10 Signs Death is Near - what to expect & how to respond to the natural dying process
No one can predict the moment of death. But physicians and nurses involved in end-of-life care know that certain symptoms are usually associated with the body's shutting down. These signs of approaching death are specific to the natural dying process (apart from the effects of particular illnesses the person may have).
Not all dying symptoms show up in every person, but most people experience some combination of the following in the final days or hours:
1. Loss of appetite
Energy needs decline. The person may begin to resist or refuse meals and liquids, or accept only small amounts of bland foods (such as hot cereals). Meat, which is hard to digest, may be refused first. Even favorite foods hold little appeal.
Near the very end of life, the dying person may be physically unable to swallow.
How to respond: Don't force-feed; follow the person's cues even though you may be distressed by a loss of interest in eating. Periodically offer ice chips, a popsicle, or sips of water. Use a moistened warm cloth around the mouth and apply balm to the lips to keep them moist and comfortable.
2. Excessive fatigue and sleep
The person may begin to sleep the majority of the day and night as metabolism slows and the decline in food and water contribute to dehydration. He or she becomes difficult to rouse from sleep. The fatigue is so pronounced that awareness of immediate surroundings begins to drift.
How to respond: Permit sleep. Avoid jostling the person awake. Assume that everything you say can be heard, as the sense of hearing is thought to persist, even when the person is unconscious, in a coma, or otherwise not responsive.
3. Increased physical weakness
A decline in food intake and lack of energy leads to less energy, even for activities like lifting one's head or shifting in bed. The person may even have difficulty sipping from a straw.
How to respond: Focus on keeping the person comfortable.
4. Mental confusion or disorientation
Organs begin to fail, including the brain. Higher-order consciousness tends to change. "Few conditions leave people hyperaware when they're dying," says palliative-care physician Ira Byock, author of Dying Well.
The person may not be aware of where he or she is or who else is in the room, may speak or reply less often, may respond to people who can't be seen in the room by others (see Passing Away: What to Expect When Witnessing a Loved One's Death), may seem to say nonsensical things, may be confused about time, or may act restless and pick at bed linens.
How to respond: Remain calm and reassuring. Speak to the person softly, and identify yourself when you approach.
5. Labored breathing
Breath intakes and exhales become raggedy, irregular, and labored. A distinctive pattern called Cheyne-Stokes respiration might be heard: a loud, deep inhalation is followed by a pause of not breathing (apnea) for between five seconds to as long as a full minute, before a loud, deep breath resumes and again slowly peters out.
Sometimes excessive secretions create loud, gurling inhalations and exhalations that some people call a "death rattle."
How to respond: The stopped breathing or loud rattle can be alarming to listeners, but the dying person is unaware of this changed breathing; focus on overall comfort. Positions that may help: the head slightly elevated with a pillow, sitting up well-supported, or the head or lying body tilted to the side slightly. Moisten the mouth with a wet cloth and moisturize with lip balm or petroleum jelly.
If there's a lot of phlegm, allow it to drain naturally from the mouth, since suctioning it out can increase its quantity. A vaporizer in the room might help. Some people are given oxygen for comfort. Be a calm, physical presence, stroking the arm or speaking softly.
6. Social withdrawal As the body shuts down, the dying person may gradually lose interest in those nearby. He or she may stop talking or mutter unintelligibly, stop responding to questions, or simply turn away.
A few days before receding socially for the last time, the dying person sometimes surprises loved ones with an unexpected burst of alert, attentive behavior. This can last less than an hour or up to a full day.
How to respond: Be aware that this is a natural part of the dying process and not a reflection of your relationship. Maintain a physical presence by touching the dying person and continuing to talk, if it feels appropriate, without demanding anything back. Treasure an alert interlude if and when it occurs, because it's almost always fleeting.
7. Changes in urination
Little going in (as the person loses interest in food and drink) means little coming out. Dropping blood pressure, part of the dying process (and therefore not treated at this point, in tandem with other symptoms), also contributes to the kidneys shutting down. The concentrated urine is brownish, reddish, or tea-colored.
Loss of bladder and bowel control may happen late in the dying process.
How to respond: Hospice medical staff sometimes decides that a catheter is necessary, although not in the final hours of life. Kidney failure can increase blood toxins and contribute to a peaceful coma before death. Add a bed pad when placing fresh sheets.
8. Swelling in the feet and ankles
As the kidneys are less able to process bodily fluids, they can accumulate and get deposited in areas of the body away from the heart, in the feet and ankles especially. These places, and sometimes also the hands, face, or feet, take on a swollen, puffy appearance.
How to respond: Usually no special treatment (such as diuretics) is given when the swelling seems directly related to the dying process. (The swelling is the result of the natural death process, not its cause.)
9. Coolness in the tips of the fingers and toes
In the hours or minutes before death, blood circulation draws back from the periphery of the body to help the vital organs. As this happens, the extremities (hands, feet, fingers, toes) become notably cooler. Nail beds may also look more pale, or bluish.
