When Death Is Near
The prospect of dying raises questions about the nature and meaning of life and the reasons for suffering and dying. No easy answers to these fundamental questions exist. In their pursuit of answers, seriously ill people and their families can use their own resources, religion, counselors, friends, and research. They can talk, participate in religious or family rituals, or engage in meaningful activities. The most important antidote to despair is often feeling cherished by another person. The torrents of medical diagnoses and treatments should not be allowed to obliterate the larger questions and the importance of human relationships.
Often, there are characteristic signs that death is near. Consciousness may decrease. The limbs may become cool and perhaps bluish or mottled. Breathing may become irregular.
Secretions in the throat or the relaxing of the throat muscles can lead to noisy breathing, sometimes called the death rattle. Repositioning the person or using drugs to dry secretions can minimize the noise. Such treatment is aimed at the comfort of the family or caregivers, because noisy breathing occurs at a time when the dying person is unaware of it. This breathing can continue for hours.
At the time of death, a few muscle contractions may occur, and the chest may heave as if to breathe. The heart may beat a few minutes after breathing stops, and a brief seizure may occur. Unless the dying person has a contagious infectious disease that poses a risk to others, family members should be assured that touching, caressing, and holding the body of a dying person, even for a while after the death, are acceptable. Generally, seeing the body after death is helpful to those close to the person. Doing so seems to counter the irrational idea that the person really did not die.
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