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The unfamiliar is often very scary, so understanding what may happen can help ease the fear and anxiety of the dying person, family and caregivers. In general, as a person gets closer to death, their body functions start to slow down.


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Breathing changes as death approaches. It may slow down or become quick and shallow.

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Sometimes breathing may stop for several seconds at a time and then start again. An irregular breathing pattern, called Cheyne-Stokes respirations, is common in people who are dying. In this pattern, breathing is very deep and rapid, followed by short breaths, and then a period of not breathing. This noise can be very upsetting to family members and visitors, but the person is usually not aware of the sound. The following can sometimes make breathing easier: Lying on the side or having pillows under the head and behind the back may help. Oxygen therapy may help some people.

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A humidifier may make breathing more comfortable. Medicines may be used to reduce the amount of mucus. The healthcare team may use suction to remove the excess mucus. As people get closer to dying, they may sleep more, become drowsy or be difficult to wake. They may fall asleep while talking. A person may slowly lose consciousness in the days or hours before death. Visiting may be tiring and difficult for the dying person. Plan visits and activities for times when the person is awake and more alert. Keep visits short and have fewer people visit at a time.

Scheduling visits may help everyone get time with the person. Be aware that it may be hard for the person to socialize or stay awake. Sometimes a person may withdraw or be less social because they are mentally preparing for death. Let them know that this is okay. Speak directly to them.

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You can also touch them lightly when speaking to them. Talk about topics that might be upsetting outside of their room. Sometimes, a person who is dying may become restless, anxious or confused. This confusion and disorientation is also called delirium. People with delirium may not know loved ones or friends, what day or time it is, or where they are. They may try to get out of bed or shift around in bed more. They may turn their sleeping cycle around so that they sleep during the day and are awake at night. A person with delirium may make jerking movements with their legs and arms, which they cannot control.

They may also lose control of their bladder or bowels. Delirium has many possible causes, including drugs, disease, brain metastases, changes in metabolism and infections.

Delirium can develop quickly over a number of hours or days. If the underlying cause of the delirium can be found, the healthcare team will treat it. Delirium can upset family members and caregivers, especially if the loved one becomes aggressive or unkind. Following these tips can help keep the person calm and safe. Be calm and reassuring. Speak slowly and quietly. Gently remind them of the time, place and who people are. Leaving a clock and a calendar that can be seen nearby may help.

Provide comfort by gently touching or stroking the person. Put your hands on your hips or raise them up.

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Having arms in two different positions while looking is also helpful. Changes to the nipple and the surrounding area: Bleeding from the nipple may be limited and difficult to see, but if you notice blood stains on your bra, pay attention. Alvarez cautions women not to panic if they notice clear or milky secretions, since these may result from normal physiologic changes during pre-pubertal stages.

But if the secretions are unusual, bloody or continuous, he recommends speaking to your health care provider. Known in the medical community as peau d'orange a French term meaning skin of an orange , any dimpling or thickening of breast skin that resembles an orange rind is a red flag. These symptoms are often associated with inflammatory breast cancer IBC , a rare but aggressive disease that usually does not involve a lump and may not be detected by a mammogram.

IBC symptoms are caused by cancer cells blocking lymph vessels in the skin. If the breast skin changes color, typically to a pink or reddish hue that covers more than half the breast, that may also be cause for concern. This type of cancer grows very fast, and patients often experience pain.

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Sometimes a patient may experience only one or two skin changes and sometimes all four. Sometimes changes are localized in the breast, upper abdomen and posterior rear part of the chest. Though IBC represents percent of all breast cancers, Dr. Alvarez says it accounts for 10 to 15 percent of all breast cancer deaths. The majority of time, these skin changes occur in less than six months. Most of our patients woke up one morning and found the changes. A non-healing sore anywhere on the breast, including the nipple: