A person's life path ends with his death. You need to be prepared for this, especially if there is a bed patient in the family. Signs before death will be different for each person. However, the practice of observations shows that it is still possible to identify a number of common symptoms that portend the proximity of death. What are these signs and what should you be prepared for?
How does a dying person feel?
A bedridden patient before death, as a rule, experiences mental anguish. In sound consciousness there is an understanding of what is to be experienced. The body undergoes certain physical changes, this cannot be overlooked. On the other hand, the emotional background also changes: mood, mental and psychological balance.
Some lose interest in life, others completely close in on themselves, others may fall into a state of psychosis. Sooner or later, the condition worsens, the person feels that he is losing his owndignity, more often thinks about a quick and easy death, asks for euthanasia. These changes are hard to observe, remaining indifferent. But you will have to come to terms with this or try to alleviate the situation with drugs.
With the approach of death, the patient sleeps more and more, showing apathy towards the outside world. In the last moments, a sharp improvement in the condition may occur, reaching the point that the patient who has been lying 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.
A bedridden patient: ten signs that death is near
At the end of the life cycle, an elderly person or a bedridden patient increasingly feels weak and tired due to lack of energy. As a result, he is increasingly in a state of sleep. It can be deep or drowsy, through which voices are heard and the surrounding reality is perceived.
A dying person can see, hear, feel and perceive things that do not actually exist, sounds. In order not to upset the patient, this should not be denied. Loss of orientation and confusion are also possible. The patient is increasingly immersed in himself and loses interest in the reality around him.
Urine due to kidney failure 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 blood circulation disorders, dark"Walking" venous spots that change location. They usually first appear on the feet. In the last moments, the limbs of a dying person become cold as the blood drains from them and is redirected to more important parts of the body.
Failure of life support systems
Distinguish between primary signs that appear at the initial stage in the body of a dying person, and secondary ones, indicating the development of irreversible processes. Symptoms may be outward or hidden.
Disorders of the gastrointestinal tract
How does a bedridden patient react to this? Signs before death, associated with loss of appetite and a change in the nature and volume of food consumed, are manifested by problems with the stool. Most often, constipation develops against this background. A patient without a laxative or enema finds it increasingly difficult to empty the bowels.
The last days of life patients spend refusing food and water altogether. You shouldn't worry too much about this. It is believed that dehydration in the body increases the synthesis of endorphins and anesthetics, which to some extent improve overall well-being.
Functional impairments
How does the condition of patients change and how does the bed patient react to this? Signs before death, associated with the weakening of the sphincters, in the last few hours of a person's life are manifested by fecal and urinary incontinence. In such cases, it is necessary to be ready to provide him with hygienic conditions, using absorbent underwear, diapersor diapers.
Even in the presence of appetite, there are situations when the patient loses the ability to swallow food, and soon water and saliva. This may result in aspiration.
In severe exhaustion, when the eyeballs are very sunken, the patient is not able to completely close the eyelids. This has a depressing effect on those around you. 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 bedridden? Signs before death in a weakened person in an unconscious state are manifested by terminal tachypnea - against the background of frequent respiratory movements, death rales are heard. 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 his side, wheezing will be less pronounced.
The beginning of the death 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 hot flashes and sudden cold. Limbs get cold, sweaty 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 died on the “usual road”. It is generally accepted that in this case, irreversible neurological processes occur without significant deviations.
Otherthe picture is observed in agonal delirium. The movement of the patient to death in this case will take place along the "difficult road". Signs before death in a bedridden patient who embarked on this path: psychosis with excessive excitement, anxiety, disorientation in space and time against the background of confusion. If at the same time there is a clear inversion of the cycles of wakefulness and sleep, then for the patient's family and relatives this condition can be extremely difficult.
Delirium with agitation is complicated by a feeling of anxiety, fear, often turning into a need to go somewhere, to run. Sometimes this is speech anxiety, manifested by an unconscious flow of words. The patient in this state can perform only simple actions, not fully 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 medical intervention.
Pain
Before death, what symptoms and signs in a bedridden patient indicate physical suffering?
As a rule, uncontrolled pain in the last hours of a dying person's life rarely increases. However, it is still possible. An unconscious patient will not be able to let you know about this. Nevertheless, it is believed that pain in such cases also causes excruciating suffering. A sign of this is usually a tense forehead and deep wrinkles appearing on it.
If there are assumptions when examining an unconscious patientabout the presence of a developing pain syndrome, the doctor usually prescribes opiates. You should be careful, as they can accumulate and, over time, aggravate an already serious condition due to the development of excessive overexcitation and seizures.
