Old people before death. Signs of imminent death: how he dies, what he feels, how a person behaves, what they say in such a situation, how to prepare and help

Especially when it comes to a serious chronic illness, relatives should be prepared for his death. And although no one will give an accurate forecast of how long a bedridden patient can live, by the combination of several signs, one can predict his imminent death and, if possible, prepare for it.

Signs of approaching death

Most often, signs of imminent death of a bedridden patient can be observed in a few days (in some cases, weeks). The behavior of a person, his everyday habits are changing, physiological signs are manifested. Since the attention of a bedridden patient is focused on internal sensations for a long time, he very sensitively feels all the changes that occur. At this time, many patients begin to increasingly talk to their relatives about the approaching death, sum up the life they have lived. The reaction at this stage is very individual, but, as a rule, a person becomes depressed and really needs the support and attention of his family. Further manifestation of signs of impending death enable the family to accept the thought of an imminent loss and, if possible, alleviate last days dying.

Common signs of impending death in bedridden patients

All signs of impending death in bedridden patients are associated with a gradual withdrawal internal organs and death of brain cells and are therefore characteristic of most people.

Type	sign
Physiological	Fatigue and sleepiness
	Respiratory failure
	Lack of appetite
	Urine color change
	Cold feet and hands
	puffiness
	Sensory failure
Psychological	Loss of orientation, confusion
	Closure
	mood swings

Fatigue and sleepiness

One of the first signs of imminent death of a bedridden patient is a change in habits, sleep and wakefulness. The body tries to conserve energy, as a result, a person is in a state of constant sleep. In the last days before death, a bedridden patient can sleep 20 hours a day. Great weakness does not allow to fully wake up. Sleep disturbances occur a few days before death.

Psychological signs

All this affects his emotional state. Relatives feel his detachment, isolation. Often a bedridden patient at this stage refuses to communicate, turns away from people. It is important for relatives to understand that such behavior is a consequence of the disease, and not a manifestation negative attitude to them. In the future, a few days before death, the decline is replaced by excessive excitement. A bedridden patient recalls the past, describing the smallest details of long-standing events. Scientists have identified three stages of changing the consciousness of a dying person:

• denial, struggle;
• memories. Dying thoughts in his past, analyzes, far from reality;
• transcendence. In other words, cosmic consciousness. At this stage, a person accepts his death, sees the meaning in it. Hallucinations often begin at this stage.

The death of brain cells leads to hallucinations: often dying bedridden patients say that someone is calling them or suddenly start talking to people who are not in the room. Most often, visions are associated with the afterlife, with the concept of heaven-hell.

Note. In the 60s. California scientists conducted a study that showed that the nature of a dying person's hallucinations has nothing to do with education, religion or intelligence level.

No matter how hard it is for relatives at this moment, one cannot contradict and try to refute the delusions of the dying. For him, everything he hears and sees is reality. At the same time, confusion of consciousness is observed: he may not remember recent events, not recognize relatives, not orient himself in time. The family will need patience and understanding. Communication is better to start with your name. Violation of the perception of reality can be observed a month before death. Delirium begins 3-4 days before death.

Refusal to eat and drink

At the same time, there is a refusal to eat. Due to the lack of movement and prolonged sleep, the patient's appetite decreases, and the swallowing reflex may disappear. The body no longer needs a lot of energy, the metabolism slows down. Refusal of food and water is a sure indicator that death will come very soon. Doctors do not recommend trying to force feed. But you can moisten your lips with water, this will at least slightly alleviate the condition. The next sign appears partly as a consequence of the refusal of water.

Kidney failure and associated signs of death

Due to the lack of water entering the body, the amount of urine excreted becomes much less, its color changes. Urine becomes dark red, sometimes brown. The color changes under the influence of toxins that poison the body. All this signals that failures in the work of the kidneys begin. Complete cessation of urination is a symptom that the kidneys have failed. From that moment on, the clock is already counting.

During this period, the bedridden patient is no longer too weakened and the process of urination cannot be controlled. Intestinal problems are added. Kidney failure leads to severe swelling of the hands and feet. Fluid that the kidneys no longer excrete accumulates in the body.

