Terminal states: preagonia, agony and clinical and biological death. Preagonia, agony What is the state of death called?

What is agony? This word was borrowed into the Russian language from French at the beginning of the 19th century. It was previously used in the 16th century. What is the known meaning of the word “agony”? It means “struggle,” “the final moments of life,” “the state preceding death.” The medical definition of agony as a state of the body was described in his writings by Hippocrates, who lived in 360 BC.

This article describes in detail how this condition occurs and what its symptoms are.

Medical interpretation

What is agony from a medical point of view? The last moment of life before irreversible death. There is such a thing as a terminal state of a person, in which resuscitation is still possible. If it is unsuccessful, agony ensues. In this case, clinical death turns into biological death. Another name for agony is death.

In this condition, a person’s blood circulation is impaired and breathing becomes very difficult, as a result, oxygen starvation and hypoxia occur. Deterioration of blood flow leads to slow heart function, subsequently to its complete stop. The duration of agony is determined by the factors that caused this process. They are different. Now let's look at them. Agony caused by some injuries or acute diseases lasts a very short period of time, up to several seconds.

In some cases, it can last up to several hours, or even less often days, causing terrible agony to a person.

Signs

Depending on what caused this condition, the signs of agony can be very different. But there are also general indicators of what is happening in the body at these moments.

The main sign of an atonal state is the appearance of arrhythmia. A person's breathing becomes frequent, intermittent and shallow. Another manifestation of arrhythmia during agony is rare breathing, with prolonged wheezing. At the same time, the dying person's head leans back and his mouth opens wide. It's like he's gasping for air. But in this state, he does not receive the required amount of air, as pulmonary edema appears.

Cardiac activity is suppressed. This is precisely the final moment in agony. In some cases, the heart rate accelerates, blood pressure increases, and the person regains consciousness for a very short period. In these last few seconds, he may still say something. This condition is an indication that resuscitation will be futile.

Another sign of an agonal state is failure of brain function. The subcortex of the brain becomes the regulator of all systems. At these moments, the body works at a primitive level, this determines the state of breathing and heart function during agony.

Other signs

Other signs of agony, depending on the reasons that caused it:

Mechanical asphyxia, in simple words suffocation. In this case, there is a sharp jump in blood pressure with a simultaneous slowing of the heartbeat (bradycardia). In this case, the skin of the upper body becomes bluish, involuntary convulsions occur, the tongue falls out, and involuntary emptying of the bladder and rectum occurs.
Agonal state in heart failure: blood pressure drops sharply, the heart rhythm is disturbed (tachycardia), the pulse weakens, the body becomes completely cyanotic, the face swells, and death throes occur.

State of agony

This human state lasts from several seconds. In some cases, its duration reaches three or more hours. The preagonal state of a person can last up to several days. During this period, a person may fall into a coma. The transition from the preagonal state to agony is called the terminal pause. Its duration ranges from a few seconds to two to four minutes.

Sometimes during agony a person, fighting for life, regains consciousness. As described above, control of body functions moves from the higher parts of the central nervous system to the secondary ones. At this moment, the body actively tries to maintain life, mobilizing its remaining strength. But this happens for a very short period of time, after which death occurs.

First symptoms

How does the agony begin? A person's breathing changes. Becomes intermittent. As the brain shuts down, breathing movements become more frequent and inhalations become deeper. The agony doesn't last long. This is a short-term process. At the end of the agony, breathing stops, then the heart, then the brain. The agony ends with a complete stop of the activity of the brain, breathing and heart.

Clinical death

After the agony, clinical death occurs. So to speak, a “bridge” between life and death. Metabolic processes in the body still function at a primitive level. Clinical death can be reversible. With timely medical intervention, there is a chance to bring a person back to life. Resuscitation carried out over the next 5-7 minutes makes it possible to start the heart, thereby ensuring blood flow to the brain tissue. Brain tissue that does not receive oxygen from the bloodstream dies within two to three minutes. If resuscitation is unsuccessful, biological death occurs and the person dies. The pathologist records the time of death.

In some cases, death occurs instantly, without agony. This happens when receiving severe and extensive injuries to the skull, when the body is instantly dismembered in accidents, during anaphylactic shock, and in some cardiovascular diseases. A blood clot that breaks away from the wall of a vessel can block a vein or artery. In this case, death occurs instantly. A rupture of a blood vessel in the brain or heart can also lead to rapid death.

