Dear Barbara, What are the first signs that someone is dying?
Usually, a medical diagnosis begins with signs and symptoms that are not "normal." The dying process from disease or old age also has recognizable signs that alert us death is approaching.
The first signs of the dying process appear in three areas: eating, sleeping, and socialization. As these areas change, they tell us the body is shutting down and entering the final stage of living. In fact, you don't even need a diagnosis to recognize that the dying process has begun.
FOOD: Months before death from disease—or even years before death when the body is gradually preparing to stop because of old age, a person's eating begins to change. First, they gradually stop eating meat and other harder-to-digest foods. Then, over time, the amount they eat decreases, and softer foods are preferred. Eventually, very little food is eaten, and liquids such as protein shakes go down more easily. Eventually, the person stops eating altogether. Liquid intake usually continues a little longer, but even that gradually stops as death approaches.
SLEEP: Sleep generally follows the same timeline as eating. It often begins with afternoon naps months before death. Over time, naps extend into the morning and afternoon, and the person may doze while watching television in the evening. Eventually, they are no longer getting out of bed and are asleep more than they're awake.
SOCIALIZATION: Withdrawal begins with not wanting to participate in outside activities. Then it progresses to not seeing friends and, eventually, not interacting much with family and those closest to them. The person is drawing inward, where there is room for only one.
End-of-life care and education are different from other areas of healthcare. If you notice these changes in your special person and there has not been a diagnosis, get a medical evaluation to determine what is causing them.
If someone close to you is showing these three areas of change and has a life-threatening or non-fixable illness, know that the dying process has begun. Now is the time to involve hospice and, if possible, an end-of-life doula to guide and support you through these final stages of living.
Something more...
Recognizing these three early signs is just the beginning. As the dying process continues, new questions arise about what to expect, how to provide care, pain management, and what happens in the final hours. The End of Life Guideline Series walks with you through each stage of the journey, giving you practical, compassionate guidance so you can care with greater confidence and less fear.
