People often ask when a person is approaching death, what will happen as death nears? The following seeks to explain the bodily and mental changes that may occur as a person approaches death, while at the same time maintaining a clear focus on the Christian's victory in Christ.
You are invited to listen along as you read by clicking this link: Forever in His Sight: What to Expect as a Person Approaches Death
The following is meant to be a guide to help you recognize the bodily and mental changes you may observe as a person nears death. This is not a checklist but a broad guide to assist in easing anxiety and to provide guidance.
It is important for you to remember throughout the dying process that although a Christian may be leaving your sight, Jesus says that he or she is forever in his sight. No matter how sick or debilitated the person may become, you can rest in this promise! The same Jesus, who said, “I am the way the truth and the life,” says, “I will never leave” this Christian or “forsake” him or her. There is only one way to the Celestial City, and the Christian is on that road because of saving faith in Jesus.
Jesus gained the victory over death so that every Christian can say with the Apostle Paul,
Where, O death, is your victory? Where, O death, is your sting? The sting of death is sin, and the power of sin is the law. But thanks be to God! He gives us the victory through our Lord Jesus Christ. (1 Corinthians 15:55-57)
Jesus already has secured the victory! Now the Christian must fight this final battle before he or she will realize the complete victory in Jesus.
Although Jesus is triumphant, this final engagement of life will still be difficult. We were not created to die. We were created to live on in eternal bliss with our bodies and souls forever. Death is the result of our sin, and at the time of death the soul is unnaturally ripped apart from the body. Death is always the culmination of sin and misery, for the “wages of sin is death,” and that is why the dying process is characterized by pain, discomfort, misery, and suffering.
The dying process can be divided roughly into four time periods: (1) months to two weeks, (2) two weeks to one week, (3) six days to one hour, and (4) minutes. In each time period, there are identifiable signs and symptoms that are observable as a person nears death. Please remember, however, that not all signs and symptoms will be present at each state.
Months to Two Weeks before Death
During this time a person may desire to isolate himself or herself. An individual may talk less, ignore those around him or her, and lose interest in favorite activities. Weariness, fatigue, exhaustion, and a feeling of heaviness follows. Naps are more frequent, and a person may desire to stay in bed most, if not all, of the day. It is important that you continue to stay with the person, even though it seems like he or she does not acknowledge your presence. Holding hands, light massage, and touching are effective ways to communicate during this time.
You also will notice a decrease in appetite. Food provides nutrients and energy for the body. The dying person is winding down, so eating will decrease and eventually will stop. The body no longer requires food to sustain itself because it is dying. So do not be alarmed when a person stops eating.
It is important that you do not force-feed the person, as you may cause food or fluid to go into the lungs. This is the time to offer favorite foods for pleasure, not nutritional value. If the person wants to, he or she will eat it. Let the dying person decide how much and what to eat.
Two Weeks to One Week before Death
During this time period, significant changes will occur. The person will be in bed and asleep most of the time. He or she may be aroused but will return to sleep almost immediately. The person may be restless, have twitching, talk to unseen people, awake and stare off, grab at unseen objects, and attempt to remove blankets and clothing. These changes are most likely due to the body’s inability to remove toxins because the organs are shutting down.
You may notice increased sweating, but the body may be cold or hot to touch. The skin may change color. If a person is feverish, he or she may appear red. The person also may appear bluish, pale, grayish, or discolored. These changes are due to a decrease in blood flow and hormonal abnormalities.
Breathing changes may occur. The person may take short, rapid breaths or stop breathing momentarily and then resume breathing again. You may notice an increase in mouth breathing and a rattling sound. The rattling is due to uncleared secretions in the lower airway and back of the throat. Breathing difficulties are caused by a number of factors, but the main problem is respiratory congestion.
Morphine is the most effective medication to relieve suffering from respiratory congestion. The morphine is used to help the person breath more easily and more deeply. It is not used to hasten death.
Now is not the time to focus on the person’s blood pressure and pulse. It is not necessary to take a temperature either. If a person appears rosy and is sweating, he or she probably has a fever. Giving a Tylenol suppository for a suspected fever will lessen symptoms and will provide comfort.
It will be necessary to count a person’s respirations, however, because this is one of the ways the dosage of morphine is adjusted. The normal respiratory range is twelve to twenty breaths per minute, above twenty indicates respiratory discomfort.
It is also important to monitor the person for moaning, facial grimacing, and agitation, as this may indicate pain. Just because a person is sleeping or does not verbalize pain does not mean that he or she is not experiencing pain. Morphine is effective in controlling pain as well air hunger.
Six Days to One Hour before Death
As a person nears death, a sudden surge of energy may occur. He or she may be alert and appear to be doing better. The person may ask to eat a favorite meal during this time and desire company. Enjoy this grace, but please do not get your hopes up. This is a common phenomenon that indicates the end is near. This surge of energy will usually leave as quickly as it arrived, and the person will resume the one-to-two-week signs with a heightened level of intensity.
Minutes before Death
Eventually the person will slip into a coma and become totally unresponsive. Increased restlessness may be observed, and breathing may become more irregular, more shallow, and slower. Respiratory congestion may become very loud. The eyes may appear cloudy, glassy, and fixed. The hands and feet may become purplish, cold or warm, and the body sweaty, ashen, and waxy. Finally, death arrives, and the final battle is over.
The Christian will open his or her eyes and see the victor, Jesus, in all his glory sitting on his throne! Jesus will be absolutely radiant, and he will welcome the Christian to heaven. He will say, “Well done, good and faithful servant; now enter into your rest,” and with a tender hand he will wipe away every tear of suffering, pain, and misery. The physical body of the Christian will be left behind to decompose. But one day, Jesus will return and miraculously resurrect the decayed body, make it a glorified body, and reunite it to his or her glorified soul. Then the Christian will live on in the Celestial City with recreated body and soul forever in his sight.
This is meant to be a guide to help with the recognition of physical and mental changes that may occur as a person approaches death. These changes are not definitive, and this is not meant to be a comprehensive guide. It is intended to help you understand what is happening to the person who is dying and to alleviate stress.
It is also important that you do not become preoccupied in looking for these changes. These are the final days of the dying person’s life, so cherish your final days and hours together, and do not cease to meditate on the sure hope of eternal life with Christ.