Symptoms associated with impaired blood circulation

With the onset of the terminal stage falls, blood circulation becomes centralized. This is a protective mechanism of the body, which in a critical situation redistributes blood flow to protect vital organs: the heart, lungs, brain. The periphery is not sufficiently supplied with blood, which causes the following signs of death in bedridden patients:

• cold feet and hands
• the patient complains of cold
• wandering spots appear (primarily on the feet).

Venous spots begin to appear shortly before death on the feet and ankles. Often they are mistaken for cadaveric spots, but their origin is different. Venous spots in a dying person appear due to slow blood flow. After death, they turn blue.

Violation of thermoregulation

Brain neurons gradually die off, one of the first to suffer is the department responsible for thermoregulation. A bedridden patient before death either becomes covered with perspiration, or begins to freeze. The temperature rises to a critical one (39-40°), then to drop sharply. When the temperature rises, it is recommended to wipe the body of the dying person with a damp towel, if possible, give an antipyretic. It will not only help bring down the fever, but also remove the pain, if any. Before death, the temperature begins to gradually drop.

Respiratory failure

General weakness affects breathing. The slowdown of all processes leads to the fact that the need for oxygen is significantly reduced. Breathing becomes rare and superficial. In some cases, noted difficult, intermittent breathing. Most often it is associated with the fear experienced by the dying. At this moment, he needs the support of his relatives, the understanding that he is not alone. As a rule, this is enough for the breathing to even out.

In the last hours, wheezing, gurgling in the chest may appear. This is due to the stagnation of fluid in the bronchi. The person is so weakened that he can no longer clear his throat on his own. And although this does not cause him any discomfort (at this point, the body's reactions are already very muffled), you can turn him on his side so that the sputum comes out.

Cheyne-Stokes respiration may also be observed. This is the phenomenon when breathing changes in waves from rare and shallow to deep and frequent. Having reached a peak at 5-7 breaths, a decline begins, then everything repeats.

Relatives need to constantly moisten or lubricate the lips of the dying. Mouth breathing causes severe dryness and can add further discomfort.

Sensory failure

decline blood pressure leads to the fact that a person before death hears practically nothing. In addition to rare moments of enlightenment, he hears a constant ringing, tinnitus.

The eyes also suffer. Lack of moisture and normal blood supply lead to a painful reaction to light. Often debilitated patients cannot open or close their eyes. At night, you can notice that the patient sleeps with his eyes open. At the same time, the eyes may sink from weakness, remaining open.

Despite the fact that it is very difficult for relatives, it is necessary to moisten the cornea with drops.

A couple of hours before death, a person loses his sense of touch. He does not feel touch, does not respond to sound.

Interesting! Scientists have proven a direct link between the loss of smell and near death. Statistically, old man, who has ceased to distinguish smells, dies within five years.

Other signs

In addition to the above, nurses in the nurses identify several more signs indicating an imminent death.

Signs before death (dying bed patient):

• the smile line is lowered;
• a person complains of nausea;
• the "mask of death" appears. The nose is pointed, the eyes and temples fall in, the ears turn slightly inside out;
• stripping (carthology). Before death, it is manifested by restless hand movements, reminiscent of collecting crumbs.

Not all of the symptoms listed are always manifested, but a complex of several is a sure sign of an early death. Signs of death in bedridden patients from old age do not differ from those described above. Some diseases, in addition to the general ones, cause specific symptoms of the death of a bedridden patient.

Death of a bedridden patient due to a stroke

The highest percentage of mortality from stroke in the hemorrhagic course of the disease. After a stroke, the patient is bedridden for 2-3 weeks. 80% of these cases are fatal. When first of all, the blood supply in the brain stem is disturbed, and specific signs of the death of a bedridden patient appear.

A bedridden patient after a stroke (signs before death):

• "closed person" The patient completely loses the ability to move (can only lower and raise the eyelids), while the consciousness remains clear;
• convulsions, muscles of the arms and legs in hypertonicity;
• asynchronous movements of the eyeballs associated with damage to the cerebellum;
• breathing becomes loud, with long pauses.