The medical term “imaginary death” is when all processes in a person are so weakly expressed that he is mistaken for dead. Breathing and heartbeat are not particularly pronounced. This happens with some types of diseases. At some points, it can be difficult to determine whether a person has died or is still alive. Only a medical professional pronounces death. A person in this condition must be given first aid as quickly as possible to avoid clinical death.

So what is agony? This short-term process can be described as a struggle for life.

How to relieve a person's agony

Modern medicine can alleviate human suffering with the help of medications. Many patients, in order to avoid the death throes, agree to euthanasia. This issue is quite controversial and sensitive. Some people cannot give up moral principles, while others are not allowed to do so by religion. Making such a choice is extremely difficult.

During agony, a person completely loses control over his own body. It is the fear of death throes that pushes people to such a decision. When taking it, a person must be fully conscious.

Life after death

There are many known facts about people returning “from the other world.” That is, they returned to life after suffering clinical death.

Quite often, after this, people’s lives change dramatically. Sometimes they acquire unusual abilities. For example, it could be clairvoyance. Also sometimes the ability to treat various ailments appears.

The opinions of scientists differ in many respects, but some still believe that this is possible.

Conclusion

Now you know what agony is and what its symptoms are. We hope that this information was interesting and useful to you.

A person's life journey ends with his death. You need to be prepared for this, especially if there is a bedridden patient in the family. The signs before death will be different for each person. However, observational practice shows that it is still possible to identify a number of general symptoms that portend the approach of death. What are these signs and what should you prepare for?

How does a dying person feel?

A bedridden patient usually experiences mental anguish before death. In a sane mind there is an understanding of what is to be experienced. The body undergoes certain physical changes, this cannot be ignored. On the other hand, the emotional background also changes: mood, mental and psychological balance.

Some people lose interest in life, others completely withdraw into themselves, and others may fall into a state of psychosis. Sooner or later, the condition worsens, the person feels that he is losing his own dignity, more often thinks about a quick and easy death, and asks for euthanasia. These changes are difficult to observe and remain indifferent. But you will have to come to terms with this or try to alleviate the situation with medications.

As death approaches, the patient sleeps more and more, showing apathy towards the world around him. In the last moments, a sharp improvement in the condition may occur, reaching the point that the patient, who has been lying down for a long time, is eager to get out of bed. This phase is replaced by subsequent relaxation of the body with an irreversible decrease in the activity of all body systems and the attenuation of its vital functions.

Bedridden patient: ten signs that death is near

At the end of the life cycle, an elderly person or a bedridden patient increasingly feels weak and tired due to lack of energy. As a result, he is increasingly in a state of sleep. It can be deep or a slumber through which voices are heard and the surrounding reality is perceived.

A dying person can see, hear, feel and perceive things and sounds that do not actually exist. In order not to upset the patient, you should not deny this. Loss of orientation is also possible and the Patient becomes more and more immersed in himself and loses interest in the reality around him.

Due to kidney failure, urine darkens to an almost brown color with a reddish tint. As a result, swelling appears. The patient's breathing quickens, it becomes intermittent and unstable.

Under pale skin, as a result of impaired blood circulation, dark “walking” venous spots appear that change location. They usually appear first on the feet. In the last moments, the limbs of a dying person become cold due to the fact that the blood, flowing from them, is redirected to more important parts of the body.

Failure of life support systems

There are primary signs that appear at the initial stage in the body of a dying person, and secondary signs that indicate the development of irreversible processes. Symptoms may be external or hidden.

Gastrointestinal tract disorders

How does a bedridden patient react to this? Signs before death associated with loss of appetite and changes in the nature and amount of food consumed, manifested by problems with stool. Most often, constipation develops against this background. Without a laxative or an enema, it becomes increasingly difficult for a patient to have bowel movements.

Patients spend the last days of their lives completely refusing food and water. Don't worry too much about this. It is believed that when dehydrated, the body increases the synthesis of endorphins and anesthetics, which to some extent improve overall well-being.

Functional disorders

How does the condition of patients change and how does a bedridden patient react to this? Signs before death associated with weakening of the sphincters in the last few hours of a person's life include fecal and urinary incontinence. In such cases, you must be prepared to provide him with hygienic conditions by using absorbent linen, diapers or nappies.

Even with an appetite, there are situations when the patient loses the ability to swallow food, and soon water and saliva. This may lead to aspiration.

