Physical Manifestations at End of Life

• July 8, 2020
• Tony Guo
• no comments

Physical Manifestations at End of Life

• Metabolism is decreased
• Body gradually slows down until all function ends
• Respiration generally ceases first
  • Heart stops beating within a few minutes

• Respiratory System
  • Cheyne-Stokes respiration (pattern of breathing characterized by alternating periods of apnea and deep, rapid breathing.)
  • Inability to cough or clear secretions
    • Grunting, gurgling, or noisy congested breathing (“death rattle”)
  • Irregular breathing that gradually slows down to terminal gasps

• Sensory System- Hearing and Touch
  • Hearing is usually last sense to disappear
  • Decreased sensation
  • Decreased perception of pain and touch

• Sensory System – Taste, Smell, and Sight
  • Blurring of vision
  • Blink reflex absent
  • Patient appears to stare
  • Eyelids remain half-open
  • Decreased sense of taste and smell

• Integumentary System
  • Mottling on hands, feet, arms, and legs
  • Cold, clammy skin
  • Cyanosis of nose, nail beds, knees
  • “Wax-like” skin when very near death

• Urinary System
  • Gradual decrease in urinary output
  • Incontinent of urine
  • Unable to urinate

• Gastrointestinal System
  • Slowing of digestive tract and possible cessation of function
  • Accumulation of gas
  • Distention and nausea
  • Loss of sphincter control
  • Bowel movement may occur before imminent death or at the time of death

• Musculoskeletal System
  • Gradual loss of ability to move
    • Trouble holding body posture and alignment
  • Loss of facial muscle tone
    • Sagging of jaw
    • Difficulty speaking
    • Loss of gag reflex
    • Swallowing can become more difficult

• Cardiovascular System
  • Increased heart rate; Later slowing and weakening of pulse
  • Irregular rhythm
  • Decreased BP
  • Delayed absorption of IM or SQ drugs