When death is near

There have been many reports over the years of patients being resuscitated after having been ‘dead’ for a short interval, perhaps for as long as several minutes. Many of these patients have afterwards reported ‘out-of-the-body’ experiences, in which they say they were able to look down at themselves. Claims have also been made about hearing intense noise or passing through bright lights. Often such experiences have been interpreted as having a religious or spiritual implication.

Some clinicians have explained these phenomena as the result of massive releases of stress hormones from the adrenal glands and within the brain, although hard clinical evidence is lacking.

When close to death most patients show little interest in food or drink. If there is no pain, death can be a peaceful process. Some patients afflicted with a terminal illness, on the other hand, retain a fighting spirit right up to the end.

The so-called ‘death rattle’, which to many is indicative of the closeness of death, is caused partly by the accumulation of mucus in the dying person’s airways and partly because the lungs become waterlogged as the heart fails. If this is the case a doctor should be contacted, who may be able to give the patient an injection to clear the mucus and therefore make him or her more comfortable. An alert patient can be helped to breathe more easily by propping him or her up in bed in a sitting position. Alternatively the patient can be laid on his or her side with the top arm and leg drawn out to provide support. A dying person is normally able to hear what is going on right up until the end, because hearing is one of the last faculties to fail. Support for someone approaching death is largely a matter of reassurance – of maintaining a loving presence – rather than trying to improve physical comfort. It is important, therefore, to remain near a dying person so that they do not feel alone.