With severe exhaustion, when the eyeballs are severely sunken, the patient is unable to completely close the eyelids. This has a depressing effect on those around you. If the eyes are constantly open, the conjunctiva must be moistened with special ointments or saline.

and thermoregulation

What are the symptoms of these changes if the patient is bedridden? Signs before death in a weakened person in an unconscious state are manifested by terminal tachypnea - death rattles are heard against the background of frequent respiratory movements. This is due to the movement of mucous secretion in the large bronchi, trachea and pharynx. This condition is quite normal for a dying person and does not cause him suffering. If it is possible to place the patient on his side, wheezing will be less pronounced.

The beginning of the death of the part of the brain responsible for thermoregulation is manifested by jumps in the patient’s body temperature in the critical range. He may feel hot flashes and sudden cold. The limbs are cold, the sweating skin changes color.

Road to death

Most patients die quietly: gradually losing consciousness, in their sleep, or falling into a coma. Sometimes in such situations they say that the patient passed away along the “usual path.” It is generally accepted that in this case, irreversible neurological processes occur without significant deviations.

A different picture is observed with agonal delirium. In this case, the patient’s movement towards death will take place along a “difficult road”. Signs before death in a bedridden patient who has taken this path: psychosis with excessive excitement, anxiety, disorientation in space and time against a background of confusion. If there is a clear inversion of the cycles of wakefulness and sleep, then for the patient’s family and relatives this condition can be extremely difficult.

Delirium with agitation is complicated by a feeling of anxiety, fear, often turning into a need to go somewhere or run. Sometimes this is speech anxiety, manifested by an unconscious flow of words. A patient in this state can only perform simple actions, without fully understanding what he is doing, how and why. The ability to reason logically is impossible for him. These phenomena are reversible if the cause of such changes is identified in time and treated with medication.

Painful sensations

Before death, what symptoms and signs in a bedridden patient indicate physical suffering?

In general, uncontrollable pain rarely worsens in the last hours of a dying person's life. However, it is still possible. An unconscious patient will not be able to let you know about this. Nevertheless, it is believed that pain even in such cases causes excruciating suffering. A sign of this is usually a tense forehead and deep wrinkles appearing on it.

If, when examining an unconscious patient, there is evidence of developing pain, the doctor usually prescribes opiates. You should be careful, as they can accumulate and over time aggravate an already serious condition due to the development of excessive overexcitation and convulsions.

Giving help

A bedridden patient may experience significant suffering before death. Relief of symptoms of physiological pain can be achieved with drug therapy. Mental suffering and psychological discomfort of the patient, as a rule, become a problem for relatives and close family members of the dying person.

An experienced doctor, at the stage of assessing the general condition of the patient, can recognize the initial symptoms of irreversible pathological changes in cognitive processes. This is primarily: absent-mindedness, perception and understanding of reality, adequacy of thinking when making decisions. You can also notice disturbances in the affective function of consciousness: emotional and sensory perception, attitude to life, the relationship of the individual with society.

The choice of methods to relieve suffering, the process of assessing the chances and possible outcomes in the presence of the patient, in some cases can itself serve as a therapeutic tool. This approach gives the patient a chance to really realize that he is sympathized with, but is perceived as a capable person with the right to vote and choose possible ways to resolve the situation.

In some cases, a day or two before the expected death, it makes sense to stop taking certain medications: diuretics, antibiotics, vitamins, laxatives, hormonal and hypertensive drugs. They will only aggravate the suffering and cause inconvenience to the patient. Painkillers, anticonvulsants, antiemetics, and tranquilizers should be left.

Communication with a dying person

How should relatives who have a bedridden patient behave?

Signs of approaching death can be obvious or conditional. If there is the slightest prerequisite for a negative forecast, you should prepare in advance for the worst. By listening, asking, trying to understand the patient's nonverbal language, you can determine the moment when changes in his emotional and physiological state indicate the imminent approach of death.

Whether the dying person knows about it is not so important. If he realizes and perceives, it makes the situation easier. You should not give false promises and vain hopes about his recovery. It is necessary to make it clear that his last will will be fulfilled.

The patient should not remain isolated from active cases. It’s bad if there is a feeling that something is being hidden from him. If a person wants to talk about the last moments of his life, then it is better to do it calmly than to hush up the topic or accuse him of stupid thoughts. A dying person wants to understand that he will not be alone, that they will take care of him, that suffering will not affect him.

