How old people die. Light at the end of the tunnel or how to tell if an elderly person is approaching death? Loss of orientation and consciousness

We all live in this world thanks to pure chance, and we die “when our time strikes,” to use poetic language. However, we cannot die just like that - everything happens according to plan, has symptoms or signs. What are these signs and is it really possible to predict that a person will soon die? Medicine says yes, it is possible, and offers the following signs of approaching death.

1. Lack of appetite

This is a natural sign of approaching death, because your body no longer needs energy - why do you need it if you are going to die tomorrow? You may not want to eat at all, or you may only want very “harmless”, light meals or products, such as porridge, a sandwich, compote, yogurt. It is unlikely that you will want to eat meat before you die - you simply will not have time to digest it before you die. Your body itself senses when you are dying and simply refuses food. In such a situation, you may have very little strength, and it is good if someone cares about you and is nearby, because lack of appetite does not mean that you do not need anything: sometimes you need a little water - just to moisten your dry lips.

2. Immense sleepiness

Before leaving for another world, a person enters a period of “borderland”: he sleeps more and more, it is more difficult for him to move and even talk, he becomes more and more immersed in that reality invisible to the living. He cannot be forbidden to do this, and relatives should act wisely by allowing the dying person to sleep as much as he wants and talk to him as if he were alive - after all, he has not yet died, and his sleep is not a deep sleep, but rather a drowsiness through which he hears and understands what is happening in the world.

3. Weakness and fatigue

Before the threshold of death, a person has little energy, he eats little or nothing, sleeps constantly, speaks little, and it may be difficult for him to turn over on his side in bed or drink water. He needs help, because his weakness and fatigue indicate that death is already near.

4. Loss of orientation and consciousness

Sometimes before death a person ceases to understand where he is and what is happening. He is in this world, but another world seems to be calling him. Organs begin to act up, the brain may turn off and then turn on, but not work as usual. In such a situation, a person behaves strangely, sometimes he does not recognize his loved ones. Relatives need to show patience and restraint when caring for the dying.

5. Heavy breathing

The dying man breathes heavily as he dies. Breathing either quickens or becomes very deep. Breathing is hoarse, uneven, the dying person seems to be suffocating. Sitting with a pillow behind him helps him - he can breathe easier while sitting than lying down.

6. Self-absorption

The natural process of death includes a loss of attention to what is happening around us, to the lives of the people around us. The dying person is preparing for death - he is no longer interested in what the living think and say. At the same time, he cannot be left alone with himself - he must feel the support of loved ones, who would like to be nearby and support the dying person.

7. Urine color changes

The urine of a dying person becomes darker - sometimes almost brown, sometimes reddish. Organs, as already mentioned, are acting up, and the same applies to the kidneys. Sometimes kidney failure before death leads to the dying person falling into a coma and subsequent quiet death.

8. Edema

This symptom is a consequence of kidney failure. You can no longer go to the toilet, so fluid accumulates in the body, causing parts of the body to swell.

9. Cold extremities

Before plunging into death, the dying person's hands and feet, especially the fingers, become cold. The blood simply flows to the most important organs, leaving the extremities almost without blood, and therefore without heat. In such a situation, loved ones should cover the dying person with a blanket to warm his frozen hands and feet.

10. Walking spots

The dying person is pale, but as a result of poor circulation, it seems that spots or patterns are “walking” on his body. Typically, such spots or patterns appear first on the feet and then on other parts of the body.

Not all of these signs are “necessary”: some of them may be absent, but it is these signs that most often say, from the point of view of medical observations, that death is not just nearby - it has almost taken possession of a person.

Unfortunately, after life there always comes death. Now science is unable to prevent old age and its inevitable fatal 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 impending 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, pauses in breathing occur, wound healing worsens, and swelling appears. Also, the patient may claim imminent death and report that he has seen dead people.

Then follow these phases:

• 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, signs of death in a cancer patient often manifest themselves in the form of pain, nausea, confusion, anxiety 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 respiratory movements (or if the bedridden patient is constantly sleeping) are not reliable indicators of imminent death in all cases. Some patients with these symptoms may suddenly recover and survive for a week, a month, or even more. Only God knows when death will occur.

How to behave correctly with a loved one

What should family 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 of recovery. Tell the patient that his last wishes will be fulfilled. He should not think that anything is being hidden from him. If a person wants to talk about life and its last moments, he needs to do this, and not try to hush up the topic and say something detached. 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 indicate he is approaching death. Symptoms are divided into psychological and physical. Scientists have noticed a pattern that, regardless of exactly why death occurs (age, injury, illness), most patients have similar complaints and emotional states.

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 sleepiness. The closer death is, the more a person sleeps. It is also noted that it becomes more and more difficult to wake up each time. The time spent awake is becoming shorter and shorter each time. The dying person feels more and more tired every day. This condition can lead to complete incapacity. The person may fall into a coma and will then require full care. Here medical personnel, relatives or a nurse come to the rescue.

Another symptom of approaching death is irregular breathing. Doctors notice a sharp change from calm breathing to rapid breathing and back again. With such symptoms, the patient requires constant monitoring of breathing and, in some cases, artificial ventilation. Sometimes “death rattles” can be heard. As a result of fluid stagnation in the lungs, noise appears during inhalation and exhalation. 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 functioning of the gastrointestinal tract changes. In particular, appetite worsens. This is due to a deterioration in metabolism. The patient may not eat at all. It becomes difficult to swallow. Such a person still needs to eat, so it is worth giving food in the form of purees in small quantities several times a day. As a result, the functioning of the urinary system is disrupted. There is a noticeable disturbance or absence of stool, urine changes color and its quantity decreases. In order to normalize these processes, enemas should be done, and kidney function can be normalized if doctors prescribe the necessary medications.

The functioning of the brain before is also disrupted. As a result, temperature changes 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 due to changes in the functioning of certain systems and organs in the body, and as a result of fear of approaching death. Before death, vision and hearing deteriorate, and various hallucinations begin. A person may not recognize his loved ones, may not hear them, or, on the contrary, may see and hear something that is not really there.

The person himself feels the approach of death. 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; others are trying to save their souls by turning to religion.

Before death, a person very often remembers his entire life, often the memories are vivid and detailed. There have also been cases when a dying person seems to go completely into some bright moment of his life and remains in it until the very end.

Death is, in any case, an inevitability that sooner or later overtakes every living person. She does not ask age and gender, but “knocks on the door,” seemingly at the most inopportune moment.

But what happens before death, how does a person feel the approach of the end? Unfortunately, answers to this question have not yet been found, since, as we know, no one has ever returned from the other world. Of course, there are no facts, but there are a great many assumptions, and they are expressed mainly by soothsayers, sorcerers, shamans and magicians. It is also doubtful to believe their words, since there are too many charlatans around.

And yet, the question of what people see before death is still acute. Many who have experienced clinical death share what they saw and felt. However, their stories are somewhat different from each other, but the essence is the same.

First story. One person who experienced clinical death managed to return to a full life, and when he was asked what he saw at that moment, he told a traditional story that you can watch on TV. This is the light at the end of the tunnel. He reported that at first he was in the dark and did not know where to go next, but then he began to notice a flickering light in front of him. The flame was so beautiful and attractive that the legs themselves led to it. When there was very little left before him, the patient returned to consciousness and learned that all this time he was considered dead for medical reasons.

Second story. Another man, who had been in a coma for six months, told everyone that he had been in a hospital room all this time, but no one had seen or heard him. He looked at himself from the outside and tried to attract everyone's attention, but again in vain. Then he did not think about who was being seen before death, since according to his internal perception he considered himself absolutely healthy. He was interested in only one question: why is he not being noticed, and how long will this last? Perhaps his movement around the hospital ward would have continued if not for his unexpected recovery from the coma.

Third story. The third man, whose heart stopped for a few seconds during the operation, during his long rehabilitation said that for a few moments he saw his late grandmother, who stretched out her hands to him. At first he began to move towards her, but then some unknown force returned him to his body and forced him to breathe. He is sure that people see their deceased loved ones before death, which is why sometimes they simply refuse to fight for their own lives.

So people’s opinions on this topic differ, but there is a category of patients who are simply sure that there is no life after death, so a person cannot see anyone before death, but simply closes his eyes and dies, as if falling asleep. This opinion also has a right to exist, especially since the rest have not yet found their real confirmation.

The study of the afterlife is a science in which there is always much unknown and unsolved. For example, it is still unknown what people see before death, where they go immediately after its arrival, and where they spend eternity in the future. In addition, all kinds of reality shows and mystical television programs, which also put forward their own versions of what a person sees before death, are even more misleading. So it’s not clear who and what to believe, and where to simply not pay attention to the next nonsense.

Scientists are still concerned about this issue, so they do not stop their numerous studies, which have not yet yielded positive results. Probably, only the person who, one unfavorable day, comes face to face with death knows the correct answer; but, alas, it is no longer possible to ask him about this.

So who do people see before death, and what do such visions mean? Although this topic has not yet been fully studied, it presents to all those interested a huge number of assumptions, opinions and hypotheses.

If you are dying or caring for someone who is dying, you may have questions about what the dying process will be like 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. It is impossible to predict the exact time of death and how exactly a person will die. But people facing death experience many of the same symptoms, regardless of the type of illness.

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

Excessive drowsiness and weakness, at the same time periods of wakefulness decrease, energy fades.

