Many people wonder what agony is and how it manifests. Some symptoms, such as pain and shortness of breath, terrorize patients, while others, such as noisy wheezing, greatly upset the patient’s immediate environment.
Palliative care specialists explain that all of these symptoms are common in the dying agony phase and that they can still be controlled to prevent unnecessary suffering.
Agony of the terminal stage of the disease is a very short temporary phase that occurs in the last days of life before biological death. It is very easy to detect it clinically, because at this final stage pronounced symptoms appear.
What is agony?
This process can take several minutes or months, depending on what happens inside the person’s body. The cessation of the physical, sensory and mental functions of the body is associated with what agony is.
When you are near a person who is in close proximity to death, you must know exactly its physical signs in order to understand what is happening.
Death agony lasts two or three days, but, in exceptional cases, can last up to five days.
The most dangerous symptoms before death: pain and shortness of breath.
Before death, the patient progressively worsens the state of consciousness, although some remain clear until the very end. Shortness of breath, pain, refusal to eat and drink, psychological disorders.
How to help a loved one
Derivatives of morphine, an opioid drug, exist to ease pain, but the use of these drugs should not be confused with euthanasia.
Sedation and euthanasia are not synonymous. The medicine is prescribed in doses sufficient to stop the pain, but not in order to accelerate death.
If the patient is at home under supervision or directly in the hospice, morphine can be administered to relieve any pain. The same will be ensured if death occurs in a hospital or other medical facility.
Cognitive disorder and loss of consciousness before death is a defense mechanism against agony, and it does not need treatment.
The goal of palliative therapy is to avoid unnecessary suffering, to fight symptoms using the most powerful drugs.
Two of the symptoms that most concern the family of a dying patient are cognitive impairment (associated with conscious activity). Cognitive impairment and loss of consciousness are a defense mechanism against this painful situation, and they should not be eliminated, even if the patient's family is experiencing difficulties.
This is due to the fact that dying patients have a specific failure of brain activity. They suffer from false memories, paranoia, and their condition varies from excitement with tension to relaxation.
This phenomenon occurs due to brain failure: just as the immature brain of an inconsolably crying child is not able to modulate a conscious response.
They can be excited and, most often, should be limited in movement. The patient is disoriented and does not know where he is, or what day and time of day it is.
Others may have hallucinations, they are associated with the fact that agony is the same biochemical process of the body as any other disease.
These disorders are caused by several reasons: chemical imbalance in the body, renal failure, infection, or reduced oxygen supply to the brain (hypoxia).
As death approaches, a person can plunge into a lethargic dream when considerable effort is required to wake him up. A coma may come. The patient can still hear, even if he / she is in a coma.
At this point, blood pressure drops. The limbs become cool when the blood stops circulating to them. Hands and feet go numb.
As the heart rate and blood pressure decrease, the patient's skin becomes paler, becomes covered with bluish spots.
Breathing changes
Often there are changes in the breathing rhythm of a dying man. Instead of taking a regular deep breath, breathing becomes irregular with long breaths, and then short and frequent. The respiratory rate is uneven, and periods of fast breathing alternate with slower ones. Some people develop a Chain-Stokes breathing rhythm with a quick breath, and then with a complete cessation of breathing.
An increase in mucus secretion in the airways is also observed. In the end, this leads to pulmonary edema, and finally to death.
Physical stages of death
Gradually refuse all the vital systems of the body. The heart no longer adequately pumps blood, which leads to lower blood pressure and less circulating blood flowing to the arms and legs, as well as to organs, such as the kidneys.
With less incoming blood, the kidneys stop working, which leads to less urine production. Urine becomes darker. Less blood enters the brain, which contributes to mental changes as death approaches.
Due to weakness and / or fatigue, a person cannot move much in bed.
In the last hours of life, appetite and thirst are reduced.
Some of the drugs people take in the last stages of a fatal illness, such as opioid pain medications, can lead to nausea and / or vomiting, which can decrease appetite.
Another sign of agony is urinary and fecal incontinence, especially in people who have not previously suffered from incontinence.
What to do, where to go
If death occurs within the walls of the house, you will have to contact the appropriate people about transporting the body of the loved one.
It is important to know these details in advance, because subsequently you will not be in the best condition to search for the necessary information.
Understanding the final physical stages of deadly agony does not mean that you will not feel pain after loss. Friends and family members who have lost a loved one feel pain and grieve as they deal with bereavement.
Be sure to get the necessary support and help if you just lost a loved one. Use available resources, such as support groups or family support, to help you deal with the loss.