At the same time, relatives and friends need to be prepared to show patience and provide all possible assistance. It is also important to listen, let them talk, and offer words of comfort.

Doctor's assessment

Is it necessary to tell the whole truth to relatives whose family has a bedridden patient before death? What are the signs of this condition?

There are situations when the family of a terminally ill patient, being unaware of his condition, literally spends their last savings in the hope of changing the situation. But even the best and most optimistic treatment plan may not produce results. It may happen that the patient will never get back on his feet or return to an active life. All efforts will be in vain, expenses will be useless.

Relatives and friends of the patient, in order to provide care in the hope of a speedy recovery, quit their jobs and lose their source of income. Trying to alleviate the suffering, they put the family in a difficult financial situation. Relationship problems arise, unresolved conflicts due to lack of funds, legal issues - all this only aggravates the situation.

Knowing the symptoms of inevitably approaching death, seeing irreversible signs of physiological changes, an experienced doctor is obliged to inform the patient’s family about this. Aware, understanding the inevitability of the outcome, they will be able to focus on providing him with psychological and spiritual support.

Palliative care

Do relatives whose family has a bedridden patient need help before death? What patient symptoms and signs indicate that she should be seen?

Palliative care for a patient is not aimed at prolonging or shortening his life. Its principles include the affirmation of the concept of death as a natural and natural process in the life cycle of any person. However, for patients with an incurable disease, especially in its progressive stage, when all treatment options have been exhausted, the question of medical and social assistance is raised.

First of all, you need to apply for it when the patient no longer has the opportunity to lead an active lifestyle or there are no conditions in the family to ensure this. In this case, attention is paid to alleviating the suffering of the patient. At this stage, not only the medical component is important, but also social adaptation, psychological balance, peace of mind of the patient and his family.

A dying patient needs not only attention, care and normal living conditions. Psychological relief is also important for him, the relief of experiences associated, on the one hand, with the inability to independently care, and on the other, with the awareness of the fact of his inevitably approaching imminent death. Trained nurses are skilled in the art of alleviating such suffering and can provide significant assistance to terminally ill people.

Predictors of death according to scientists

What should relatives who have a bedridden patient expect?

Symptoms of the approaching death of a person “eaten” by a cancerous tumor were documented by the staff of palliative care clinics. According to observations, not all patients showed obvious changes in their physiological state. A third of them did not show symptoms or their recognition was conditional.

But in most terminally ill patients, three days before death, a noticeable decrease in response to verbal stimulation could be noted. They did not respond to simple gestures and did not recognize the facial expressions of the personnel communicating with them. The “smile line” in such patients was lowered, and an unusual sound of the voice was observed (groaning of the ligaments).

In addition, some patients had hyperextension of the neck muscles (increased relaxation and mobility of the vertebrae), non-reactive pupils were observed, and patients could not close their eyelids tightly. Of the obvious functional disorders, bleeding was diagnosed in the gastrointestinal tract (in the upper sections).

According to scientists, the presence of half or more of these signs may most likely indicate an unfavorable prognosis for the patient and his sudden death.

Signs and folk beliefs

In the old days, our ancestors paid attention to the behavior of a dying person before death. The symptoms (signs) of a bedridden patient could predict not only his death, but also the future wealth of his family. So, if in the last moments a dying person asked for food (milk, honey, butter) and relatives gave it, then this could affect the future of the family. There was a belief that the deceased could take wealth and good luck with him.

It was necessary to prepare for imminent death if the patient shuddered violently for no apparent reason. It was believed that she looked into his eyes. Also a sign of imminent death was a cold and pointed nose. It was believed that it was death that held the candidate in the last days before his death.

The ancestors were convinced that if a person turns away from the light and most of the time lies facing the wall, he is on the threshold of another world. If he suddenly felt relief and asked to be moved to his left side, then this is a sure sign of imminent death. Such a person will die without pain if the windows and doors in the room are opened.

Bedridden patient: how to recognize the signs of impending death?

Relatives of a dying patient at home should be aware of what they may encounter in the last days, hours, moments of his life. It is impossible to accurately predict the moment of death and how everything will happen. Not all of the symptoms and signs described above may be present before the death of a bedridden patient.

