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I’m a hospice nurse — this is what happens in the distressing moment before death

Caregiver tenderly holding the hand of an elderly patient in a hospital bed
A hospice nurse has revealed the things every person does before they die.

At death’s doorstep, nearly everyone does the same thing, a hospice nurse has revealed.

Maria Sinfield, from Lancashire, England, said people typically call out for their loved ones during their “frightening” final days.

“From a very personal point, I was with my dad when he died and he called out for his mom and dad as though they were there,” 64-year-old Sinfield, who works at Marie Curie, told the Daily Mail.

“Some people are accepting that they are dying, but you can find other people may not be,” she added, saying that some people express regrets about things they didn’t say or do.

One patient, she recalled, wanted to speak with a family member with whom they had not spoken in a long time.

“They were really distressed prior to that and seeing the family member really made a difference, just to know that person was there,” she said.

She recalled her own father calling out for his parents while at death’s doorstep. masyastadnikova – stock.adobe.com
She recalled her own father calling out for his parents while at death’s doorstep. masyastadnikova – stock.adobe.com

People may also feel distressed, restless or confused as they near the end of their life, sometimes hallucinating.

“Sometimes confusion can happen when someone has been deep asleep,” she explained. “In those last few hours that person could have lost consciousness, and then wake up from that, because that’s what naturally happen, and then wake up in what seems like a strange environment.”

But most people just need someone to talk to, she noted. Sitting with family members can calm their anxiety and make them comfortable, she continued, and that the simple “symptom management” is vital during end of life care.

“There’s a real balance of ensuring that we are giving that person the best quality of life that they can possibly have,” she said.

As they approach death, patients tend to slow down, eat less, grow more tired and could even experience changes in their behaviors, which can cause concern among family members, although it’s normal.

“You gradually see over those last weeks and days, somebody really slows down and becomes very fatigued easily. Families might notice that the person sleeps more,” she said.

“Often the person is not using as much energy, they are not being as active, so they need less food and drink.”

“There’s a real balance of ensuring that we are giving that person the best quality of life that they can possibly have,” Sinfield said. Pixel-Shot – stock.adobe.com
“There’s a real balance of ensuring that we are giving that person the best quality of life that they can possibly have,” Sinfield said. Pixel-Shot – stock.adobe.com

At the very end, typically in the last few hours of their life, Sinfield said a person’s breathing will change to become more shallow, slow and may even sound like “rattling,” which can be “very distressing” for family to hear despite not being painful for the patient.

“Sometimes when that breathing changes and the person has lost consciousness and they are not able to speak to the family anymore, they are unable to clear the secretions in the mouth or in the throat,’ she said, explaining the “rattling noise.”

Death is a natural part of life, but some people are scared of it, she said. But, as a nurse, instead of using euphemisms to soften the discussions around death, she would rather be “honest” and speak openly.

“I talk to families very openly about what to expect when their loved ones dying. I use that language as well,” she explained. “Families often want to protect their loved ones from death because they are frightened.”