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Caring for a dying friend or family member can be a deeply emotional and overwhelming experience, but there are ways you can offer them support when it's most needed.

Terminally ill patients may display a host of new symptoms in their final moments - and while this may be distressing for loved ones to witness, it's important to know how to respond to sudden changes to reduce the discomfort felt by dying patients. Usually, a dying patient will spend their last moments in a hospital or palliative care setting, where there will be assistance from healthcare staff to respond to their needs - but it's important for loved ones to recognise signs that death may be near. 

Here is a list of 11 signs to spot, and what to do if you feel a dying person is experiencing the symptom, as advised by medical experts.

1. A decreased appetite

Often during end-of-life care, a patient will be much less active than usual, meaning their body will need less energy. You may notice them stop eating or drinking as their appetite naturally decreases. In some cases, a person may completely stop eating before they die. Keeping their lips moistened with Vaseline or lip balm can help ease feelings of discomfort

2. Sleeping more

You may notice a person spends less time awake in the lead up to their death. If you're caring for a dying loved one, it is advised to help them feel comfortable and allow them to sleep, changing their position in bed every 1–2 hours. Hearing is often the last sense that a person loses before they die, so speaking to them in a calm and quiet voice can provide reassurance.

 3. A change in toilet habits

Bowel habits are often a strong indicator of your digestive health, but for dying patients, toilet habits can change entirely. If a dying person is eating and drinking less, their may be a reduction in bowel movements. They may pass solid waste and urinate less often. Patients who lose control of urination are often given a catheter to help - a tube inserted into your bladder, which allows your urine to drain freely. Changes in toilet habits are usually expected in patients nearing the end of their lives. 

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4. Weakening muscles

Weakened muscles can occur in the days leading up to someone's death. It means the patient may not be able to carry out the usual tasks they were able to do previously. Simple movements, such as drinking from a cup or turning over in bed, may no longer be possible. Loved ones should help them carry out these tasks if they are experiencing difficulties. 

5. Changing vital signs

End-of-life patients may see their vital signs change in the following ways:

  • blood pressure drops
  • breathing changes
  • heartbeat becomes fast, faint, or irregular
  • a pulse may be hard to detect

6. Dropping body temperature

In the days before death, blood circulation reduces so that the body can focus on its internal organs. This means very little blood will flows to the hands, feet, or legs, causing the skin to become cold. A dying patient's skin may be cold to the touch, or look pale or mottled with blue and purple patches. The patient may not feel cold themselves, but offering a blanket may help if a relative or friend thinks they need one.

7. Changing breathing

A person who is dying may display noticeable changes in their breathing, which can be distressing to watch. A patient might display a sudden change of speed in their breathing, as well as grunting, gurgling, or rattling noises when breathing. If you notice this, you should try not to worry. It is advised to try to find a position that makes breathing easier for the patient. This may be on their back, side or sitting up. Speaking to a doctor is recommended if someone is concerned about this change in breathing pattern.

 8. Increasing pain

It may be difficult to watch a dying loved-one experience pain near death, as treatment usually cannot manage a person’s pain levels during this time. Seeing a pained expression, or hearing a noise that might indicate someone is in pain, is never easy.

9. Becoming less social

When energy levels reduce, a dying patient may not be able to spend as much time with loved-ones. If a dying person begins to withdraw from social situations, their loved ones should try not to worry or be offended. It is advised to arrange visits when the patient is in the mood to see someone.

10. Experiencing confusion

A dying patient may become confused or incoherent at times. Friends and family are advised to keep talking to a dying person, by explaining what is happening around them and introducing each visitor.

11. Hallucinations

Hallucinations or distorted visions is not an uncommon thing for dying patients to experience. While it may seem concerning, the best thing to do is help to remind the person of the time of the day, what is happening, and who is with them. To avoid startling the patient, use calm and confident tones to communicate. 

Story by Zahra Khaliq: Mirror

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