Customer question:
What are the physical signs of a dying person, or what are the last signs of dying? Anonymous customer
Answer pharmacist:
Many fatal diseases can cause the following symptoms: pain, difficulty breathing, digestive problems, skin damage, and fatigue. Depression, anxiety, confusion, delirium, unconsciousness, and disability may occur.
Pains
Most people fear pain when faced with dying. However, pain can usually be managed by keeping the patient awake, involved in the environment, and comfortable.
Radiation can manage some types of cancer pain. Physiotherapy or analgesics, e.g. paracetamol and acetylsalicylic acid are used to manage mild pain. Some people find adequate pain relief with hypnosis or biofeedback, methods that also have no known side effects. Often, however, narcotics are needed, e.g., codeine and morphine. Ingested narcotics can effectively relieve pain for long hours, but more potent narcotics can be given by injection. Drug addiction should not be a concern in such circumstances, and appropriate medications should be started early, not until the pain becomes unbearable. There is no usual dose for these drugs: some patients need a little, others much more.
Difficult breathing
Fighting for every breath is undoubtedly a wrong way to live and die, all the more so because it is preventable. Breathing can be facilitated in various ways - e.g., relieving fluid accumulation, changing the patient's position, providing supplemental oxygen, or shrinking a tumor that is narrowing the airways with radiation or corticosteroids.
Video content: 5 symptoms at the end of life.
Narcotics sometimes help patients who are constantly breathing a little more complicated, even if they are not in pain. Taking narcotics at bedtime can ensure good sleep because it prevents the patient from frequently waking up gasping for air.
If these methods are not effective, most hospice physicians agree that such a patient should be given a narcotic in a dose large enough to eliminate labored breathing, even if the patient loses consciousness as a result. A patient who wants to avoid difficult breathing at the end of life must agree that the doctor will treat his symptoms thoroughly, even though such treatment may cause unconsciousness or slightly hasten death.
Digestive problems
These problems, including dry mouth, nausea, constipation, bowel obstruction, and loss of appetite, are common in very ill people. Some are caused by diseases, and others, such as constipation, are side effects of medications.
Dry mouth can be remedied with moist mouth pads or hard candies. Various products can be purchased to soothe chapped lips. To prevent dental problems, a person should brush their teeth or use oral sponges to clean their teeth, mouth, and tongue. Mouthwashes that contain little or no alcohol should be used because alcohol-based products can dry out the mucous membrane very much.
Nausea and vomiting can occur due to medication, intestinal obstruction, or advanced disease. Your doctor may need to change medications or prescribe an antiemetic (anti-nausea medicine). Nausea from bowel obstruction can also be treated with antiemetics; other relief measures can be used.
Constipation (constipation) is very annoying. Poor food intake, lack of physical activity, and certain medications can cause a lazy bowel. Abdominal cramps may occur. Stool softeners, laxatives, and enemas may be necessary to relieve constipation, mainly if narcotics cause it. The elimination of constipation is usually a great relief, even in the late stages of the disease.
Intestinal obstruction may require surgery. Sometimes, however, it is more appropriate to use drugs that paralyze the intestines, perhaps together with nasogastric suction, which keeps the stomach empty; the choice depends on the patient's general condition, the time he is expected to have left, and the cause of the arrest. Narcotics are helpful for pain relief.
Loss of running eventually occurs in most dying patients. The reduction in running is natural, does not cause additional physical problems, and probably plays a role in an easy death, although it can cause distress to the patient and his loved ones. The patient will not keep his strength if he forces himself to eat, but he may be able to enjoy his favorite home-cooked meals in small quantities.
If death is not expected within a few hours or days, food and fluids may be tried for a period of time—intravenously or through a tube inserted through the nose into the stomach for a few days—to see if better nutrition improves the patient's well-being, mental acuity, or energy. The patient and the family must explicitly agree with the doctor on the goal of these measures and when they should be abandoned if they do not help.
Less consumption of food and drink does not cause suffering. In fact, with heart failure and kidney failure, regular drinking often causes shortness of breath because fluid builds up in the lungs. Reduced eating and drinking can reduce the need for suction because there is less fluid in the throat, and it can relieve pain due to less pressure on the tumors. They may even contribute to a more abundant release of the body's natural painkillers (endorphins). Therefore, patients should not be forced to eat or drink, especially if this would require coercion, intravenous infusions, or hospital admission.
Skin defects
Dying patients are susceptible to skin lesions that cause discomfort. Those most at risk are those who move very little, are confined to bed, or mostly sit. Even the simple pressure of the skin while sitting or moving on the sheets can break or damage the skin. Every effort should be made to protect the skin. If the skin breaks or a wound appears, this should be reported to the doctor immediately.
Fatigue
Most fatal diseases cause fatigue. The dying person may try to save energy for essential activities. Frequent visits to the doctor or continuing an exercise that is no longer beneficial are not essential, especially if they exhaust the patient and take away his energy for an activity that would give him more satisfaction.
Depression and anxiety
Sadness when thinking about the end of life is natural, but it is sadness, not depression. A person who is depressed shows no interest in what is happening, sees only the unpleasant side of life, or does not experience any emotions. H Dying people and their relatives should discuss this mood with a doctor so that depression can be recognized and treated. Treatment - usually consisting of medication and counseling - is often effective, even in the last weeks of life, and improves the quality of the remaining time.
Anxiety is more than ordinary worry. It is a feeling of worry and apprehension so intense that it interferes with daily activities.* Feelings of ignorance or helplessness can cause anxiety; in this case, it can be facilitated if caregivers offer more information or help. Anxiety during death is more likely in people who are otherwise prone to feeling anxious during periods of stress in life. Ways that have helped such a person in the past - e.g., conversation, medication, or redirecting one's worries into creative pursuits - will probably help him even while dying. A dying person suffering from anxiety should seek help from a professional counselor; he may need anxiolytic drugs.
Confusion, delirium, and unconsciousness
Very ill patients can quickly become confused. Confusion can be triggered by medication, a mild infection, or even a change in living environment. Reassurance and reorientation of the patient may alleviate confusion, but the physician should be notified to look for treatable causes. A confused patient should be lightly sedated, and a caregiver should always be present.
A dying person who is delirious or mentally deranged will not understand dying. When death is near, a hysterical person can sometimes experience surprising periods of lucidity. These can be very important to relatives but can be misinterpreted as an improvement. The family must be prepared for such periods but should not expect them.
Almost half of the dying have been unconscious for the last few days. If the relatives believe that the unconscious dying person can still hear them, they can say goodbye to him as if they did. For a man to pass out in unconsciousness is a peaceful way to die, significantly if he and his own have calmed down and all the plans have been made.
Disability
Fatal diseases are often accompanied by progressive disability. The affected person is gradually unable to take care of the house or apartment, prepare food, take care of material affairs, walk, and take care of himself. Most of those dying in the last weeks need help. Such a disability should be expected and, if possible, prepared for, e.g., by choosing an apartment accessible by wheelchair and close to relatives caring for the patient.
Help, e.g., occupational therapy, physiotherapy, and home nursing, can help a person stay home even as the disability progresses. Some people choose to stay at home even though they know it is not safe; they prefer an early death to a stay in an institution.
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