How to respond: A warm blanket can keep the person comfortable, or he or she may be oblivious. The person may complain about the weight of coverings on the legs, so keep them loose.
10. Mottled veins
Skin that had been uniformly pale or ashen develops a distinctive pattern of purplish/reddish/bluish mottling as one of the later signs of death approaching. This is the result of reduced blood circulation. It may be seen first on the soles of the feet.
How to respond: No special steps need to be taken.
Note: These general signs of impending death can vary in sequence and combination from person to person. If a person is on life support (respirator, feeding tube), the process dying follows can be different. The signs of death listed here describe a natural dying process.
Prepping For Death, by J.D.A.
By James Wesley, Rawles on November 3, 2011 4:55 PM
Preparing for death is probably not the usual topic discussed on this board, but a recent illness in my family has put this issue squarely in my face. It is my hope that all reading this blog will live many more years and will leave this earth either via the Rapture or natural causes at a ripe old age.
That being said, death is something we have to consider in our plans. I approach this topic from two angles: 1) losing a loved one in a non-Schumer situation, 2) losing a loved one in a Schumeresque situation. I hope to cover the spiritual, emotional and financial aspects of both scenarios.
The situation: My mother-in-law has been diagnosed with a terminal brain tumor for which there isn’t a cure. Just like a bolt from the blue, this tumor has taken everyone by surprise. Part of the frustration about this, is that my mother-in-law is in her early sixties and in overall good health. Her family genetics suggested she would live well into her eighties.
The docs call this thing the Terminator of brain tumors. It kills plain and simple and there isn’t a Sara Connor to take this thing out. Our family is taking this pretty hard as one would expect.
Now what does this have to do with prepping you might ask?
Hopefully we have been following the advice and recommendations we read on this blog about storing up food, water, ammo, etc. Most on this blog are prepared to ride out a Schumer type situation ranging anywhere from one week to a year or longer.
But are we prepared for the ultimate “bug out” situation? Death. The stark reality of this situation is that we will get one chance to be ready for it. Unlike prepping for disasters, the choice you make regarding the issue of death, and ultimately, of Heaven and Hell is final. There are no do-overs. No second chances.
1) Non-Schumer Scenario
Spiritual Aspects of Death
It is my prayer that all who read this blog have accepted, or will accept, Jesus Christ as their Savior. The Hope and Promise of Christianity is that we are made a part of God’s family. I believe the Bible clearly teaches there is a Heaven and a Hell. The Bible also clearly teaches the only way one can be assured of an eternity in Heaven is accepting Jesus Christ as Lord and Savior. In John 14:6 the Bible records Jesus as saying: “I am the way, and the truth, and the life; no one comes to the Father but through Me.” (NASB)
To me that is about as clear as it gets. There is only one way to Heaven. I want to go on public record as saying Christ saved me when I was eleven years old. Since then, I’ve tried to live my life the best I can according to His principles; though I must admit I fail Him every day. The beauty of Christianity though, is that I don’t have to be “good enough” to get into Heaven. Christ has already paid for my sins and there is nothing I can do to earn my way into Heaven. Ephesians 2:6-8 tells us:
“For by grace you have been saved through faith; and that not of yourselves, it is the gift of God; not as a result of works, so that no one may boast.” (NASB)
The decision one makes about Jesus Christ determines which destination you will spend eternity: Heaven or Hell.
One of the benefits of Christianity is that we will have an eternity to spend with Him and our departed family members. I once heard a pastor (Dr. Johnny Hunt) make the following statement regarding part of the Hope that is found in Christianity: “For those who are Christians, we can take comfort in knowing that when our loved ones go home to be with the Lord, we will be with them longer than we will be without them.”
That’s a profound, but very true statement when you think about it. It is also a comforting statement that will help with the emotional issues we face during death. But what about the loved ones who have been left behind? There will be emotional and financial issues to deal with that will place stress on the surviving loved ones.
In dealing with the spiritual aspects of death, my wife and I have found that it has been best to be as up front with the children as possible. They are Christians, but are still young and have a lot of questions. Why do people have to die? Why isn’t God healing my relative? Am I going to get a tumor and die? Where is Heaven?
Like me, you probably won’t have all of the answers to their questions so I recommend we bone up on what the Bible has to say about these issues. Now is a good time to start thinking these through. Ask with faith in prayer and God will give you the answers as noted in the Book of James 1: 2-8.
Be supportive of your spouse. Understandably they will not be thinking rationally and will be focused on their dying loved one. This is where the ‘for better or worse’ part of the marriage vows comes into play. You must be prepared to pick up the slack around the house. For guys this means you may have to help get the kids ready for school, get breakfast going, laundry, cleaning, etc. Make it as easy as possible for your spouse remembering that you will be going through this with your parents one day. Recognize your own stress level and keep a cool head. The children will be watching you. It’s ok to let them see your emotions, but you can’t act hysterical. You are the glue for the family at this point.