These signs of death in a bedridden patient after a stroke indicate irreversible processes in the body and an early death.

Important! Scientists have found that the survival rate of women after a stroke is 10% lower than that of men. However, stroke is the third leading cause of death for women.

Death of a bedridden patient with oncology

With oncology, things are a little more complicated. How a person with cancer dies depends on the type of tumor. The location of the metastasis causes different symptoms and sensations in the dying person. However, there are some general signs:

• pain syndrome intensifies;
• sometimes gangrene of the legs develops;
• paralysis of the lower extremities may also occur;
• severe anemia;
• weight loss.

Death from cancer is always painful. Ordinary painkillers at this stage no longer help, the condition improves only after taking drugs. An exhausted person needs peace and family support.

Death, its stages and signs

State	Stage	Description
Terminal	Preagonal	A defense mechanism to reduce suffering. Irreparable processes of destruction occur in the body
	Agonal	The body's last attempt to prolong life. All powers are ejected in a brief burst of activity
	clinical death	Stopping the work of the heart and lungs. 6-10 minutes
biological death		Irreversible stop of all vital processes in the body. 3-15 minutes
Final death*		Destruction of neural connections in the brain. Death of the individual

* - the term "final death" is accepted within the framework of a theory that tries to include the destruction of the personality in the stages of dying. In accordance with the concept, the destruction of the neural connections of the brain occurs a few minutes after biological death. It is with the destruction of ties that the death of a person as a person occurs.

Terminal state

The preagonal stage can last from several days to a couple of hours. On it, a bedridden patient may experience the following symptoms:

• vomiting with black masses, other biological fluids of the same color (before death, uncontrolled emptying is observed Bladder and intestines). Most often, this symptom is observed in oncology;
• pulse is frequent;
• mouth half open;
• pressure drop;
• change in skin color (turns yellow, turns blue);
• convulsions and convulsions.

The onset of clinical death is preceded by the stage of agony. The agony can last from several minutes to half an hour (cases have been recorded when the agony lasted for several days). The first sign of the onset of agony is a breath in which the entire rib cage including the muscles of the neck and face. The heart rate accelerates, blood pressure briefly rises. During this period, a bedridden patient before death may feel relief. The circulatory system is changing: all blood is redirected to the heart and brain to the detriment of other internal organs.

Breathing stops first, the heart still continues to work for 6-7 minutes. Clinical death is diagnosed in the presence of the following symptoms:

• stop breathing,
• the pulse on the carotid arteries is not palpable,
• extended .

Diagnoses clinical death only a doctor. The difficulty is that in some diseases, the processes of vital activity do not stop, but become barely noticeable. There is a so-called "imaginary death".

In the absence of breathing for 5 minutes, cell death begins in the brain. There comes the final stage of death - biological.

biological death

There are early and late signs of biological death:

Early	Cloudy, dry cornea	After 1-2 hours
	Beloglazov's symptom (cat's eye)	30 minutes after death. When the fingers squeeze the eyeball, the pupil is deformed, acquiring an elongated shape
Late	Dry skin and mucous membranes	1.5-2 hours. Lips tight, dark brown
	body cooling	Body temperature drops by 1 degree for every hour that passes after a bedridden patient dies
	The appearance of dead spots	Occur when dying (after 1.5 hours) and continue to appear for several hours after death. The reason is that the blood descends under the force of gravity and becomes visible through the skin.
	Rigor	A bedridden patient after death undergoes rigor mortis after 2-4 hours. Rigor numbness will completely disappear only after 2-3 days
	Decomposition	/No/

Of course, even having noticed and correctly assessed all the signs, one cannot be absolutely ready for death. loved one. But you can try to make his last hours and days as comfortable as possible. Psychologists and doctors give the following recommendations for relatives of a dying bedridden patient:

• to see the suffering of a family is a heavy burden for a dying person, therefore, if there is no strength to cope with emotions, it is better to use a sedative;
• if a person does not recognize an imminent death, one cannot convince him;
• if the dying person expresses a desire, invite a priest.

The most important thing that is required from loved ones at such a moment is attention and love. Conversations, tactile contact, moral support, readiness to fulfill any request - all this will help the bedridden patient to adequately meet his death.

