It is impossible to predict when the moment death will actually happen. People can hover between life and death for a long time and it is easy to miss the moment. However, there are certain signs which indicate the person is approaching the end of life, such as:
Congestion in the lungs: The person’s breath becomes laboured and ‘gurgling’ which can sound alarming. However, this is quite normal and caused by secretions pooling in the back of the throat.
Yawning: Even when unconscious or semi-conscious, the person may often yawn. This is a natural response of the body’s need to get oxygen to the vital organs.
Coldness in the limbs: Often the person’s hands, arms, feet and legs become cold with the skin colour changing to a pallid yellow as blood circulation slows down. However, this may not happen until right at the end.
Tea-coloured urine: The decrease of fluid in-take means the kidneys begin to shut down. This causes the person’s urine to become concentrated and tea-coloured or cease altogether. It may also have a pungent, acetone smell.
Incontinence: As the muscles of the body cease to function, there may be a loss of bladder and bowel control. In some cases, nursing staff may need to insert a catheter.
Agitation and restlessness: Dying people who are confused or semi-conscious can become quite distressed. They may also cry out. Nursing staff will often give medication to calm them down.
Dark Bruising: As the body systems slow down, blood may coagulate or pool, particularly at the base of the spine creating patches which look like dark purple bruising.
Smell: This is like a sweet and sour acetone odour caused by the body’s systems closing down. Be aware that this will happen, and that it may at first be unpleasant for you.
No longer responding: The person can no longer speak even when awake and will take rasping breaths through an open mouth. This can sound like loud snoring which may be very disconcerting to listen to. It also makes the mouth dry. You can help to ease this by gently wiping their mouth and lips with a damp cloth.
Breathing patterns change: The person can alternate between loud rasping breaths to quiet breathing. Towards the end, the dying will often breathe only periodically, with an intake of breath followed by no breath for several seconds, and then a further intake. This is known as Cheyne-Stokes breathing. It can be upsetting to witness as the person seems to have ceased breathing only to start again.
When death happens, it happens very quickly: There is no doubt about what is taking place. Sometimes the person will give several outward pants as their heart stops. Others may give a long out breath followed quite a few seconds later by what seems another intake of breath. This may be repeated a few times and can be alarming if you are not ready for it. However, this is only the lungs expelling air.
Other indicators are very clear:
- There will be no pulse
- Skin colour rapidly drains to a sallow yellow.
- Facial expression change or loosen. You may not feel you ‘recognise’ the person anymore. Some people look remarkably at peace.
- There is a sense of no-one ‘being home’.
What you may experience immediately after someone has died
In medical terms the dying process is a biological closing down of the body’s systems. It is difficult to know during this process when the person’s consciousness dies. However, the moment of death can be experienced in many ways. It can be an intensely spiritual encounter. Alternatively, it may feel rather prosaic. The essence of the person has gone, leaving behind a body that seems to be like an empty envelope.
You may feel grief. You may feel numb. You may feel relief. It may feel like an anti-climax – especially in a hospital or institution where nursing staff may be coming in and out to deal with necessary practicalities.
If it’s what you want, staff may also leave you alone for a while with the body – and that can be both reassuring and sometimes unexpectedly peaceful.
Sometimes, those present report less immediate physical experiences. For example, carers and relatives may talk of seeing vapours leaving or hovering over the body. Others have described loving light filling the room or a sudden change in room temperature. Or there may be a heaviness in the air which takes time to clear. Or there may be other strange phenomena.
Relatives and friends who were not present at the time of death may experience ‘seeing’ the dead person and/or sensing the dead person and knowing exact time of death before they are officially informed. These ‘visitations’ are usually comforting and reassuring, and never forgotten.
It’s not unusual to feel disconnected
It’s not unusual after someone has dies, especially when you were present at the time, to feel disconnected from people, places or things. It can feel as if you are in a dream or looking at life through frosted glass or walking around in a bubble. This can be especially difficult when you are thrown into the intensity of making funeral arrangements.
It can be hard to explain how you are feeling, especially to those who have never witnessed a death. However, feeling strange or disconnected from reality is understandable when we have watched someone conclude their journey. Life will never be the same again. It can’t be when we have witnessed something as profound as this.
You may feel you don’t know what to do with yourself. You can find yourself aimlessly wandering around, feeling lost and alone and deeply questioning everything in your life. For some people this can lead to feelings of release and freedom. For others, grief can be a very raw, protracted experience. We only really know what the death of someone means us as we go through our grieving process.
For anyone looking for support in how to talk to children about death and dying, I hope the Granny Mo series will be of help