Maria Sinfield, an end-of-life nurse from Lancashire (pictured) has worked for end-of-life charity Marie Curie for ten years
Death is the inevitable consequence of life that we will all face at some point.
But what is dying like? And what do those on the brink say or do in their final moments?
Here, hospice nurse Maria Sinfield shares with MailOnline what happens to your body as death approaches, as well as the most common things people say and do towards the end.
The Lancashire nurse has worked for end-of-life charity Marie Curie for ten years and has seen first-hand what patients experience in their final days.
She says patients may become confused, hallucinate and even call out to loved ones who have already passed away as they die.
Ms Sinfield, 64, also said families can find the last days of their loved ones’ lives “frightening” as they see their bodies being sluggish and eating less.
She says it’s crucial to remember that everyone’s end-of-life experiences can be different.
However, Ms Sinfield added that while thinking about death can be difficult, understanding what to expect can make it easier for the family.
End-of-life nurse explains that patients can become confused, hallucinate and call out to loved ones who have already passed away
When you die, your vital organs stop working, your brain and heart stop working, and you stop breathing.
But in many cases this is not sudden and during the dying process the body begins to slow down as vital systems begin to weaken.
This can cause a person to lose consciousness and experience changes in their behavior that can upset their loved ones, Ms Sinfield explains.
‘You gradually see that someone really slows down in the last few weeks and days and gets tired quickly. Families may notice that the person is sleeping more,” she says.
She explains that many people near the end of their lives need to rebuild their energy to perform even basic tasks, such as having a conversation or eating a meal.
Ms Sinfield says the latter is often a major ‘concern’ for families, but explains this is normal.
“Often the person doesn’t expend as much energy, isn’t as active, and so needs less food and drink,” she says.
She adds that as a person’s body begins to slow down, he or she may also have difficulty regulating their temperature and may feel unusually hot and cold as their blood circulation begins to slow.
“It’s important to just take into account that individual person and how he or she is feeling at that moment,” says Ms Sinfield.
As a patient reaches the last few hours of life, Ms Sinfield explains that their breathing pattern changes subtly: it becomes slower and more shallow.
The breathing changes can be so small and gentle that the family may not notice that the patient has stopped breathing for extended periods, she says.
“Sometimes, if breathing changes and the person has lost consciousness and can no longer talk to the family, he or she is unable to clear the secretions in the mouth or throat,” she says.
This can cause a ‘rattling sound’ or a ‘secretion sound’, which can be ‘very disturbing’ to hear.
“That doesn’t cause distress or pain to the person dying,” says Ms Sinfield, adding that changing the person’s position can help.
Although death is a natural phenomenon, Ms Sinfield says many people find the concept and process scary.
However, she does not shy away from talking about it openly and avoids using euphemisms such as ‘wiping out’.
Instead, she believes that as a nurse she has a responsibility to be “honest.”
‘I talk very openly with families about what they can expect when their loved ones die. I use that language too,” she says.
“Families often want to protect their loved ones from death because they are afraid.”
But it’s not just families who have to come to terms with death.
Many people feel at the end of their lives that they need to see people or make amends, Ms Sinfield says.
“Some people accept dying, but other people may not,” she says.
“Some people have things they want to do or say that they haven’t done yet.
“I remember one particular patient who was upset because they had to talk to a family member they hadn’t talked to in a while, but we were able to get that family member to them.
“They were really upset before that and seeing the family member really made a difference, just to know that person was there.”
She has also witnessed cases, even in her own family, of people calling out to deceased loved ones as if they were in the room with them.
“From a very personal point of view, I was with my father when he died and he called out for his mother and father as if they were there,” she says.
‘He wasn’t confused or anything, he was in the last hours of his life and was unconscious all the time.
“It was nice to have a family member sitting with him, I felt like he would be safe and secure.”
In some cases, patients may feel ‘restless’ and confused, but putting that person at ease and offering support can help, Ms Sinfield explains.
“Symptom management is critical in end-of-life care to ensure the person feels comfortable without being overly sedated,” she says.
“There’s a real balance to making sure we’re giving that person the best quality of life they can possibly have.”
In addition to medication, this care often also includes emotional support.
Ms Sinfield says some people can naturally feel ‘saddened’ as death approaches.
But she notes that in many cases the patient just needs someone to talk to.
Mrs. Sinfield recalls an instance in which a dying man was worried about his wife and all he “needed was just someone to listen to him and talk to him, and not be afraid to do that.”
She adds that some people experience confusion at the end of their lives, and this can take the form of sudden onset hallucinations.
“Sometimes confusion can arise when someone has been deeply asleep,” she says.
“In those last few hours, that person could have lost consciousness and then woken up because that’s what happens naturally, and then woke up in what seems like a strange environment.”
Marie Curie is free supporting line is available to anyone with an illness that is likely to kill them and to those close to them.
It provides practical and emotional support with everything from symptom management and daily care to financial information and bereavement support.