The life path of a person ends with his death. You need to be prepared for this, especially if the family has a bedridden patient. The signs before death will be different for each person. However, the practice of observation suggests that a number of common symptoms can be distinguished, which portend the nearness of death. What are these signs and what should be prepared for?
What does a dying person feel?
A lying patient before death, as a rule, experiences mental torment. In common sense there is an understanding of what remains to be experienced. The body undergoes certain physical changes, this cannot be overlooked. On the other hand, the emotional background is also changing: mood, mental and psychological balance.
Some lose their interest in life, others completely shut themselves down, others may fall into a state of psychosis. Sooner or later, the condition worsens, a person feels that he is losing his own dignity, more often thinks of a quick and easy death, asks for euthanasia. These changes are difficult to observe, remaining indifferent. But you have to come to terms with this or try to alleviate the situation with drugs.
With the approach of death, the patient is sleeping more and more, showing apathy to the world around him. In the last moments, a sharp improvement in the condition can occur, reaching the point that the patient lying down for a long time is eager to get out of bed. This phase is replaced by subsequent relaxation of the body with an irreversible decrease in the activity of all body systems and the attenuation of its vital functions.
Lying patient: ten signs that death is near
At the end of the life cycle, an elderly person or a bedridden patient increasingly feels weakness and fatigue due to a lack of energy. As a result, he is increasingly in a state of sleep. It can be deep or a nap through which voices are heard and the surrounding reality is perceived.
A dying person can see, hear, feel and perceive actually non-existent things, sounds. In order not to upset the patient, this should not be denied. Loss of orientation and confusion are also possible . The patient is more and more immersed in himself and loses interest in the reality surrounding him.
Urine due to a malfunction of the kidneys darkens to almost brown with a reddish tinge. As a result, edema appears. The patient's breathing quickens, it becomes intermittent and unstable.
Under the pale skin as a result of a violation of blood circulation, dark “walking” venous spots appear that change their location. At first they usually appear on the feet. In the last moments, the limbs of a dying person become colder due to the fact that the blood, casting from them, is redirected to more important parts of the body.
Failure Life Support Systems
There are primary signs that appear at the initial stage in the body of a dying person, and secondary, indicating the development of irreversible processes. Symptoms may have an external manifestation or be hidden.
Gastrointestinal Disorders
How does the bed patient react to this? Symptoms before death associated with loss of appetite and changes in the nature and volume of food consumed are manifested by problems with stool. Most often, against the background of this, constipation develops. It is becoming increasingly difficult for a patient without a laxative or enema to empty his intestines.
Patients spend the last days of life, generally refusing food and water. Do not worry too much about this. It is believed that with dehydration in the body, the synthesis of endorphins and anesthetics increases, which to some extent improve overall well-being.
Functional impairment
How does the condition of patients change and how does the bed patient react to this? Signs before death associated with a weakening of the sphincters in the last few hours of a person's life are manifested by incontinence of feces and urine. In such cases, you must be prepared to provide him with hygienic conditions, using absorbent underwear, diapers or diapers.
Even with appetite, there are situations when the patient loses the ability to swallow food, and soon water and saliva. This can lead to aspiration.
With severe exhaustion, when the eyeballs are greatly sagging, the patient is not able to completely close his eyelids. It is depressing to others. If the eyes are constantly open, the conjunctiva must be moistened with special ointments or saline.
Respiratory and thermoregulatory disorders
What are the symptoms of these changes if the patient is a bedridden patient? Symptoms before death in a weakened person in an unconscious state are manifested by terminal tachypnea - dying rales are heard against the background of frequent respiratory movements. This is due to the movement of the mucous secretion in the large bronchi, trachea and pharynx. This condition is quite normal for a dying person and does not cause him suffering. If it is possible to lay the patient on its side, wheezing will be less pronounced.
The beginning of the dying off of the part of the brain responsible for thermoregulation is manifested by jumps in the patient’s body temperature in a critical range. He can feel sudden flushes of heat and sudden cold. The limbs are frozen, sweating skin changes color.