Giving help
A bedridden patient may experience considerable suffering before death. 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 the initial symptoms of irreversible pathological changes in cognitive processes. This is, first of all: absent-mindedness, perception and understanding of reality, the adequacy of thinking when making decisions. You can also notice 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 of alleviating suffering, the process of assessing the chances and possible outcomes in the presence of the patient in individual cases, can itself serve as a therapeutic tool. This approach gives the patient a chance to really realize that they sympathize with him, but they are perceived as a capable person with the right to vote and choose possible ways to solve the situation.
In some cases, a day or two before the expected death, it makes sense to stop taking certain medications: diuretics, antibiotics, vitamins, laxatives, hormonal and hypertensive drugs. They will onlyexacerbate suffering, cause inconvenience to the patient. Painkillers, anticonvulsants and antiemetics, tranquilizers should be left.
Communicating with a dying person
How to behave relatives, in whose family a bed patient?
Signs of approaching death can be explicit or conditional. If there are the slightest prerequisites for a negative forecast, it is worth preparing in advance for the worst. Listening, asking, trying to understand the non-verbal language of the patient, you can determine the moment when changes in his emotional and physiological state indicate the imminent approach of death.
Whether the dying person will know about it is not so important. If he realizes and perceives, it alleviates the situation. False promises and vain hopes for his recovery should not be made. It must be made clear that his last wish will be done.
The patient should not remain isolated from active affairs. It is bad if there is a feeling that something is being hidden 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 blame stupid thoughts. A dying person wants to understand that he will not be alone, that he will be taken care of, that suffering will not touch him.
At the same time, relatives and friends need to be ready to show patience and provide all possible assistance. It is also important to listen, to speak out and to say words of comfort.
Medical evaluation
Is it necessary to tell the whole truth to relatives, inwhose family is bedridden before death? What are the signs of his condition?
There are situations when the family of a terminally ill patient, being in the dark about his condition, literally spends his last savings in the hope of changing the situation. But even the best and most optimistic treatment plan can fail. It will happen that the patient will never get back on his feet, will not return to an active life. All efforts will be in vain, spending will be useless.
Relatives and friends of the patient, in order to provide care in the hope of a speedy recovery, quit their jobs and lose their source of income. In an attempt to alleviate suffering, they put the family in a difficult financial situation. Relationship problems arise, unresolved conflicts due to lack of funds, legal issues - all this only aggravates the situation.
Knowing the symptoms of imminent death, seeing irreversible signs of physiological changes, an experienced doctor is obliged to inform the patient's family about this. Informed, understanding the inevitability of the outcome, they will be able to focus on providing psychological and spiritual support.
Palliative care
Do relatives who have a bed patient need help before they die? What are the patient's symptoms and signs that she should be treated?
Palliative care for the patient is not aimed at prolonging or shortening his life. In its principles, the assertion of the concept of death as a natural and regular process of lifecycle of any person. However, for patients with an incurable disease, especially in its progressive stage, when all treatment options have been 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 the family does not have the 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. Psychological relief is also important for him, easing the experiences associated, on the one hand, with the inability to self-service, and on the other hand, with the realization of the fact of the imminent imminent death. Trained nurses and palliative care physicians are skilled in the art of alleviating such suffering and can provide significant assistance to terminally ill people.
Predictors of death according to scientists
What to expect for relatives who have a bed patient in the family?
The symptoms of the approaching death of a person "eaten" by a cancerous tumor were documented by the staff of palliative care clinics. According to observations, not all patients showed obvious changes in the physiological state. A third of them did not show symptoms or their recognition was conditional.
But in most terminally ill patients, three days before death could be noteda marked decrease in the response to verbal stimulation. They did not respond to simple gestures and did not recognize the facial expressions of the personnel communicating with them. The "smile line" in such patients was omitted, an unusual sound of the voice was observed (grunting of the ligaments).
Some patients, in addition, had hyperextension of the neck muscles (increased relaxation and mobility of the vertebrae), non-reactive pupils were observed, patients could not close their eyelids tightly. 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 may most likely 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 death, but also the future prosperity of his family. So, if a dying person asked for food (milk, honey, butter) in the last moments and relatives gave it, then this could affect the future of the family. There was a belief that the deceased could take with him we alth and good luck.
It was necessary to prepare for imminent death if the patient shuddered violently for no apparent reason. It was believed that it was death that looked into his eyes. Also a sign of close death was a cold and pointed nose. There was a belief that it was for him that death was holding the candidate in his last days.before his death.
Ancestors were convinced that if a person with a fatal illness turns away from the light and most of the time lies facing the wall, he is on the threshold of another world. If he suddenly felt relieved and asked to be transferred to his left side, then this is a sure sign of an imminent death. Such a person will die without pain if you open the windows and the door in the room.
A bedridden patient: how to recognize the signs of impending death?
Relatives of a dying patient at home should be aware of what they may face 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 bedridden patient.
The stages of dying, like 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 cannot be changed.
