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impending death
Clinical manifestations:
1) 1-3 months prior
a) withdrawal from the world & people
b) decreased food intake
c) increased desire to sleep
d) going inside of self; less interest in outside world
e) less communication
2) 1-2 weeks prior
a) disorientation
b) agitation
c) talking with the unseen, especially friends & relatives who have died
d) confusion
e) picking at clothes
f) sleeping but responding
g) increased fatigue & lethargy
h) eating & drinking very little
i) decreased blood pressure
j) increase or decrease in pulse
k) color changes, pale, bluish
l) increased perspiration
m) changes in respiration, increased congestion
n) fluctuations in body temperature
3) hours to days prior to death
a) intensification of 1-2 week signs
b) possible temporary surge in energy
c) decrease in blood pressure
d) fixed gaze or expression
e) irregular respirations
f) restlessness or no activity
g) mottling of skin
h) weak pulse, difficult to find
i) decreased urine output
j) incontinence of bowel & bladder
4) minutes prior to death
a) Cheyne-stokes breathing or very shallow respirations
b) cannot be awakened
Related
death
hospice
palliative care
General
end of life
References
- Hui D, dos Santos R, Chisholm G et al
Clinical signs of impending death in cancer patients.
Oncologist. 2014 Jun;19(6):681-7.
PMID: 24760709 Free PMC Article
- Weissman DE
FAST FACTS AND CONCEPTS #3. SYNDROME OF IMMINENT DEATH
Palliative Care Network of Wisconsin
https://www.mypcnow.org/wp-content/uploads/2019/01/FF-3-Imminent-Death.-3rd-ed.pdf