Road to death
Most patients die quietly: gradually losing consciousness, in a dream, falling into a coma. Sometimes it is said about such situations that the patient passed away along the “usual road”. It is generally accepted that in this case, irreversible neurological processes occur without significant deviations.
Another picture is observed with agonal delirium. In this case, the patient’s movement to death will follow a “difficult road”. Symptoms before death in a bedridden patient who has embarked on this path: psychoses with excessive excitement, anxiety, disorientation in space and time against a background of confusion. If at the same time there is a clear inversion of the wakefulness and sleep cycles, then for the patient's family and relatives this condition can be extremely serious.
Delirium with agitation is complicated by a sense of anxiety, fear, often turning into a need to go somewhere, to run. Sometimes this is a speech disturbance, manifested by an unconscious stream of words. A patient in this condition can perform only simple actions, not completely understanding what he is doing, how and why. The ability to reason logically is impossible for him. These phenomena are reversible if the cause of such changes is identified in time and stopped by medication.
Pain
Before death, what are the symptoms and signs of a bedridden patient that indicate physical suffering?
As a rule, uncontrolled pain in the last hours of a dying person’s life rarely increases. However, this is still possible. A patient who is unconscious will not be able to let this know. Nevertheless, it is believed that pain in such cases causes painful suffering. A sign of this is usually a tense forehead and deep wrinkles appearing on it.
If, when examining a patient unconscious, there are suggestions of a developing pain syndrome, the doctor usually prescribes opiates. Care should be taken, since they can accumulate and, over time, aggravate an already serious condition due to the development of excessive overexcitation and seizures.
Giving help
A lying patient before death can experience significant suffering. The relief of symptoms of physiological pain can be achieved with drug therapy. Mental suffering and psychological discomfort of the patient, as a rule, become a problem for relatives and close family members of the dying.
An experienced doctor at the stage of assessing the general condition of the patient can recognize his initial symptoms of irreversible pathological changes in cognitive processes. This is primarily: distracted attention, perception and understanding of reality, the adequacy of thinking in decision-making. You can also observe violations of the affective function of consciousness: emotional and sensory perception, attitude to life, the relationship of the individual with society.
The choice of methods to alleviate suffering, the process of assessing the chances and possible outcomes in the presence of the patient in some cases, by itself, can serve as a therapeutic tool. This approach gives the patient a chance to really realize that they sympathize with him, but perceive him as a competent person with the right to vote and choose possible solutions to the situation.
In some cases, a day or two before the alleged death, it makes sense to stop taking certain medications: diuretics, antibiotics, vitamins, laxatives, hormones, and hypertension. They will only aggravate the suffering, cause the patient inconvenience. Painkillers, anticonvulsants and antiemetics, tranquilizers should be left.
Communication with a dying person
How to behave to relatives in whose family a bedridden patient?
Signs of impending death may be overt or conditional. If there are the slightest prerequisites for a negative outlook, you should prepare in advance for the worst. By listening, asking, trying to understand the nonverbal language of the patient, you can determine the moment when changes in his emotional and physiological state indicate the imminent approach of death.
Whether a dying person knows about it is not so important. If aware and perceives - this makes the situation easier. False promises and vain hopes of his recovery should not be given. It must be made clear that his last will will be fulfilled.
The patient should not remain isolated from active affairs. It’s bad if you get a feeling that they are hiding something from him. If a person wants to talk about the last moments of his life, then it is better to do it calmly than to hush up the topic or criticize silly thoughts. A dying person wants to understand that he will not be alone, that they will take care of him, that his suffering will not affect him.
At the same time, relatives and friends need to be prepared to show patience and provide all possible assistance. It is also important to listen, give a say and say words of comfort.
Medical assessment
Do I need to tell the whole truth to relatives whose family has a bedridden patient before death? What are the signs of his condition?
There are situations when the family of a terminally ill patient, being ignorant of his condition, in the hope of changing the situation, literally spends his last savings. But even an impeccable and most optimistic treatment plan may not produce results. It so happens that the patient will never stand on his feet, will not return to an active life. All efforts will be in vain, spending will be useless.
