“Life ends, but love doesn’t.” Isn’t it? It is hard to see our loved ones parting off from us, it is hard to see our loved ones dying. But, we all have an end to our life at a point. Sometimes, it might be hard for us to know that someone we love (especially, older adults) is about to die in the next few weeks, days, or maybe hours. However, there are some end-of-life symptoms of older adults. In this article, we will take a look at some of the end-of-life symptoms of older adults.
End-Of-Life Symptoms Of Older Adults:
Caring for our loved ones through their final stages of life is never easy. But, getting familiar with end-of-life symptoms in older adults might help you understand how your loved ones might be experiencing and this might also promote a smooth transition for all.
The end-of-life period is a period or stage in a person’s life when the body systems are shutting down and when death is imminent. It usually lasts from a matter of days to a couple of weeks before death. Some people die gently, while others have to experience various symptoms that are inevitable.(1)
Weeks before death, older adults might show symptoms like low mood, withdrawal, and lack of motivation, loss of appetite, increased fatigue, and general weakness, are some other end-of-life symptoms of older adults before few weeks.
Days before death, some signs that might be experienced by the older adults are a drop in blood pressure, heart rate, labored breathing, drop in body temperature, difficulty swallowing, refusing food, no urination or bowel movements, illusions, and hallucinations. They might also likely sleep more before few days of their end-of-life. Vision might also be impaired. Some people also experience a certain amount of restlessness.
Some of the signs that might be experienced hours before death are noisy breathing, cold extremities, abnormal breathing, purple, pale, gray, or blotchy skin on feet, knees, and hands, weak pulses, and changes in consciousness and unresponsiveness.
At death, their breathing stops, there is no pulse, and if eyes remain open, their pupils will be dilated. The skin starts to look waxy and pale. After death, tears might still be falling from the eyes and, small movements of legs, arms might also be seen.
Be known, that everyone is different. So, everyone might not experience all these end-of-life symptoms. Now let us take a look at some end-of-life symptoms of older adults.
Appetite And Digestive Changes:
As a person nears the end of life, digestion and the body’s metabolism gradually slows down. Only fewer calories are required, and thus there is a loss of appetite and reduced thirst, which is quite obvious.
Shortness Of Breath:
Breathing abnormalities or shortness of breath are among the most common end-of-life symptoms. It is common for most people to experience some degree of breathlessness as they are near to their death. Fortunately, some simple and effective treatments such as deep-breathing exercising, relaxation techniques, medications, and oxygen can bring quick relief.
Confusion could be one of the end-of-life symptoms of older adults. Older adults might periodically get confused. It might be difficult for your loved ones to identify time, place, and even close loved ones when they are near to death. You might also notice a limited attention span or repetitive motions in them, like tugging at clothing or pulling at sheets.
Depression and Anxiety:
As people come near their end of life, they might experience a growing worry or fear for themselves or their loved ones. Depression and anxiety are common end-of-life symptoms.
Sleeping More And Fatigue:
Fatigue and generalized weakness are common when someone is near the end of life. People spend most of their time sleeping and energy levels reduce as older adults come near to the end of their life.
Withdrawal From The World:
One might notice a sense of withdrawal from the world when death is near. The person few days before death might spend more time talking about their past. They might connect with only fewer people and keep away from outside events.
Urinary And Bladder Incontinence:
One more end-of-life symptom of older adults is urinary and bladder incontinence. As the kidneys start falling, urine turns more concentrated and also darker. Both, bowel functions and bladder get harder to control.
Changing Vital Signs:
Body temperature, heart rate, and blood pressure start dropping as death comes nearer. Because of reduced blood circulation, the feet, legs, arms, and hands start to feel cool when touched. The skin might also turn purple, dark blue, or appear mottled.
Darkened Urine and Decrease In Urination:
Darkened urine and reduced urination are some symptoms before the end of life in older adults. These symptoms occur due to significantly decreased fluid intake and reduced function of the kidney. In certain cases, urinary retention, obstruction, and skin breakdown can be prevented by a catheter.
Tarry And Blood Feces:
Older adults when they are near to death might have end-of-life symptoms like tarry and bloody feces. However, these symptoms can also appear in certain curable cases like peptic ulcer.(3)
Someone nearing death might hear, see, or feel things that you usually don’t. They might even feel like speak to others who have died earlier. Sensory changes can also result in hallucinations, illusions, and delusions.
Changes In Vision:
Your loved one might have weak eyesight when they are nearing the end of their life. They might turn their head directly towards various light sources because of a reduction in their eyesight.
Loss Of Consciousness:
Sometimes waking up older adults nearing their death could be difficult. They would eventually be uncommunicative and unresponsive, and lose their consciousness. Their eyes might develop a glassy appearance.
One of the end-of-life symptoms of older adults could be breathing changes. They experience slow and shallow breathing with periods of shortness of breath. As their throat muscle relax, fluid can also get collected in their throat. They might be extremely weak to clear it by coughing and this can result in “death rattle” or noisy breathing.
Cold Hands And Feet And Skin Mottling:
Their hands and feet might turn colder and skin might become mottled or blotchy and purplish. This mottling of the skin might slowly work its way to the legs and arms, and the nail beds and lips can turn purple or blue.
Changes In Muscle Function:
Some other end of life symptoms of older adults could be myoclonic jerks or sudden involuntary muscle movements, and loss of reflexes in arms and legs. Myoclonus is not painful, however, they can be distressing.
To minimize jerking movements and improving sleep quality, older adults nearing end of their life can be given some medications as prescribed by the doctor.
Various Ways To Support Your Loved Ones During Their End Of Life:
Various ways are there to support your loved ones during their end of life. Your doctor would advise you the ways to provide physical and emotional comfort to your loved ones. Let us take a look on those ways.
Providing Physical Comfort:
There are some ways you can provide your loved ones physical comfort when they are near to their death. Below are some of them:
- Help them remain hydrated with ice chips or by applying a wet cloth to their lips.
- Apply lip balm or any alcohol-free lotion to manage their dry skin.
- Use a humidifier to help them breathe properly.
- To pevent bedsores, change positioning every few hours.
- Prepare soft foods for them. However, do not force them to eat if they do not want.
- Offer comfy bedding to them as required.
- Let them sleep as much as they want and whenever they want to.
- Block out any loud noise and use low lighting in their rooms.
Providing Emotional Comfort:
- Even if they do not respond to you, assume that they are hearing you. So, speak to them directly and softly. Tell them when you enter and leave their room.
- Offer them light physical contact by placing hands on their shoulders or by holding their hands to let them know you are there for them.
- Encourage them to converse with you if they are ready for it. Be a good listener and let them lead the conversation. Do not talk about stressful topics.
- Sit with them and play their favorite music at soothing low volume.
- Express your love towards them.
- Do not interrupt or ignore their thought process. If they get confused, you try being calm.
- Let them say goodbye if they want to. Do not deny reality. This way your loved ones and you can be at peace.
Letting go our loved ones is never easy. However, known about end-of-life symptoms of older adults can help us provide the right emotional and physical support that our loved ones require as they transition. Allow yourself time and scope to grieve, take care of yourself, seek support from your family members, and reach out for help if you need, once your loved ones have passed.