- Physical changes : These changes are part of the ageing process. The skin can become paper-thin and pale, with dark liver spots appearing on hands, feet and face. Hair can also thin and the person may shrink in stature. Teeth can discolour or develop dark stains.
- Their external world begins to diminish – until the dying person no longer wants to leave the house or their bed.
- Increased sleep: The person begins to sleep for long periods. This can be distressing for relatives, but it’s important to understand that physical exertion for someone approaching death is exhausting, and, for the moment, all effort is being put into staying alive. Nearer the end, they may increasingly drift in and out of consciousness.
- Appetite reduces: The body knows it no longer needs fuel to keep it going, and those who are dying often lose their desire to eat or drink. They can begin to lose weight sometimes quite rapidly. It’s important not to force food or drink onto someone who no longer wants it. But do take guidance from nursing staff.
- Change of language: The person may start to talk about ‘leaving’, ‘flying’, ‘going home’, ‘being taken home’, ‘being collected’, ‘going on holiday’ or making some kind of journey. They may also begin to express heart-felt gratitude to their carers and to their family as a preparation to say their farewells.
- Special requests: They may want to do something special such as visit a particular site, or be surrounded by their favourite flowers, or to hear certain music, or to have family photographs near, or to make contact with someone who has been important in their lives.
- The dying may also feel compelled to resolve unfinished business. Towards the end of life, the dividing line between the outer world and inner world can become very thin. For example, we know now from research how, when they are nearing death, people are often called by an almost organic process to confront and resolve unfinished issues from their past, particularly with family members.
- Deathbed visions: It is not uncommon in the weeks, days or even hours and moments before death for a dying person to speak of being ‘visited’ by dead relatives, friends, groups of children, religious figures, or even favourite pets.
A little more about deathbed visions
The dying will say these apparitions have come to ‘collect’ them or help them let go. Even when semi-conscious and unable to communicate to those sitting with them, it may appear that they are reaching out to take hold of something, and then feeling it between their fingers as if puzzled. They may also appear to be thinking deeply, as if they are being ‘shown’ information that they may not have considered before.
The dying, and those who witness these end-of-life experiences, usually describe them with loving, reassuring words such as calming, soothing, greeting, comforting, beautiful, readying.It is not known how many dying people have such visions and experiences.
But research does suggest that they happen in all cultures and religions, occurring generally within weeks, days or hours of death.However, it is probable that many end-of-life experiences are not reported, because either the dying person is afraid appearing confused or distressed, or believes he or she will be given medication to stop them happening.
Carers may keep quiet about them because they feel it is not professional to talk about such things. Or they simply do not have the time to sit with the dying and therefore miss them.
Relatives may not speak about such experiences to staff or to family and friends for fear of ridicule or disbelief. Nevertheless , research suggests that end-of-life visions and dreams hold profound meaning for the dying, and help them come to terms with their dying process