Physical Weakness, Mental Confusion, and Labored Breathing
10 Signs Death Is Near : Page 2
3. Increased physical weakness
A decline in food intake and lack of energy leads to less energy, even for activities like lifting one's head or shifting in bed. The person may even have difficulty sipping from a straw.
How to respond: Focus on keeping the person comfortable.
4. Mental confusion or disorientation
Organs begin to fail, including the brain. Higher-order consciousness tends to change. "Few conditions leave people hyperaware when they're dying," says palliative-care physician Ira Byock, author of Dying Well.
The person may not be aware of where he or she is or who else is in the room, may speak or reply less often, may respond to people who can't be seen in the room by others (see Passing Away: What to Expect When Witnessing a Loved One's Death), may seem to say nonsensical things, may be confused about time, or may act restless and pick at bed linens.
How to respond: Remain calm and reassuring. Speak to the person softly, and identify yourself when you approach.
5. Labored breathing
Breath intakes and exhales become raggedy, irregular, and labored. A distinctive pattern called Cheyne-Stokes respiration might be heard: a loud, deep inhalation is followed by a pause of not breathing (apnea) for between five seconds to as long as a full minute, before a loud, deep breath resumes and again slowly peters out.
Sometimes excessive secretions create loud, gurling inhalations and exhalations that some people call a "death rattle."
How to respond: The stopped breathing or loud rattle can be alarming to listeners, but the dying person is unaware of this changed breathing; focus on overall comfort. Positions that may help: the head slightly elevated with a pillow, sitting up well-supported, or the head or lying body tilted to the side slightly. Moisten the mouth with a wet cloth and moisturize with lip balm or petroleum jelly.
If there's a lot of phlegm, allow it to drain naturally from the mouth, since suctioning it out can increase its quantity. A vaporizer in the room might help. Some people are given oxygen for comfort. Be a calm, physical presence, stroking the arm or speaking softly.