychological discomfort of the patient, as a rule, become a problem for relatives and close family members of the dying.

Experienced doctor at the evaluation stage general condition the patient can be recognized initial symptoms irreversible pathological changes cognitive processes. First of all, this is: absent-mindedness, perception and understanding of reality, the adequacy of thinking when making decisions. You can also notice violations of the affective function of consciousness: emotional and sensory perception, attitude to life, the relationship of the individual with society.

The choice of methods of alleviating suffering, the process of assessing the chances and possible outcomes in the presence of the patient in some cases, in itself can serve therapeutic agent. This approach gives the patient a chance to really realize that they sympathize with him, but they perceive him as a capable person with the right to vote and choose. possible ways solving the situation.

In some cases, a day or two before the expected death, it makes sense to stop taking certain medications: diuretics, antibiotics, vitamins, laxatives, hormonal and hypertonic drugs. They will only exacerbate suffering, cause inconvenience to the patient. Painkillers, anticonvulsants and antiemetics, tranquilizers should be left.

Communication with a dying person

How to behave relatives, in whose family there is a bed patient? Signs of approaching death can be obvious or conditional. If there are the slightest prerequisites for a negative forecast, it is worth preparing in advance for the worst. Listening, asking, trying to understand the non-verbal language of the patient, you can determine the moment when changes in his emotional and physiological state indicate the imminent approach of death.

Whether the dying person will know about it is not so important. If he realizes and perceives, it alleviates the situation. False promises and vain hopes for his recovery should not be made. It must be made clear that his last will will be fulfilled. The patient should not remain isolated from active affairs.

It is bad if there is a feeling that something is being hidden from him. If a person wants to talk about last moments your life, it is better to do it calmly than to hush up the topic or blame stupid thoughts. A dying person wants to understand that he will not be alone, that he will be taken care of, that suffering will not touch him.

At the same time, relatives and friends need to be ready to show patience and provide all possible assistance. It is also important to listen, let them talk and say words of comfort.

Medical assessment

Is it necessary to tell the whole truth to relatives in whose family there is a bed patient before death? What are the signs of this condition? There are situations when the family of a terminally ill patient, being unaware of his condition, in the hope of changing the situation, spends literally recent savings.

But even the best and most optimistic treatment plan can fail. It will happen that the patient will never get on his feet, will not return to active life. All efforts will be in vain, spending will be useless.

Family and friends of the patient to provide care in the hope of speedy recovery quit their job and lose their source of income. In an attempt to alleviate suffering, they put the family in a difficult financial situation. Relationship problems arise, unresolved conflicts due to lack of funds, legal issues - all this only aggravates the situation.

Knowing the symptoms of imminent death, seeing irreversible signs physiological changes, experienced doctor must notify the family of the patient. Informed, understanding the inevitability of the outcome, they will be able to focus on providing him with psychological and spiritual support.

Palliative care

Do relatives who have a bed patient need help before death? What symptoms and signs of the patient suggest that she should be treated? Palliative care for the patient is not aimed at prolonging or shortening his life. Its principles affirm the concept of death as a natural and regular process of the life cycle of any person.

However, for patients incurable disease, especially in its progressive stage, when all treatment options have been exhausted, the question of medical and social assistance is raised. First of all, you need to apply for it when the patient is no longer able to conduct active image life or in the family there are no conditions to ensure this. In this case, attention is paid to alleviating the suffering of the patient.

At this stage, not only the medical component is important, but also social adaptation, psychological balance, peace of mind the patient and his family. A dying patient needs not only attention, care and normal living conditions. For him, psychological relief is also important, alleviating the experiences associated, on the one hand, with the inability to self-service, and on the other, with the realization of the fact of the imminent imminent death.

Prepared nurses and doctors in palliative clinics know the subtleties of the art of alleviating such suffering and can provide significant assistance to terminally ill people.

Predictors of death according to scientists

What to expect for relatives who have a bed patient in the family? Symptoms of the approaching death of a person "eaten" cancerous tumor, documented by clinic staff palliative care.

According to observations, not all patients showed obvious changes in the physiological state. A third of them did not show symptoms or their recognition was conditional. But in the majority of terminally ill patients, three days before death, a marked decrease in the response to verbal stimulation could be noted. They did not respond to simple gestures and did not recognize the facial expressions of the personnel communicating with them.

The “smile line” in such patients was omitted, an unusual sounding of the voice (grunting of the ligaments) was observed. Some patients also had hyperextension neck muscles(increased relaxation and mobility of the vertebrae), non-reactive pupils were observed, patients could not close their eyelids tightly. From explicit functional disorders bleeding was diagnosed gastrointestinal tract(in upper divisions).

According to scientists, the presence of half or more of these signs can highly likely bear witness to poor prognosis for the patient and his sudden death.

Bedridden patient: how to recognize the signs of impending death?

Relatives of a dying patient at home should be aware of what they may encounter in the last days, hours, moments of his life. It is impossible to accurately predict the moment of death and how everything will happen.

Not all of the symptoms and symptoms described above may be present before the death of a bedridden patient. The stages of dying, like the processes of the origin of life, are individual. No matter how hard it is for relatives, you need to remember that it is even more difficult for a dying person.

Close people need to be patient and provide the dying person as much as possible. possible conditions, moral support and attention and care. Death is an inevitable outcome of the life cycle and cannot be changed.

<...>Yuri Dudnik