Final Days & Hours Before Death of a Hospice Patient

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Last Updated on September 26, 2021 by Frank Davis

When a person is in the final hours of his or her life, there are signs and symptoms that may be able to tell us when they are dying. Being aware of what to expect can help family, friends, and caregivers prepare for the death of the hospice patient and make the experience less stressful. Hospice providers usually provide their families with educational materials and information about what to expect before their loved one dies, and how they can offer comfort. 

A family can say farewell to their loved one if they know when that person is in their final hours. For close relatives and friends, knowing when death is approaching is crucial, as missing the chance to say goodbye to the patient can be devastating.

The purpose of this article is to provide information on the hours leading up to death.

Physical Changes

During death’s final hours, changes in the body occur. It is not always the case that patients undergo these changes. Because of this, it is hard to predict death in advance.

Generally, the following are a few physical signs:

• Weakness or fatigue may occur
• The urine may have a dark color and may be less frequent
• A blotchy, cold, or blue complexion may develop on the hands and feet
• There may be an irregular heart rate and it can go up or down
• In general, blood pressure usually decreases
• An irregular breathing pattern, shallow breathing or short periods of not breathing is typical, as is rapid, deep breathing

Patients may refuse to eat or drink

In the final days and hours before the hospice patient passes away they often lose the desire to eat and drink. They are not starving or dehydrating, but rather its a normal process of dying. The hospice patients digestive system is closing and it’s not that they refuse to eat or drink, but that they can not.

Family members may be worried and stressed when they see that their loved one is not eating or drinking. As foods and liquids are seen as a sign of good health or living, family members may try to force their loved to eat and drink. This is not advisable because when the digestive system is shutting down forcing foods and liquids may cause further complications.

Some of the symptoms from overeating and overdrinking are:

• Choking
• Bloating
• Nausea
• Edema
• Vomiting
• Aspiration.

Patient may withdraw

Patients at the end of their lives tend to withdraw from family and friends.  A desire to detach from the world could be an indication of a desire to release and let go. 

While interacting with hospice patients, you may encounter:

• Confusion
• Lack of responsiveness
• Not being able to answer questions
• Inattention to the world around them

The patient may require fewer calories during this period when the digestive system is shutting down. It could therefore result in the body conserving energy and the patient sleeping more. It is possible that at this time the hospice patient will sleep more than he or she is awake. 

Care of the Patient

 While hospice provides medical care, the primary caregiver provides non-medical care. Nevertheless, family members and friends can play a role in helping their loved ones in their final hours.

 Below we have listed a few ways that you may be able to help with their care:

• You should not force patients to consume liquids or food to prevent complications
• Keeping lips and mouth moist with ice chips or swabs
• A raised head of bed may help ease dyspnea
• A fan can help relieve breathlessness
• Protect patients from self-injury or accidents when they are restless or agitated with safety measures
• People who are dying often have hallucinations that are visual or auditory. It is not unusual for deceased family members to appear. Recognizing them and supporting them would be ideal. Do not argue with the patient as this can cause unwanted disputes and stress.
• In studies, patients have been shown to hear even while unconscious. Even if the patient does not respond, family members and friends can still talk and touch the patient to provide comfort

Conclusion

Each hospice patient shows a different set of symptoms, making the final days and hours difficult to predict. A hospice patient’s inability to eat and drink, withdrawal, antisocial behavior, and physical changes indicate they may be near their end. Each step of the process is explained and notified to family and friends by hospice care providers. Additionally, family members can assist in patient care and make them more comfortable by taking certain steps. 

If you have questions regarding hospice services in the last days or hours of a patient’s life, please give Hospice Valley a call at (747) 755-5181. It is important to us to answer any and all queries you may have, so we look forward to hearing from you.