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Unfortunately, after life there is always death. Now science is unable to prevent old age and its inevitable lethal consequences. Relatives and friends of seriously ill patients need to be prepared for this. What does a bedridden patient experience before death? How should caregivers respond to signs of approaching death? We will talk about this below.

Phases of death

There are several phases of a person's condition that occur before his death. Signs of the first stage ("pre-active phase") can begin 2 weeks before the terrible event. During this period, the patient begins to consume less food and liquid than usual, there are pauses in breathing, wound healing worsens, and swelling appears. Also, the patient can claim an imminent death and report that he saw dead people.

Then the following phases follow:

• clinical death (signs of vital activity disappear, but metabolic processes still occur in the cells);
• biological death (almost complete cessation of physiological processes in the body);
• final death (final phase).

Signs of approaching death

Signs of death in a bedridden patient may be different in each case. There are several main ones:

Certain diseases cause specific symptoms. Thus, the signs of death in a cancer patient are often manifested in the form of pain, nausea, confusion, restlessness and shortness of breath (with a stroke, such symptoms are less common).

It should also be noted that low blood pressure or prolonged cessation of breathing (or if the patient is constantly asleep) are not reliable indicators of imminent death in all cases. Some patients with these symptoms may recover suddenly and live for a week, a month, or even more. Only God knows when death will come.

How to behave properly with loved ones

What should relatives and friends do if they see signs of approaching death? It is always very difficult to talk to a dying person. There is no need to give false promises and hopes for recovery. Tell the patient that his last wishes will be granted. He should not think that something is being hidden from him. If a person wants to talk about life and its last moments, you need to do it, and not try to hush up the topic and say something distant. Before death, let the patient know that he is not alone, say words of consolation.

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A dying person has a number of symptoms that characterize his approach to death. Symptoms are divided into psychological and physical. Scientists have noticed a pattern that, regardless of why death occurs (age, injury, illness), most patients have similar complaints and emotional state.

Physical symptoms of approaching death

Physical symptoms are various external changes in the normal state of the human body. One of the most noticeable changes is drowsiness. The closer death is, the more a person sleeps. It is also noted that every time it becomes more difficult to wake up. Wake time is getting shorter every time. The dying man feels more and more tired every day. This condition can lead to complete incapacity. A person can fall into a coma, and then he will need full care. Here, medical staff, relatives or a nurse come to the rescue.

Another symptom of the approach of death are violations of the rhythm of breathing. Doctors notice a sharp change in calm breathing to rapid breathing and vice versa. With such symptoms, the patient requires constant control of breathing and, in some cases, mechanical ventilation. Sometimes "death rattles" are heard. As a result of stagnation of fluid in the lungs, noises appear during inhalations and exhalations. To reduce this symptom, it is necessary to constantly turn the person from one side to the other. Doctors prescribe various medications and therapies.

The work of the gastrointestinal tract is changing. In particular, appetite worsens. This is due to the deterioration of metabolism. The patient may not eat at all. It becomes hard to swallow. Such a person still needs to eat, so it is worth giving food in the form of mashed potatoes in small quantities several times a day. As a result, the functioning of the urinary system is also disrupted. A violation or absence of stool is noticeable, urine changes its color and its quantity decreases. In order to normalize these processes, enemas should be done, and the work of the kidneys can be normalized when the necessary drugs are prescribed by doctors.

The work of the brain before is also disturbed. As a result, temperature fluctuations occur. Relatives begin to notice that the patient has very cold extremities, and the body becomes pale and reddish spots appear on the skin.

psychological symptoms of approaching death

Psychological symptoms can occur both with changes in the functioning of certain systems and organs in the body, and as a result of fear of approaching death. Before death, the work of vision and hearing deteriorates, various hallucinations begin. A person may not recognize his loved ones, not hear them, or, on the contrary, may see and hear something that is not really there.

The approach of death is felt by the person himself. Then he goes through the stages of accepting that this is the end. A person loses interest in everything, apathy and unwillingness to do anything appear. Some people begin to rethink their lives, trying to fix something in the last moments, someone is trying to save their soul, turning to religion.

Before death, a person very often remembers his whole life, often vivid and detailed memories. There have also been cases when the dying person seems to leave completely at some bright moment of his life and stay in it until the very end.

http://www.eparhia-saratov.ru

The law of death is common to all mankind. Death is inevitable. But if a person thinks that his life ends with a coffin, he drives himself into a dead end. Christians know that there is no death and eternal life awaits us. But how difficult it is to come to terms with the inevitable, especially if a loved one dies! What can be done to alleviate his suffering and help him end his life with dignity?

We often think that the dying person needs only care and comfort; this is wrong. It happens that when an elderly person - father, mother, husband or wife - falls ill, relatives, realizing that the disease is incurable, quickly send him or her to a hospital or other institution.<…>Old people, men and women, come up to important hour their life without love, not reassured and not reconciled, but humiliated, unhappy and sometimes embittered.

Relatives believe that it will be better for him there, they know what to do there. From time to time, a wife or husband will visit a sick person and think that they have done everything that is necessary and possible. But it is difficult for them to see a sick person, and the further the disease goes, the more difficult it is. Visits are made shorter and less frequent. Children are also busy with their own; Of course, they also think about a sick father or mother, but in general, all this is perceived mainly as a complication of their own life.

Soon, however, it will be necessary to decide where to die: in a hospital or at home. It is difficult to die in any conditions, but dying at home, when those whom you love and who love you are near you, it is easier. Think each and every one of yourself; when it's your turn - where?

Death is different, sometimes it is sudden in the midst of complete well-being, such a death is usually sudden, bright and tragic, but there is another death, this is death that quietly creeps up and, as it were, humbly waits at the head of its minute, this is the death of seriously decrepit old men and women, such a death is of little interest and far less has been written about her than about her first friend. Sooner or later, we all will have to face death, because "contra vim mortis non est medicamen in hortis", sometimes death has to be met not in the intensive care unit burning around the clock with all the lights, but at home, in the family circle, of course, this is in any case a very difficult event , but you should not completely lose your head, reveling in your experiences, but on the contrary, you should make the last days and hours of a loved one as comfortable as possible, how to recognize the signs that the end is already near and help the dying person on these last difficult stages of his journey .

No one can predict when death will come, but people on duty, often encounter people who are seeing off their last days in this world, they are well aware of the symptoms of approaching death, the symptoms of the fact that there are only a few days and hours of a human being.

Loss of appetite
In a gradually fading person, energy needs decrease more and more over time, the person begins to refuse food and drink, or take only small amounts of neutral simple food (for example, porridge). Coarse food is usually given up first. Even once-favorite dishes do not deliver former pleasure. Just before death, some people are simply unable to swallow food.

What to do: do not try to force-feed a person, listen to the wishes of the dying person, even if you are deeply upset by his refusal to eat. Periodically offer the dying person pieces of ice, fruit ice, sips of water. Wipe soft cloth lips and skin around the mouth moistened with warm water, treat the lips with hygienic lipstick so that the lips do not dry out, but remain moist and supple.

Increased fatigue and drowsiness
A dying person can spend most of the day in a dream, since the metabolism fades away, and the reduced need for water and food contributes to dehydration, the dying person wakes up more difficultly, weakness reaches such an extent that the person perceives everything around him completely passively.

What to do: let the dying person sleep, do not force him to stay awake, do not disturb him, everything you say, he can hear, suggest that hearing is preserved even if the person is unconscious, in a coma or other forms of impaired consciousness.

Severe physical exhaustion
Decreasing metabolism produces less and less energy, it remains so small that it becomes very difficult for a dying person not only to turn in bed, but even to turn his head, even a sip of liquid through a straw can cause great difficulties for the patient.

What to do: Try to maintain a comfortable position for the patient and help him if necessary.

Confusion or disorientation
The functional insufficiency of many organs is growing, not bypassing the brain, consciousness begins to change, usually, with one speed or another, its oppression occurs, the dying person may no longer be aware of where he or she is, who surrounds him, may speak or respond less readily, can communicate with people who are not or cannot be in the room, can talk nonsense, confuse time, day, year, can lie motionless on the bed, or can become restless and pull the bed linen.

