Signs and symptoms of dying
Each person brings to dying his/her own uniqueness. Each death, like each person, is different. However, people who are in the dying process do share some common signs and symptoms.
Your loved one may seem unresponsive, withdrawn, or in a comatose-like state. This indicates preparation for release, a detaching from surroundings and relationships, and a beginning of "letting go." Because hearing may remain all the way to the end, speak to your loved one in your normal tone of voice, hold his/her hand, and say whatever you need to say that will help the person "let go."
- Vision-like Experiences
Your loved one may relate perceptions which are not detectable to you. This should not necessarily be thought of as hallucinatory activity. Do not contradict, explain away, belittle or argue about what your loved one claims to have seen or heard; these are real experiences to your loved one. Affirm his or her experiences. They are normal and common. If they frighten your loved one, explain to him/her that they are normal.
Your loved one may perform repetitive and restless behaviors. While this restlessness may be related to his/her physical condition, it can also indicate that something is still unresolved or unfinished that is disturbing him/her, and preventing him/her from letting go. Hospice team members can assist you in identifying what may be happening and help you find ways to help the person find release from the tension or fear. Other things which may be helpful in calming the person are to recall a favorite place or experience the person enjoyed, read something comforting, and/or to play music.
- Fluid and Food Decrease
When your loved wants little or no fluid or food, this may indicate that the person is ready for the final shut down. Do not force food or fluid. You help your loved one by giving him/her permission to let go whenever he/she is ready. At the same time affirm your loved one's ongoing value to you and the good you will carry forward into your life that you received from him/her.
- Decreased Socialization
Your loved one may only want to be with a very few or even just one person. As your loved one's perceptions are changing, he/she may also indicate a desire for the presence of different support persons. Such a shift in preferences does not mean you are any less loved or important. It may mean you have already fulfilled your task with him/her. If you are requested to be of support in the final stages, your loved one needs your affirmation, support and permission.
- Unusual Communication
Your loved one may make a seemingly "out of character" statement, gesture, or request. This may result from changes in the brain due to his/her illness. It can also indicate that he/she is ready to say good-bye and is checking to see if you are ready to let him/her go. Accept the moment as a beautiful gift when it is offered. Kiss, hug, hold, cry, and say whatever you most need to say.
- Providing for Spiritual Desires
If your loved one has previously discussed a desire for specific spiritual support near the time of physical death, be prepared to honor such wishes in order to provide invaluable comfort. Such practices may include having a spiritual symbol close at hand, reading some significant text or prayer, and/or having a chosen spiritual support person visit.
- Giving Permission
Giving permission to your loved one to "let go" without making him/her feel guilty for leaving or trying to keep him/her with you to meet your own needs can be difficult. A dying person will normally try to hold on, even though it brings prolonged discomfort, in order to be sure that those who are going to be left behind will be all right. Therefore, your ability to release the dying person from this concern and give him/her assurance that is all right to let go whenever he/she is ready is one of the greatest gifts you have to give your loved one at this time.
- Saying Good-Bye
Saying good-bye is your final gift of love to your loved one, for it achieves closure and makes the final release possible. Tears are a normal and natural part of saying good-bye and do not need to be hidden. They express your love and help you to let go. It may be helpful to lie in bed with your loved one and hold him/her, or to take his/her hand and say everything you need to say. You final words may include "I love you" "Please forgive me," "I forgive you," and "Thank you for...."