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Denys Cope RN, BSN, MSS
Ask the Expert Nurse and End of Life Coach

February 2nd, 2008
How do I know if my loved one is close to the end of their life?

Dying is a natural process with predictable stages. Once you are familiar with the identifiable stages you will know that changes in the breathing pattern mark progress from one stage to another. Usually the breath is regular, as your loved one grows weaker and weaker, but are not in the “labor” or “active dying” stage.

When the breath changes and there are recognizable periods of apnea, or pauses in the breathing, this usually means your loved one is within a week or so of dying, and is now considered “actively dying.”
This apnic breathing pattern is a phase, it is not when they will stop breathing. This pattern can go for several days. Eventually the breath will become regular at the very end, and become slower and shallower. The actual time of death is usually very, very peaceful.
Predicting how close a person actually is to dying is very difficult. While there are identifiable stages, much like labor during birth, the labor at the end of life can go very quickly or be prolonged, and anything in between. There is an element of mystery to it all, and we, as the witnesses, are called to live moment to moment, as much as we want a definite timeline.

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