What Happens in the Last 24 Hours Before Death? A Hospice Perspective

The final 24 hours of a person’s life can be a deeply emotional time for both the dying person and their loved ones. At Lenity Light Hospice, we strive to provide compassionate care and support during this delicate period. Understanding what to expect can help families prepare and find peace in these last moments.

Physical Changes and Signs

In the last 24 hours of life, the body undergoes several changes as it begins to shut down. These changes are natural and a part of the process of dying.

1. Decreased Appetite and Thirst: It’s common for patients to stop eating and drinking as their bodies no longer require or can process food and fluids.
2. Changes in Breathing: Breathing patterns may become irregular, with periods of rapid breaths followed by pauses (Cheyne-Stokes breathing). This can be unsettling to witness but is a normal part of the dying process.
3. Cool Extremities: Hands and feet may become cool to the touch as circulation decreases. Body temperature may drop, and skin may change color, appearing mottled or bluish.
4. Increased Sleep and Unresponsiveness: Patients may spend more time sleeping and may become unresponsive. This is not an indication of discomfort but a sign that the body is conserving energy.
5. Restlessness and Agitation: Some patients may experience restlessness or agitation. This can be managed with pain medication and comforting measures by the hospice team.
6. Changes in Urine Output: There may be a decrease in urine output as kidney function declines. Urine may become darker in color.
7. Lowered Blood Pressure and Heart Rate: As the body shuts down, blood pressure and heart rate typically decrease. This is a sign that the body is preparing for the final stages of life.

Emotional and Psychological Aspects

The emotional and psychological aspects of dying are just as important as the physical changes. Each person experiences this transition in their unique way.

1. Withdrawal: As the end approaches, patients may withdraw from their surroundings and interactions. This is a natural part of the process as they focus inward.
2. Hallucinations and Visions: It’s not uncommon for dying patients to report seeing deceased loved ones or having visions. This can be a source of comfort and is a normal experience.
3. Peace and Acceptance: Many patients reach a state of peace and acceptance about their impending death. Hospice care focuses on supporting this emotional transition.
4. Family and Friends Support: Family members and friends play a crucial role during this time. Holding their hand, talking to them, and being present can comfort the dying person immensely.

Role of Hospice Care

The role of hospice care in the final 24 hours is to ensure the patient’s comfort and dignity. At Lenity Light Hospice, our team works tirelessly to provide holistic care tailored to the needs of the patient and their family.

1. Pain and Symptom Management: Effective pain and symptom management is a top priority. Medications are administered as needed to keep the patient comfortable and to relieve any painful or distressing symptoms.
2. Emotional and Spiritual Support: Counselors, social workers, and chaplains are available to offer emotional and spiritual support to both the patient and their family, providing bereavement support and guidance.
3. Family Involvement: Families are encouraged to spend time with their loved one, say their goodbyes, and participate in the care process as much as they feel comfortable.
4. Creating a Peaceful Environment: The hospice team works to create a peaceful and soothing environment, whether the patient is at home or in a hospice facility. This may include soft music, dim lighting, and other comforting measures.

After Death

When death occurs, the hospice team continues to provide support. They will confirm the death, assist with post-death care, and help the family with any necessary arrangements.

1. Pronouncement of Death: A hospice nurse will pronounce the death and notify the appropriate authorities.
2. Support for Loved Ones: The hospice team offers bereavement support and resources to help the family cope with their loss.
3. Arrangements: Assistance with contacting the funeral home and making other necessary arrangements is provided.

The last 24 hours of life can be challenging, but with the support of hospice care, it can also be a time of profound connection and peace. At Lenity Light Hospice, we are dedicated to walking this journey with you, providing care, comfort, and compassion every step of the way.