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    How to help your loved—and yourself—cope

    Physical Changes: weight loss, drop in body temperature and blood pressure, change in skin tone. For most, activity decreases significantly in the final days and hours of life. These changes usually herald death within hours to days.

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    When death does occur, the skin turns to a waxen pallor as the blood settles. Breathing Changes: periods of rapid breathing and no breathing, coughing or noisy breaths. When a person is just hours from death, you will notice changes in their breathing: The rate changes from a normal rate and rhythm to a new pattern of several rapid breaths followed by a period of no breathing apnea. This is known as Cheyne-Stokes breathing—named for the person who first described it.

    This breathing is often distressing to caregivers but it does not indicate pain or suffering. The secretion that causes this sound can often be dried up with the use of certain medicines, such as atropine or scopolamine.

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    Sometimes a vaporizer can ease breathing. You may also want to try repositioning your loved one to his or her side, which can help diminish the sound of noisy breathing.

    Changes in Consciousness: decrease in consciousness, unresponsive periods; patients may experience hallucinations, illusions and delusions. Sensory Changes It is not unusual for dying persons to experience sensory changes, which are misperceptions that can be categorized as illusions, hallucinations, or delusions: Illusions - They may misperceive a sound or get confused about some physical object in the room. They might hear the wind blow but think someone is crying, or they may see the lamp in the corner and think someone is standing there.

    Illusions are misunderstandings about something that is actually in their surroundings.

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    Hallucinations - Dying persons may hear voices that you cannot hear, see things that you cannot see, or feel things that you are unable to touch or feel.