The stages of dying, like the processes of the birth of life, are individual. No matter how hard it is for relatives, you need to remember that it’s even harder for a dying person. Close people need to be patient and provide the dying person with the best possible conditions, moral support and attention and care. Death is an inevitable outcome of the life cycle, and this cannot be changed.

It is not customary to talk about death out loud in our time. This is a very sensitive topic and not for the faint of heart. But there are times when knowledge is very useful, especially if there is a cancer patient or a bedridden elderly person at home. After all, this helps to mentally prepare for the inevitable end and notice the changes taking place in time. Let's discuss together the signs of death of a patient and pay attention to their key features.
Most often, signs of imminent death are classified into primary and secondary. Some develop as a consequence of others. It is logical that if a person begins to sleep more, then he eats less, etc. We will look at all of them. But, cases may be different and exceptions to the rules are acceptable. The same as options for a normal median survival rate, even with a symbiosis of terrible signs of a change in the patient’s condition. This is a kind of miracle that happens at least once in a century.

Changing sleep and wake patterns
Discussing the initial signs of approaching death, doctors agree that the patient has less and less time to stay awake. He is more often immersed in superficial sleep and seems to be dozing. This saves precious energy and reduces pain. The latter fades into the background, becoming, as it were, background. Of course, the emotional side suffers greatly. The paucity of expression of one’s feelings, the self-isolation of the desire to remain silent more than to speak leave an imprint on relationships with others. The desire to ask and answer any questions, to be interested in everyday life and the people around you disappears.
As a result, in advanced cases, patients become apathetic and detached. They sleep almost 20 hours a day unless there is acute pain or serious irritating factors. Unfortunately, such an imbalance threatens stagnant processes, mental problems and accelerates death.

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Swelling

Edema appears on the lower extremities

Very reliable signs of death are swelling and spots on the legs and arms. We are talking about malfunctions in the kidneys and circulatory system. In the first case of oncology, the kidneys do not have time to cope with toxins and they poison the body. In this case, metabolic processes are disrupted, blood is redistributed unevenly in the vessels, forming areas with spots. It is not for nothing that they say that if such marks appear, then we are talking about complete dysfunction of the limbs.

Problems with hearing, vision, perception

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The first signs of death are changes in hearing, vision and normal sensation of what is happening around. Such changes can occur against the background of severe pain, cancer, blood stagnation or tissue death. Often, before death, you can observe a phenomenon with the pupils. The eye pressure drops and when pressed you can see how the pupil is deformed like a cat's.
Regarding hearing, everything is relative. It can recover in the last days of life or even worsen, but this is more agony.

Reduced need for food

Deterioration of appetite and sensitivity are signs of imminent death

When a cancer patient is at home, all her loved ones note the signs of death. She gradually refuses food. First, the dose decreases from a plate to a quarter of a saucer, and then the swallowing reflex gradually disappears. There is a need for nutrition through a syringe or tube. In half of the cases, a system with glucose and vitamin therapy is connected. But the effectiveness of such support is very low. The body tries to use up its own fat reserves and minimize waste. This worsens the patient’s general condition, causing drowsiness and difficulty breathing.
Urinary problems and problems with natural needs
It is believed that problems with going to the toilet are also signs of approaching death. No matter how funny it may seem, in reality there is a completely logical chain in this. If defecation is not carried out once every two days or with the regularity to which a person is accustomed, then feces accumulate in the intestines. Even stones can form. As a result, toxins are absorbed from them, which seriously poison the body and reduce its performance.
It's about the same story with urination. It's harder for the kidneys to work. They allow less and less fluid to pass through and eventually the urine comes out saturated. It contains a high concentration of acids and even blood is noted. For relief, a catheter can be installed, but this is not a panacea against the general background of unpleasant consequences for a bedridden patient.

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Problems with thermoregulation

Weakness is a sign of imminent death

Natural signs before the death of a patient are impaired thermoregulation and agony. The limbs begin to get very cold. Especially if the patient has paralysis, then we can even talk about the progress of the disease. The blood circulation decreases. The body fights for life and tries to maintain the functioning of the main organs, thereby depriving the limbs. They may turn pale and even become blue with venous spots.

Weakness of the body

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The signs of imminent death may be different for everyone, depending on the situation. But most often, we are talking about severe weakness, weight loss and general fatigue. A period of self-isolation begins, which is aggravated by internal processes of intoxication and necrosis. The patient cannot even raise his arm or stand on a duck for natural needs. The process of urination and defecation can occur spontaneously and even unconsciously.