Breathing changes, periods of rapid breathing are replaced by pauses in breathing.

Hearing and vision change, for example, a person hears and sees things that others do not notice.

Appetite worsens, the person drinks and eats less than usual.

Changes in the urinary and gastrointestinal systems. Your urine may turn dark brown or dark red, and you may have bad (difficult) stools.

Body temperature changes, ranging from very high to very low.

Emotional changes, the person is not interested in the outside world and certain details of everyday life, such as time and date.

A dying person may experience other symptoms depending on the disease. Talk to your doctor about what you can expect. You can also contact the program for helping the hopelessly ill, where all your questions regarding the dying process will be answered. The more you and your loved ones know, the more prepared you will be for this moment.

Excessive drowsiness and weakness associated with approaching death

As death approaches, a person sleeps more and it becomes more and more difficult to wake up. Periods of wakefulness are becoming shorter and shorter.

As death approaches, your caregivers will notice that you are unresponsive and that you are in very deep sleep. This condition is called coma. If you are in a coma, you will be confined to a bed and all your physiological needs (bathing, turning, eating and urinating) will have to be supervised by someone else.

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

Respiratory changes as death approaches

As death approaches, periods of rapid breathing may be followed by periods of breathlessness.

Your breath may become wet and congested. This is called the "death rattle." Changes in breathing usually occur when you are weak and normal secretions from your airways and lungs cannot be released.

Although noisy breathing may be a signal to your family, you probably won't feel any pain or notice any congestion. Since the fluid is deep in the lungs, it is difficult to remove it. Your doctor may prescribe oral tablets (atropine) or patches (scopolamine) to relieve congestion.

Your loved ones may turn you on your other side to help the discharge come out of your mouth. They can also wipe this discharge with a damp cloth or special tampons (you can ask for it at a help center for the hopelessly ill or buy it at pharmacies).

Your doctor may prescribe oxygen therapy to 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

Deterioration of vision is very common in the last weeks of life. You may notice that your vision has become difficult. You may see or hear things that no one else notices (hallucinations). Visual hallucinations are common before death.

If you are caring for a dying person who is hallucinating, you need to reassure them. Acknowledge what the person sees. Denying hallucinations can be distressing to a 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 comas said that they could hear the entire time they were in the coma.

Hallucinations

Hallucinations are the perception of something that is not actually there. Hallucinations can involve all the senses: hearing, seeing, smelling, tasting or touching.

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

Other types of hallucinations include gustatory, olfactory and tactile.

Treatment for hallucinations depends on the cause.

ChangesappetiteWithapproachingof death

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

Since food has such important social significance, it will be difficult for your family and friends to watch you not eat. However, changes in metabolism mean that you do not need the same amount of food and fluid as before.

You can consume small amounts of food and liquid as long as you are active and able to swallow. If swallowing is a problem for you, you can prevent thirst by moistening your mouth with a damp cloth or a special swab (available at a pharmacy) soaked 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, the urine becomes very concentrated. Its quantity is also 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 your bowel movements cause you discomfort. Stool softeners may be recommended to prevent constipation. You can also use an enema to cleanse your colon.

As you become increasingly weak, it is natural that you will have difficulty controlling your bladder and bowels. A urinary catheter may be placed in your bladder as a means of long-term urine drainage. The terminally ill program may also provide toilet paper or underwear (they can also be purchased at the pharmacy).

Changes in body temperature as death approaches

As death approaches, the area of ​​the brain responsible for regulating body temperature begins to function poorly. You may have a high fever and then feel cold within a minute. Your hands and feet may feel very cold to the touch and may even become pale and blotchy. Changes in skin color are called mottled skin lesions and are very common in the last days or hours of life.

The person caring for you can monitor your temperature by rubbing your skin with a wet, slightly warm washcloth or giving you the following medications:

Acetaminophen (Tylenol)

Ibuprofen (Advil)

Naproxen (Aleve).

Many of these medications are available in the form of rectal suppositories if you have difficulty swallowing.

Emotional changes as death approaches

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

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

In the days before your death, you may enter a unique state of conscious awareness and communication that may be misinterpreted by your family and friends. You can talk about how 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 may be mixed with distant events. You can remember very long ago events in great detail, but not remember what happened an hour ago.

You may be thinking about people who have already died. You may say that you heard or saw someone who has already died. Your loved ones may 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 bring your loved one back 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 this may be scary for you to watch. Psychosis occurs in many people before death. It may have one cause or be the result of several factors. Reasons may include:

Medicines such as morphine, sedatives and painkillers, or taking too much of a medicine that doesn'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.

Delirium tremens can sometimes be prevented by using 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 illness, such as nausea or difficulty breathing. Controlling pain and other symptoms is an important part of your treatment and improving your quality of life.

