Our dad is dying and no one in my family knows what to do. What should we expect during the dying process? [Part 1 of 2]
Although the dying process is affected by many variables, such as pneumonia, in general, most people die three to seven days after stopping all fluids. The following are the most common symptoms in the final two weeks.
Weakness and Fatigue. They start sleeping more—both day and night. They are tired and it takes all their energy to do what they do.
Reduced Intake. They have no appetite and so eat progressively less. Although some continue sipping fluids, most will refuse anything for the several days preceding death. They are becoming dehydrated, a normal and protective part of dying, which is not painful. ‘Pushing’ them to eat, may cause choking and greater distress. Instead, offer sips of water or juice if they’re alert enough to swallow; but once they stop drinking, just moisten their mouth with wet swabs and keep their lips lubricated.
Loss of Bowel/Bladder Control. Bowel movements and urination decrease; they often begin losing control. Sometimes a catheter for the bladder can be inserted, but usually only extra padding is needed.
Breathing Changes. Frequently, a pattern of deep, slow breaths followed by progressively longer intervals of no breathing, will develop. This may continue for days and then in the final hours, the breaths may become very shallow and rapid. They are not “suffocating” and the addition of oxygen usually only irritates them and may prolong dying. Often, a small dose of morphine reduces any apparent breathing distress. If the “death rattle” develops, putting them in the ‘position-of-safety’ (on their side with the bed flat and their head down) usually helps.
Eyes won’t close. Sometimes a person’s eyes won’t close completely; lubricant drops/ointment can be comforting.
In Part 2, I will discuss pain control, confusion, and communication.