If your relatives are out of town it is recommended to keep a bag packed and your vehicle ready to go at a moment’s notice. Like a Schumer event, you don’t know when ‘The Call’ will come and you will want to leave as soon as possible. It would be a bummer to have your ride in the shop when you need it. There are a lot of issues you need to consider before a loved one dies. These are not fun topics to think about, but if you haven’t planned for them they come at you fast and furious. These are not decisions to make when your emotions are bouncing all over the place.
Have you discussed end-of-life care? Is there a living will in place? Have you discussed what ‘heroic measures’ the doctors should take…or not take? Do you know what the wishes are for the funeral service? Where will the burial be? Are all immediate family members, i.e., brothers, sisters, etc, in agreement on these questions?
In an unusual bit of prepping, my folks have created what they call the Death Folder. In it are all of the vital papers, copies of powers of attorney, last wishes, etc. It is a great idea in that it relieves you of the majority of decisions you have to make in these circumstances. If you have one of these, be familiar with it. I highly recommend you put one together if you don’t have one. Consider it part of your “bug out” bag.
If you are the primary bread winner in the house you need to review your life insurance. Is there enough to cover your mortgage, pay off your debts, provide for college for the children, enable your surviving loved ones to maintain their prepping plans, etc? Talk to an insurance professional as to whether you need term or whole life.
You also need to consider how your life would change if your spouse were to die before you. Depending on the age of your children there may be extra costs for day-care.
If you aren’t a believer in life insurance, be sure you have some form of assets your loved ones will have access to in either scenario. You don’t want to leave them in a financial bind.
Following Dave Ramsey’s advice, I’ve elected to go with term life to cover these needs. Term life is very affordable right now. I work in the insurance industry and I’ve seen cases where the surviving family did not have insurance and the financial constraints in which they were left when the breadwinner died. I‘ve also seen the other side where a family received the proceeds from the life insurance policy which relieved their financial concerns. (Disclaimer: I do not work with Dave Ramsey or any of his affiliates. I am not a licensed agent so I cannot sell you anything. I am not disclosing the company I work for as I do not want my company to be mistaken as endorsing, or not endorsing, any content associated with this blog.)
2) Death in a Schumeresque Times
Losing a loved one when circumstances are normal will place an incredible strain on the family. But what happens if you lose a loved one in a Schumer event?
You will still have to contend with the emotional and spiritual aspects of death. Most likely, you won’t have to worry about the financial concerns. But death in a Schumer event presents additional things to consider.
Impact on Plans
Undoubtedly, you have made your prep plans with the roles your spouse and other loved ones would assume. Hopefully you each have learned one or more skills you will need in these situations. The basic survival skills such as building a fire, shelter, water purification should be known by everyone. But what about the specialty skills? Let’s face it, we can’t be masters of all topics.
Maybe somebody is very adept at medical procedures. One may be proficient at animal husbandry. Have you learned to can food or field dress an animal? What about security? If you are trying to provide security with rotating shifts there will be one less person available.
The loss of a family member with one or more of these skills could seriously impair your prep plans; especially if it is just your immediate family.
There is one other aspect of this that may come off as cold and unfeeling, but it is a reality we have to contend with. When a loved one passes away under any circumstances we want to have a proper burial and pay our respects. We will want time to mourn for our loved one. But time to mourn may not be available right away due to circumstances. There may be time for only a few words or moments of reflection.
Then there is the responsibility of properly burying our loved one. This should be done respectfully and quickly with an eye towards both physical and mental health management. The World Health Organization offers some good advice on how to properly handle these situations.
Methods to minimize infection when handling a deceased body include:
Use gloves if available
Wrap the body in a plastic sheet or bed sheet if available
Wash hand with soap and water after handling bodies
Avoid touching your face or mouth with your hands
Time and temperature are other considerations to contend with. The hotter the climate the faster a body will decompose. In hot climates, the body will decompose to the point where facial recognition is not possible within 48 hours. In colder climates this process will be slower.
A proper grave should be prepared. There is no official depth for a grave but typically one dug about six feet deep will be sufficient.
The location of the grave relative to your home is important as you want to have this located a minimum of 200 meters away from water sources and areas where crops are planted. It is recommended that the bottom of the grave should be at least two meters above the groundwater table.
There should be a formal service for the departed loved one if circumstances permit. This will help provide closure for family and/or friends.
If you are in a bug out situation, depending on OPSEC, you may want to mark the grave for posterity and as a means for later visitation.
A whole new set of emotions will have to be dealt with in this scenario. To say you are in a stressful situation already is an understatement. This will only add to it. The time you have to grieve will vary depending if you are bugging in or out. It may be hard for the children to understand why you have to keep moving and you can’t visit mom or dad’s grave. You may not have time right away to answer all of their questions, but you need to promise them you will.
The final message to convey in this article is that even in spite of death, life will continue for those left behind. We can honor the life of our departed loved ones by living that life as they would have wanted us to.
I am sure there are other aspects of this topic I have not considered and I welcome any input from my fellow Preppers. If nothing else, I hope these words get us to think about this very real situation.
In summary, a Schumer situation is something we may or may not have to face. But Death, unfortunately, is something we will all have to deal with. As with all things, it’s best to be prepared.
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