What to do: stay calm yourself and try to calm the dying person, speak softly to the person and let him know who is in this moment is by his bed or when you approach him.

Difficulty breathing, shortness of breath
Respiratory movements become erratic, jerky, a person may experience difficulty in breathing, so-called pathological types of respiration can be observed, for example, Cheyne-Stokes respiration - a period of increasing loud respiratory movements alternating with decreasing in depth, after which there is a pause (apnea) lasting from five seconds to minutes, followed by another period of deep, loud rising breathing movements. Sometimes excess fluid in respiratory tract creates loud bubbling sounds during respiratory movements, which are sometimes called the "death rattle".

What to do: prolonged apnea (pause between breaths) or loud gurgling can be alarming, however, the dying person may not even be aware of this kind of change, focus on ensuring overall comfort, a change in position, for example, putting it under the back and head can help another pillow, you can give an elevated position or slightly turn his head to the side, moisten his lips with a damp cloth and treat his lips with hygienic lipstick. If separated a large number of sputum, try to facilitate its discharge through the mouth in a natural way, because artificial suction can only increase its separation, a humidifier in the room can help, in some cases oxygen is prescribed, in any case, stay calm, try to calm the dying.

Social exclusion
While irreversible changes gradually build up in the body, the dying person gradually begins to lose interest in the people around him, the dying person may stop communicating completely, mutter nonsense, stop answering questions, or simply turn away.
A few days before, before completely plunging into oblivion, a dying person can surprise relatives with an unusual burst of mental activity, begin to recognize those present again, communicate with them, and respond to speech addressed to him, this period can last less than an hour, and sometimes even a day. .

What to do: in any case, remember that all this is a natural manifestation of the process of dying and is by no means a reflection of your relationship, support physical contact with the dying, touch, continue to communicate with him if appropriate, and try not to expect any response from him in return, cherish episodes of suddenly clear consciousness when they happen, since they are almost always fleeting.

Changed urination pattern
The dying person has a reduced need for food and fluid intake, a decrease in blood pressure is part of the process of dying (which, due to the latter, does not need to be corrected to a normal level, like some other symptoms), urine becomes small, it becomes concentrated - rich brownish, reddish colors, or colors of tea.
Control over the natural functions can later be completely lost in the process of dying.

What to do: A urinary catheter may be placed to control and facilitate the passage of urine, as instructed by medical staff, although this is usually not necessary in the final hours. The onset of kidney failure leads to the accumulation of "toxins" in the circulating blood and contributes to a peaceful coma before death. And, simply, lay a fresh film.

Swelling of the hands and feet
progressive kidney failure leads to the accumulation of fluid in the body, it usually accumulates in tissues located at a distance from the heart, that is, usually in the fatty tissue of the hands and, in particular, the feet, this gives them a somewhat puffy, swollen appearance.

What to do: usually this does not require special measures (prescription of diuretics) because they are part of the process of dying, and not its cause.

Coldness of the fingertips and toes
In the hours to minutes before death, the peripheral blood vessels constrict in an attempt to maintain circulation to the vital organs of the heart and brain as blood pressure progressively decreases. With spasm of peripheral vessels, the limbs (fingers of the hands and feet, as well as the hands and feet themselves) become noticeably colder, the nail beds become pale or bluish.

What to do: At this stage, the dying person may already be in a state of unconsciousness, otherwise, a warm blanket can help maintain comfort, the person may complain about the weight of the blanket covering their legs, so free them as much as possible.

Spots on the skin
On the skin, which was previously evenly pale, a distinctly distinguishable variegation and spots of a purple, reddish, or bluish tint appear - one of the final signs of imminent death - the result of circulatory disorders in the microcirculatory bed (venules, arterioles, capillaries), often at first such spotting is detected on the feet.

What to do: No special action is required.

The described symptoms are the most common signs of an approaching natural death, they can vary in the order of occurrence and be observed in different combinations in different people, in the case when the patient is in the intensive care unit, under artificial ventilation, and a multicomponent intensive drug therapy process. dying can be completely different, but here the process of natural death is described in general terms.