We understand death for the first time when he puts his hand upon one whom we love.
— Madame deStael (1766-1817)
When death comes suddenly, there is little time to prepare. In contrast, watching an older person become increasingly frail may mean that it’s hard to know when the end of life begins because changes can happen so slowly. But, if you do know death is approaching and understand what will happen, then you do have a chance to plan.
Listen carefully to what doctors and nurses are saying. They may be suggesting that death could be soon. You might also ask—how much time do you think my loved one has left, based on your experience with other patients in this condition?
Just as each life is unique, so is each death. But, there are some common experiences very near the end:
Each of these symptoms, taken alone, is not a sign of death. But, for someone with a serious illness or declining health, these might suggest that the person is nearing the end of life.
In addition, when a person is closer to death, the hands, arms, feet, or legs may be cool to the touch. Some parts of the body may become darker or blue-colored. Breathing and heart rates may slow. In fact, there may be times when the person’s breathing becomes abnormal, known as Cheyne-Stokes breathing. Some people hear a death rattle, noisy breathing that makes a gurgling or rattling sound. The chest stops moving, no air comes out of the nose, and there is no pulse. Eyes that are open can seem glassy.
After death, there may still be a few shudders or movements of the arms or legs. There could even be an uncontrolled cry because of muscle movement in the voice box. Sometimes there will be a release of urine or stool, but usually only a small amount since so little has probably been eaten in the last days of life.