Foggy mind

Many see signs of approaching death in the way the patient’s normal reaction to the world around him disappears. He can become aggressive, nervous, or vice versa – very passive. Memory disappears and attacks of fear may occur due to this. The patient does not immediately understand what is happening and who is nearby. The areas of the brain responsible for thinking die off. And obvious inadequacy may appear.

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Predagonia

This is a protective reaction of all vital systems in the body. Often, it is expressed in the onset of stupor or coma. The main role is played by regression of the nervous system, which causes in the future:
- decreased metabolism
- insufficient ventilation of the lungs due to breathing failures or alternating rapid breathing with stopping
- serious damage to organ tissue

Agony

Agony is characteristic of the last minutes of a person’s life

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Agony is usually called a clear improvement in the patient’s condition against the background of destructive processes in the body. Essentially, these are the last efforts to maintain the necessary functions for continued existence. May be noted:
- improved hearing and restored vision
- adjusting breathing rhythm
- normalization of heart contractions
- restoration of consciousness in the patient
- muscle activity like cramps
- decreased sensitivity to pain
The agony can last from several minutes to an hour. Usually, it seems to foreshadow clinical death, when the brain is still alive, and oxygen ceases to flow into the tissues.
These are typical signs of death in bedridden people. But you shouldn’t dwell too much on them. After all, there may be another side of the coin. It happens that one or two such signs are simply a consequence of an illness, but they are completely reversible with proper care. Even a hopelessly bedridden patient may not have all these signs before death. And this is not an indicator. So, it is difficult to talk about mandatory rules, as well as to impose death sentences.

The death of a person is a very sensitive topic for most people, but, unfortunately, each of us has to face it in one way or another. If there are elderly bedridden or cancer-stricken relatives in the family, it is necessary not only for the caregiver to mentally prepare for an imminent loss, but also to know how to help and make the last minutes of a loved one’s life easier.

A person who is bedridden for the rest of his life constantly experiences mental anguish. Being of sound mind, he understands what inconvenience he causes to others, and imagines what he will have to endure. Moreover, such people feel all the changes occurring in their body.

How does a sick person die? To understand that a person has several months/days/hours left to live, you need to know the main signs of death in a bedridden patient.

How to recognize the signs of impending death?

Signs of death of a bedridden patient are divided into initial and investigative. At the same time, some are the cause of others.

Note. Any of the following symptoms may be the result of long-term symptoms and there is a chance of reversing it.

Changing your daily routine

The daily routine of an immobile bedridden patient consists of sleep and wakefulness. The main sign that death is near is that a person is constantly immersed in a superficial sleep, as if dozing. During such a stay, a person feels less physical pain, but his psycho-emotional state seriously changes. The expression of feelings becomes scarce, the patient constantly withdraws into himself and remains silent.

Swelling and changes in skin color

The next reliable sign that death is imminent is the appearance of various spots on the skin. Before death, these signs appear in the body of a dying bedridden patient due to disruption of the functioning of the circulatory system and metabolic processes. Spots occur due to uneven distribution of blood and fluids in the vessels.

Problems with the senses

Elderly people often have problems with vision, hearing and tactile sensations. In bedridden patients, all diseases become aggravated due to constant severe pain, damage to organs and the nervous system, as a result of circulatory disorders.

Signs of death in a bedridden patient manifest themselves not only in psycho-emotional changes, but also the external image of the person certainly changes. You can often observe the so-called “cat's eye”. This phenomenon is associated with a sharp drop in eye pressure.

Loss of appetite

As a result of the fact that a person practically does not move and spends most of the day sleeping, a secondary sign of approaching death appears - the need for food decreases significantly, and the swallowing reflex disappears. In this case, in order to feed the patient, a syringe or probe is used, glucose is used, and a course of vitamins is prescribed. As a result of the fact that a bedridden patient does not eat or drink, the general condition of the body worsens, problems with breathing, the digestive system and “going to the toilet” appear.

Violation of thermoregulation

If the patient experiences a change in the color of the limbs, the appearance of cyanosis and venous spots, death is inevitable. The body uses up its entire energy supply to maintain the functioning of its main organs, reducing blood circulation, which in turn leads to paresis and paralysis.

General weakness

In the last days of life, a bedridden patient does not eat, experiences severe weakness, he cannot move independently or even get up to relieve himself. His body weight decreases sharply. In most cases, bowel movements can occur arbitrarily.

