Many people wonder what agony is and how it manifests itself. Some symptoms, such as pain and shortness of breath, terrorize patients, while others, such as noisy wheezing, greatly upset those close to the patient.
Palliative care experts explain that all of these symptoms are common during the death throes phase and can still be controlled to prevent unnecessary suffering.
The agony of the terminal stage of the disease is a very short time phase that occurs in the last days of life before biological death. It is very easy to detect it clinically, because in this final stage, pronounced symptoms appear.
What is agony
This process can take minutes or months, depending on what's going on inside the person's body. The cessation of the physical, sensory and mental functions of the body is related to what agony is.
When you are near a person who is in an ambulanceclose to death, you need to know exactly its physical signs in order to understand what is happening.
The death agony lasts two or three days, but in exceptional cases it can last up to five days.
The most dangerous symptoms before death: pain and shortness of breath.
Before death, the state of consciousness progressively worsens in the patient, although some remain clear to the very end. There is shortness of breath, pain, refusal to eat and drink, psychological disorders.
How to help a loved one
Derivatives of morphine, an opioid drug, exist to relieve pain, but the use of these drugs should not be confused with euthanasia.
Sedation and euthanasia are not synonymous. The drug is prescribed in doses sufficient to stop pain, but not to hasten death.
If the patient is cared for at home or directly in a hospice, morphine can be administered to relieve any pain. The same will be ensured if the death occurs in a hospital or other medical facility.
Cognitive breakdown and loss of consciousness before death is a defense mechanism against agony and does not need treatment.
The goal of palliative care is to avoid unnecessary suffering, to fight symptoms using the most powerful drugs.
Two of the symptoms that most concern the family of a dying patient are cognitive impairments (associated with conscious activity). Cognitive impairment and loss of consciousness are the mechanismprotection from this painful situation and should not be removed, even if the patient's family is experiencing difficulties.
This is due to the fact that dying patients have a specific brain failure. They suffer from false memories, paranoia, and their condition ranges from agitation with tension to relaxation.
This phenomenon is due to brain failure: just as the immature brain of an inconsolably crying baby is unable to modulate a conscious response.
They can be agitated and, more often than not, should be restricted in movement. The patient is disoriented and does not know where he is, or what day and time of day it is.
Others may have hallucinations, they are due to the fact that agony is the same biochemical process of the body as any other disease.
These disorders are caused by several reasons: a chemical imbalance in the body, kidney failure, infections or reduced oxygen supply to the brain (hypoxia).
As death approaches, a person may fall into a lethargic sleep where considerable effort is required to wake them up. A coma may occur. The patient can still hear even if he/she is in a coma.
At this stage, blood pressure drops. The limbs become cool when the blood stops circulating to them. Hands and feet go numb.
As the heart rate and blood pressure decrease, the patient's skin becomes paler, covered with bluish spots.
Breathing changes
Changes in the breathing rhythm of a dying person are often observed. Instead of taking regular deep breaths, breathing becomes irregular with long breaths and then short and frequent breaths. The respiratory rate is uneven, and periods of fast breathing alternate with slower ones. Some people develop a Cheyne-Stokes breathing pattern with rapid inhalation and then complete cessation of breathing.
There is also an increase in mucus secretion in the respiratory tract. Eventually, this leads to pulmonary edema, and finally to death.
Physical stages of death
All vital systems of the body gradually fail. The heart no longer pumps adequately, resulting in lower blood pressure and less circulating blood flow to the arms and legs, as well as organs such as the kidneys.
With less blood coming in, the kidneys stop working, resulting in less urine production. Urine becomes darker. Less blood flows to the brain, which promotes mental changes as death approaches.
Due to weakness and/or fatigue, the person cannot move much in bed.
In the last hours of life, appetite and thirst decrease.
Some of the drugs people take in the last stages of a terminal illness, such as opioid painkillers, can cause nausea and/or vomiting, which reduces appetite.
Another sign of agony is incontinence andfeces, especially in people who have never been incontinent before.
What to do, where to go
If death occurs within the walls of a home, you will need to contact the appropriate people regarding the transportation of the body of a loved one.
It's important to know these details ahead of time because you won't be in the best shape to look up the information you need later on.
Understanding the final physical stages of death agony doesn't mean you won't feel the pain of loss. Friends and family members who have lost a loved one feel pain and mourn as they deal with bereavement.
Be sure to get the support and help you need if you've just lost a loved one. Use available resources, such as support groups or family support, to help you cope with your loss.
