Symptoms of the end of life include physical and mental changes that signal the body is shutting down. As organ systems prepare to stop, circulation, blood pressure and body temperature fluctuations cause changes in the dying person's appearance. A withdrawal from previously enjoyed activities is common. It is usually during this withdrawal period that a person mentally prepares for death.
Adopting a quiet, reflective attitude is common during the final months or weeks of life. In some cases, the dying person may become depressed. Signs of the end of life may also include the desire to contact lost friends or loved ones to mend previously injured relationships.
Appetite loss is also among the symptoms of the end of life. As the body prepares for death, it stops processing nutrients properly, and eating may cause discomfort. Ice chips and light liquids can be offered during this time, but the decision whether to eat and drink should be left up to the dying person. Shortly before death, some terminally ill people get a burst of hunger and may request favorite foods that they previously lost interest in eating.
From a couple of weeks to a few days before death, the dying person may sleep much more than he or she previously slept. The body is using what energy is left to allow the person to rest. A burst of energy a few days before death is a common occurrence. During this time, the dying person may become talkative and possess more physical energy than in previous weeks.
Symptoms of the end of life typically include a cooling of skin on the dying person's extremities. This is usually noticed by loved ones as they hold the dying person's hand or stroke his or her arm during the final days and hours of life. The cooled skin temperature is caused by reduced blood pressure, which in turn reduces circulation to hands and feet. Slippers can be offered to warm the feet. Hands can be kept under a sheet or blanket.
Cheyne-Stokes breathing occurs a few hours before death. This breathing involves short, rapid breaths followed by long intervals of not breathing. As fluids build in the lungs, the terminal patient may cough. This is sometimes called a rattle cough due to its rattling sound. It does not mean the dying person is in any discomfort; however, if it is stressful for loved ones to hear, there are several medications that will reduce its frequency.
Skin color changes are typical symptoms of the end of life. A gray tone takes the place of normal skin tones. In addition, mottled patches may be present on extremities. Such symptoms do not cause discomfort.
Shortly before death, the dying person may experience pleasant hallucinatory sights and sounds. Such hallucinations are common symptoms of the end of life and real to the person having them. In other cases, her or she hallucinates that people are trying to cause harm.
Following death, breathing has ceased and the eyes are partially open. The mouth may be relaxed and open. Skin is cold to the touch.