Changes in consciousness and memory problems

If the patient develops:

memory problems;
sudden change in mood;
attacks of aggression;
Depression means damage and death of the areas of the brain responsible for thinking. A person does not react to the people around him and the events taking place, and carries out inappropriate actions.

Predagonia

Predagonia is a manifestation of the body’s defensive reaction in the form of stupor or coma. As a result, metabolism decreases, breathing problems appear, and necrosis of tissues and organs begins.

Agony

Agony is a dying state of the body, a temporary improvement in the physical and psycho-emotional state of the patient, caused by the destruction of all life processes in the body. A bedridden patient before death may notice:

improved hearing and vision;
normalization of respiratory processes and heartbeat;
clear consciousness;
reduction of pain.

Symptoms of clinical and biological death

Clinical death is a reversible process that appears suddenly or after a serious illness and requires urgent medical attention. Signs of clinical death that appear in the first minutes:

If a person is in a coma, attached to a ventilator, and the pupils are dilated due to the action of medications, then clinical death can only be determined by the results of an ECG.

If timely assistance is provided, within the first 5 minutes, you can bring a person back to life. If you provide artificial support for blood circulation and breathing later, you can return the heart rate, but the person will never regain consciousness. This is due to the fact that brain cells die earlier than the neurons responsible for the vital functions of the body.

A dying bedridden patient may not show signs before death, but clinical death will be recorded.

Biological or true death is the irreversible cessation of the functioning of the body. Biological death occurs after clinical death, so all primary symptoms are similar. Secondary symptoms appear within 24 hours:

cooling and numbness of the body;
drying of mucous membranes;
the appearance of cadaveric spots;
tissue decomposition.

Behavior of a dying patient

In the last days of their lives, dying people often remember what they have lived through, telling the most vivid moments of their lives in all the colors and details. Thus, a person wants to leave as much good things about himself as possible in the memory of his loved ones. Positive changes in consciousness lead to the fact that a bedridden person tries to do something, wants to go somewhere, while being indignant that he has very little time left.

Such positive changes in mood are rare; most often, dying people fall into deep depression and become aggressive. Doctors explain that mood changes may be associated with taking strong narcotic painkillers, the rapid development of the disease, the appearance of metastases and horse races.

A bedridden patient before death, being bedridden for a long time, but in a healthy mind, ponders his life and actions, evaluates what he and his loved ones will have to endure. Such reflections lead to changes in the emotional background and mental balance. Some of these people lose interest in what is happening around them and in life in general, others become withdrawn, and still others lose their minds and ability to think sensibly. The constant deterioration of health leads to the fact that the patient constantly thinks about death and asks to alleviate his situation through euthanasia.

How to ease the suffering of a dying person

Bedridden patients, people after injury or those with cancer most often experience severe pain. To block these symptoms, the attending physician prescribes strong painkillers. Many painkillers can only be purchased with a prescription (for example, Morphine). To prevent the development of dependence on these drugs, it is necessary to constantly monitor the patient’s condition and change the dosage or stop taking the drug if an improvement occurs.

How long can a bedridden patient live? No doctor will give an exact answer to this question. A relative or guardian caring for a bedridden patient needs to be with him around the clock. To further and alleviate the suffering of the patient, special means should be used - beds,. To distract the patient, you can place a TV, radio or laptop next to his bed; it is also worth getting a pet (cat, fish).

Most often, relatives, having learned that their relative is in need, refuse him. Such bedridden patients end up in hospitals, where everything falls on the shoulders of the workers of these institutions. Such an attitude towards a dying person not only leads to his apathy, aggression and isolation, but also aggravates his health. In medical institutions and boarding houses, there are certain standards of care, for example, each patient is allocated a certain amount of disposable products (diapers, nappies), and bedridden patients are practically deprived of communication.

When caring for a bedridden relative, it is important to choose an effective method of alleviating suffering, provide him with everything he needs and constantly worry about his well-being. Only in this way can his mental and physical torment be reduced, as well as prepare for his inevitable death. You cannot decide everything for a person; it is important to ask his opinion about what is happening, to provide a choice in certain actions. In some cases, when there are only a few days left to live, it is possible to cancel a number of heavy medications that cause inconvenience to a bedridden patient (antibiotics, diuretics, complex vitamin complexes, and hormonal agents). It is necessary to leave only those medications and tranquilizers that relieve pain and prevent the occurrence of convulsions and vomiting.

