Death is one of the undeniable facts of life that every person has to experience sooner or later. Facing the prospect of dying is quite difficult an ordeal but being prepared for it helps you accept the reality and cope with it in a better way. No one knows about the exact time of death but there are certain signs that begin appearing during the last few days of life.

Signs of Death in Elderly

Signs of death are unique to every person depending upon the health condition of a person. However, some of the commonly observed signs of death in old people are listed below.

1.      Reduced Appetite

Since the energy requirements of a dying person are very low, the appetite of the person reduces considerably. Inability to swallow due to the dryness of mouth and parched lips may be other reasons for refusing to eat when a person is about to die. As a result, the person prefers to feed on soft foods or fluids only. 

2.      Increased Sleep

Towards the end of life, a person becomes excessively drowsy and sleepy. It becomes quite difficult to wake such a person from the state of deep sleep. One reason for enhanced sleepiness may be increased fatigue, because with low energy levels, the person becomes exhausted even with the slightest activities like talking and shifting the sides. 

3.      Excessive Physical Weakness

During the last of his/her days, a person experiences physical weakness which is out of proportion with the level of physical activity due to low food consumption and energy deficit. As a result, even low level activities like shifting the side become too much to handle and the person becomes extremely exhausted. 

4.      Fever

When death is near, one of the common symptoms to appear is fever with rigors and chills. Feverish feeling with rise of body temperature is quite common during the last days.  

5.      Disorientation

Altered consciousness is one of the most obvious signs of death in elderly people. Most of the people tend to lose the sense of time, place and person. Bouts of non-coherent speech are quite common. The person may even experience visual or auditory hallucinations, talking to an invisible person and claiming to hear stuff that other people cannot hear. 

6.      Difficulty Breathing

The breathing of a dying person becomes rather labored and strenuous. The person may even experience Cheyne-Stokes Breathing (progressively deeper, rugged breathing with intervals of no breathing in between). The person may even make a rattling sound, known as the "death rattle", produced by forced passage of air through stagnant secretions within the wind pipes. 

7.      Agitation

As death approaches, a person becomes excessively restless and agitated. Breathing difficulty is one of the causes of edginess. The person may pull at the clothes or the bed covers in an attempt to seek relief. Just before death, the person enters the state of "terminal delirium" characterized by extreme agitation and distress, which can be quite disturbing for the loved ones of the dying person. 

8.      Social Isolation

When a person is getting to the very end, he/she becomes drawn. Failing to respond to queries, mumbling to no one in particular and social withdrawal are frequently observed.

9.      Modified Bladder Habits

Changes in the bowel and bladder habits are quite common during the last days. The urine output is quite low and the urine is quite concentrated and dark in color. Besides, loss of bladder control is also one of the common signs of death in elderly individuals which results in frequent bed-wetting. 

10.     Puffiness of Hands and Feet

Since the kidneys almost lose their function towards the end, the body is unable to get rid of body fluids which start accumulating in hands and feet resulting in visible swelling of ankles and hands. As a result, the hands and feet become excessively enlarged and take on a puffy appearance. 

11.     Cold Extremities

Immediately preceding the death of a person, his/her blood circulation is re-directed from his peripheral organs like limbs towards the core vital organs as a part of the body’s innate mechanism to maintain the functions of those organs.  As a result, the person's fingertips, toes, hands and feet are quite cold to touch.

12.     Mottled Skin Vessels

Since the blood supply to arms and legs is significantly reduced towards the very end, the veins of the skin, especially those of the soles on the feet, become stark with a mottled appearance. The superficial vessels supplying the skin become purplish-bluish in color.  

What to Do

If one of your loved ones is on the death-bed, here is what you can do to ease his/her discomfort.

• Keep the person’s arms and legs covered to keep them warm.
• If the person is disoriented, don’t lose patience and calmly try to explain things like “you have to take your medicine”, even if you have to repeat things multiple times.
• If the person is unresponsive, sit at the bedside quietly, holding his/her hand, offering words of comfort.
• In case of bowel or bladder incontinence, try to keep the person clean. You can also employ the services of a trained nurse for that purpose.
• Since low appetite is one of the common signs of death in elderly, it is nothing to worry about. Don't force feed the person if he/she is unwilling to eat.
• To relieve parched lips, wipe the person’s mouth with a moist cloth or give him/her little sips of water or fresh juices time to time.
• In case of breathing difficulty, elevate the head of the person and turn him/her on the side to aid breathing.
• Fever can be brought down by applying cold towels to the forehead and the limbs.

Death is one of the most difficult parts of life but with proper care, the last time of an elderly person can be made as convenient and comfortable as humanly possible.