3. Changes in Breathing
What happens: Breathing patterns may shift noticeably. Breath may become shallow, rapid, or irregular, with periods of pause known as Cheyne-Stokes respiration. A gurgling sound, sometimes called the “death rattle,” can occur as secretions accumulate in the throat.
How to cope:
Reposition the person gently onto their side to help ease breathing.
Use a cool-mist humidifier or a small fan to improve air comfort.
Remember: the rattling sound does not mean the person is choking or in distress. It is a physical change, not a sign of suffering.
4. Coolness and Mottling of the Skin
What happens: As circulation slows, the hands, feet, and legs may feel cool to the touch. The skin may develop a blotchy, purplish, or grayish appearance, particularly on the knees, feet, and hands.
How to cope:
Cover the person with a light, soft blanket for warmth. Avoid heating pads or electric blankets, as the skin becomes fragile and sensitive.
If it brings comfort, gently massage warm lotion into the arms or shoulders.
Understand: these changes reflect the body’s natural slowing, not pain or distress.
5. Confusion or Restlessness
What happens: The person may speak to people who are not present, appear agitated, or pull at bed linens. This is often due to metabolic changes, decreased oxygen, or the brain’s natural transition.
How to cope:
Remain calm and reassuring. Do not argue or try to correct their perceptions. A gentle phrase like, “You are safe. I am here,” can provide comfort.
Dim bright lights, reduce background noise, and play familiar, soothing sounds such as hymns, nature recordings, or soft instrumental music.
Recognize that this restlessness is typically physiological, not emotional fear.