Brain reaction before death

In the last hours of a person’s life, his brain activity is disrupted, numerous irreversible changes appear as a result of oxygen starvation, hypoxia and the death of neurons. The person may hallucinate, hear something, or feel as if someone is touching them. Brain processes take a matter of minutes, so the patient often falls into a stupor or loses consciousness in the last hours of life. The so-called “visions” of people before death are often associated with a past life, religion, or unfulfilled dreams. To date, there is no exact scientific answer about the nature of the appearance of such hallucinations.

What are the predictors of death according to scientists?

How does a sick person die? Based on numerous observations of dying patients, scientists have drawn a number of conclusions:

Not all patients experience physiological changes. One in three people who die have no obvious symptoms of death.
60 - 72 hours before death, most patients lose their reaction to verbal stimuli. They do not respond to a smile, do not respond to the guardian’s gestures and facial expressions. There is a change in voice.
Two days before death, there is increased relaxation of the neck muscles, i.e., it is difficult for the patient to keep his head in an elevated position.
Slow, also the patient cannot close his eyelids tightly or squint his eyes.
You can also observe obvious disturbances in the functioning of the gastrointestinal tract, bleeding in its upper sections.

Signs of imminent death in a bedridden patient manifest themselves in different ways. According to the observations of doctors, it is possible to notice obvious manifestations of symptoms in a certain period of time, and at the same time determine the approximate date of death of a person.

	Development time
Changing your daily routine	A few months
Swelling of the limbs	3-4 weeks
Perception disturbance	3-4 weeks
General weakness, refusal to eat	3-4 weeks
Impaired brain activity	10 days
Predagonia	Short-term manifestation
Agony	From a few minutes to an hour
Coma, clinical death	Without assistance, a person dies within 5-7 minutes.

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Agony has polymorphic symptoms, but mainly consists of symptoms of depression of the vital functions of the body due to severe hypoxia. These include: disappearance of pain sensitivity, loss of consciousness, mydriasis, extinction of pupillary, corneal, tendon and skin reflexes. The most important sign of agonal syndrome is the formation of respiratory arrhythmia: Cheyne-Stokes type - intermittent, frequent, superficial or, conversely, Kussmaul type - rare, very deep and noisy with a long period of apnea. The auxiliary muscles of the neck, shoulder girdle, and torso are involved in breathing. With each breath, the head is thrown back, the mouth is wide open, the patient seems to swallow air, but the efficiency of breathing is up to 15% of normal due to terminal pulmonary edema (the surfactant of the alveoli is destroyed, they collapse, switching off from breathing, the capillaries of the lung become empty, switching off from the bloodstream, alveolocapillary shunts open). The exhalation muscles and the diaphragm are switched off from breathing, or their contraction occurs simultaneously with the contraction of the inhalation muscles.

Depression of cardiac activity is the “last chord of life.” After a certain terminal pause, the efficiency of heart contractions increases somewhat, tachycardia appears, blood pressure rises slightly, for a short period, literally to say the last “sorry,” consciousness may even be restored, but this is a bad prognostic sign, indicating that resuscitation will be ineffective.

The third leading sign is the shutdown of the functions of the cerebral cortex (neocortex) and at the same time the excitation of the subcortex and stem structures, i.e. regulation of the functions of other systems switches to a primitive, uncoordinated, vegetative type, which determines the state of breathing and cardiac activity during the period of agony.

Additional manifestations depend on the cause that caused the agony. When dying from traumatic shock and blood loss: the skin and mucous membranes are waxy-pale, the nose becomes pointed, the cornea of the eyes loses transparency, the pupils dilate sharply, with hypotension there is pronounced tachycardia with a slow decline in cardiac activity.

With mechanical asphyxia, initially, blood pressure rises sharply with simultaneous bradycardia and extrasystole, the skin of the upper half of the body is sharply cyanotic, convulsions, involuntary movements, prolapse of the tongue, paralysis of the sphincters of the urethra and rectum.

When dying from heart failure: blood pressure progressively drops and tachycardia increases with a weakened pulse, severe cyanosis of the whole body, the face becomes puffy, and convulsions are possible.

In extreme situations, agony is an indication for stopping resuscitation; in cases of natural dying, resuscitation is not indicated at all.