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

A person may become so afraid of pain and other physical symptoms that they may consider physician-assisted suicide. But the pain before death 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 cope with the pain of death. Be sure to ask for help. Ask a loved one to tell the doctor about your pain 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 bear it so that they see a doctor immediately.

Spirituality

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

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

Caring for a dying relative

Physician-assisted suicide Physician-assisted suicide refers to the practice of medical professionals assisting a person who voluntarily chooses to die. This is usually done by prescribing a lethal dose of medication. Although the doctor is indirectly involved in the death of a person, he is not the direct cause of it. Oregon is currently the only state to have legalized physician-assisted suicide. A person with a terminal illness may consider suicide with the assistance of a physician. Among the factors that can cause such a decision are severe pain, depression and fear of dependence on other people. A dying person may consider himself a burden to his loved ones and not understand that his family wants to provide him with their help as an expression of love and sympathy. Often, a person with a terminal illness will consider physician-assisted suicide when their physical or emotional symptoms do not receive effective treatment. Symptoms associated with the dying process (such as pain, depression or nausea) can be controlled. Talk to your doctor and family about your symptoms, especially if your symptoms bother you so much that you think about dying.

Control of pain and symptoms at the end of life

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

Physical pain

There are many painkillers available. Your doctor will choose the easiest and most atraumatic drug to relieve pain. Oral medications are usually used first because they are easier to take and less expensive. If your pain is not severe, painkillers can be purchased without a doctor's prescription. These include drugs such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen. It is important to stay ahead of your pain and take your medications as scheduled. Irregular use of medications is often the cause of ineffective treatment.

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

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

Rectal suppositories. Suppositories can be taken if you have trouble swallowing or nausea.

Drops under the tongue. Just like nitroglycerin tablets or heart pain sprays, liquid forms of some substances, such as morphine or fentanyl, can be absorbed by the blood vessels under the tongue. These medications are given in very small quantities—usually just a few drops—and are an effective way to control pain for people who have trouble swallowing.

Patches applied to the skin (transdermal patches). These patches allow painkillers, such as fentanyl, to pass through the skin. The advantage of patches is that you instantly receive the required dose of medication. These patches provide better pain control than pills. In addition, a new patch must be applied every 48 to 72 hours, and the tablets must be taken several times a day.

Intravenous injections (drips). Your doctor may prescribe treatment with a needle inserted into a vein in your arm or chest if your pain is very severe and cannot be controlled with oral, rectal, or transdermal treatments. Medicines can be given as a single injection several times a day, or continuously in small quantities. Just because you are connected to an IV does not mean your activities will be limited. Some people carry small, portable pumps that provide small amounts of medication throughout the day.

Injections into the area of ​​the spinal nerves (epidural) or under the spinal tissue (intrathecal). For acute pain, strong painkillers such as morphine or fentanyl are injected into the spine.

Many people who suffer from severe pain fear that they will become dependent on painkillers. However, addiction rarely occurs in terminally ill people. If your condition improves, you can slowly stop taking the medicine to prevent dependence.

Painkillers can be used to manage the pain and help keep it at a tolerable level. But sometimes painkillers make you drowsy. You can only take a small amount of medication and therefore endure little pain and still remain active. On the other hand, perhaps weakness is not a big deal for you and you are not bothered by drowsiness caused by certain medications.

The main thing is to take medications on a specific schedule, and not just when “the need arises.” But even if you take medications regularly, you may sometimes feel severe pain. These are called "breakthrough pain." Talk to your doctor about what medications you should always have on hand to help manage breakthrough pain. And always tell your doctor if you stop taking your medicine. Stopping suddenly can cause serious side effects and severe pain. Talk to your doctor about ways to relieve pain without using drugs. Alternative medical therapy can help some people relax and get rid of pain. You can combine traditional treatment with alternative methods, such as:

Acupuncture

Aromatherapy

Biofeedback

Chiropractic

Imaging

Healing Touch

Homeopathy

Hydrotherapy

• Magnetotherapy

• Meditation

For more detailed information, see the Chronic Pain section.

Emotional stress

While you are learning to cope with your illness, short-term emotional distress is normal. Depression that lasts more than 2 weeks is no longer normal and should be reported to your doctor. Depression can be treated even if you have a terminal illness. Antidepressants in combination with counseling from a psychologist will help you cope with emotional distress.

Talk to your doctor and family about your emotional distress. Although feelings of grief are a natural part of the dying process, this does not mean you have to endure severe emotional pain. Emotional suffering can make physical pain worse. They can also have a negative impact 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. Talk to your doctor about any symptoms you may experience. Symptoms such as nausea, fatigue, constipation or shortness of breath can be managed with medications, special diets and oxygen therapy. Have a friend or family member describe your symptoms to a doctor or emergency services worker. It can be helpful to keep a journal and write down all your symptoms.