Relatives and relatives of the patient, in order to provide care in the hope of a speedy recovery, quit their job and lose their source of income. Trying to alleviate the suffering, they put the family in a difficult financial situation. Relationship problems, unresolved conflicts due to lack of funds, legal issues - all this only exacerbates the situation.
Knowing the symptoms of an inevitably approaching death, seeing irreversible signs of physiological changes, an experienced doctor must inform the patient's family about this. Informed, understanding the inevitability of the outcome, they will be able to focus on providing him with psychological and spiritual support.
Palliative care
Is help needed for relatives in whose family a bedridden patient is present before death? What symptoms and signs of the patient indicate that she should be consulted?
Palliative care for a patient is not aimed at prolonging or shortening his life span. In its principles, the assertion of the concept of death as a natural and regular process of the life cycle of any person. However, for patients with an incurable disease, especially in its progressive stage, when all treatment options are exhausted, the question of medical and social assistance is raised.
First of all, you need to apply for it when the patient no longer has the opportunity to lead an active lifestyle or in the family there are no conditions to ensure this. In this case, attention is paid to alleviating the suffering of the patient. At this stage, not only the medical component is important, but also social adaptation, psychological balance, peace of mind of the patient and his family.
A dying patient needs not only attention, care, and normal living conditions. For him, psychological unloading is also important, alleviating the experiences associated, on the one hand, with the inability of self-service, and on the other, with the realization of the fact of an imminently approaching imminent death. Trained nurses and doctors at palliative clinics possess the subtleties of the art of alleviating such suffering and can provide significant assistance to terminally ill people.
Scientists Assess Death Predictors
What to expect for relatives who have a bedridden patient in the family?
Symptoms of the approaching death of a person “eaten up” by a cancerous tumor were documented by the staff of the palliative care clinics. According to observations, not all patients showed marked changes in their physiological state. A third of them did not show symptoms or their recognition was conditional.
But in most terminally ill patients, three days before the death, a marked decrease in the response to verbal irritation could be noted. They did not respond to simple gestures and did not recognize the facial expressions of the faces of the personnel communicating with them. The "smile line" in such patients was omitted, an unusual sound of the voice was observed (groaning of ligaments).
In some patients, in addition, there was hyperextension of the cervical muscles (increased relaxation and mobility of the vertebrae), non-reactive pupils were observed, patients could not close their eyelids. Of the obvious functional disorders, bleeding in the gastrointestinal tract (in the upper sections) was diagnosed.
According to scientists, the presence of half or more of these signs can with high probability indicate an unfavorable prognosis for the patient and his sudden death.
Signs and folk beliefs
In the old days, our ancestors paid attention to the behavior of a dying person before death. Symptoms (signs) in a bedridden patient could predict not only demise, but also the future prosperity of his family. So, if a dying man asked for food (milk, honey, butter) in his last moments and relatives gave it, then this could affect the future of the family. It was believed that the deceased could take wealth and fortune with him.
It was necessary to prepare for an imminent death if the patient trembled for no apparent reason. It was believed that this death looked into his eyes. Also a sign of a close passing away was a cold and pointed nose. It was believed that it was his death that kept the candidate in the last days before his death.
The ancestors were convinced that if a person with a deadly disease turns away from the light and most of the time lies facing the wall, he is on the verge of a different world. If he suddenly felt relieved and asked to shift it to his left side, then this is a sure sign of an imminent death. Such a person will die without suffering if you open the windows and the door in the room.
Lying patient: how to recognize signs of impending death?
Relatives of a patient dying at home should be aware of what they may encounter in the last days, hours, moments of his life. It is impossible to accurately predict the moment of death and how everything will happen. Not all of the symptoms and signs described above may be present before the death of a bed patient.
The stages of dying, as well as the processes of the origin of life, are individual. No matter how hard it is for relatives, you need to remember that it is even more difficult for a dying person. Close people need to be patient and provide the dying person with the maximum possible conditions, moral support and attention and care. Death is the inevitable outcome of the life cycle, and this cannot be changed.