Dear Barbara, I would like to know why the breathing pattern is different at
end of life. My Mother had fast and labored respirations. She did have
COPD, but my Dad had the same breathing pattern and he did not die from
COPD. This was very disturbing to me. Are they suffering when breathing
like that?
The irregular, difficult breathing that occurs at end of life frightens most
people. As we watch we feel something bad is happening. Our loved one is
hurting, struggling, suffering, and of course this is disturbing to us.
In the hours to minutes, sometimes even days, before death, a person’s
breathing changes. First it becomes fast, often with congestion, and then
gradually the breaths becomes slower and slower. As breathing slows (ten
times, or even six times, a minute) the person actually breaths like a fish,
with their mouth opening and closing. This can be frightening if you don’t
know that it’s normal.
The congestion that occurs before death will depend upon how hydrated or
dehydrated a person is. The more fluids in their body, the more congestion.
Sometimes changing their position (laying them on their side) will help to
redistribute the fluid, and the breathing will sound quieter. Suctioning the
fluid generally does not eliminate it. The bottom line is that congestion and
difficult breathing are a part of the normal dying process.
Is the person suffering? I think not, although it appears that they are. By the
time they are hours from death their awareness of what is going on around
them and of their body has diminished. What I envision is the little chick
working hard to get out of its shell. In the hours before death from disease
our body is shutting down. It is laboring to release itself from this planet. It
is a struggle, just as the chick is struggling, but I don’t think either the
person or the chick are suffering.
Something more about Laboring to Leave:
Difficult breathing during the natural dying process is only one of the many changes that we will witness when a person is dying. It's comforting to know what to expect during that process. Gone From My Sight (The Little Blue Book) is a "road map" of what will occur during the dying process. The Eleventh Hour is the companion book and is more specific about the changes in the last days, hours, minutes, seconds and just after death. These two books, along with your nursing staff, will provide knowledge so that you can better support the one who is laboring to leave.
27 comments
Hi Joanne, I am sorry you are having a hard time understanding you aunt’s last minutes of life. From what you described she did a good job of getting out of her body, nothing abnormal or pathological happened. Her eyes, her breathing, all the normal part of dying. I do believe she was at peace and nothing bad was happening as she died.
I am not versed in the bible and it’s teaching about dying, death and end of the world prophecies. What I do believe, from my many experiences with people as they die, is that our loved ones who have died before us come to help us get from this world to the next, that we do not die alone. I believe it is our own fears that tend to haunt us, make us uncomfortable, and create any negativity that might be present as we die, not God. My blessings are with you. Barbara
My Aunt, (I was very close to her) passed away this past June… I have been grieving to no end in sight… I keep thinking while watching her trying to breathe, the patterns were very inconsistent which I hear is normal.. She had jaundice from breast to bone metastatic cancer… I can’t seem to let go of the fact that her hand was dropped at the side of her hospital bed and it looked swollen and very pale yellowish in color (after she had taken her last breath ) but before that final moment she turned her head to me on the side which I was standing with one of her eyes slightly opened.. it really upset me (so I gently closed it) I was watching her neck, and yes, it did remind of a fish gasping for air.. Our Susie then turned the other way and I could not see her face.. I keep praying that she was passing on over to Heaven (as like, when I was put to sleep in surgery).. Please help me try to believe she was at peace with her Angel, loved ones or most importantly our Lord Jesus Christ and He was lifting her away from her body.. gently and lovingly, carrying her up to Heaven.
I am a Christian and want to believe that she died peacefully, whatever that means.. (I have been put under for a few surgeries) in my life time.. and it was fine.. I woke up gradually hearing people faintly like they gradually spoke in and out… I never experienced any pain.. just a somehow blissful sleep…
I feel so guilty about my fear of the unknown. What about these near death experiences.. I have heard positive and negative things .. that it is the enemie’s (Satanic beings) and not really our loved ones who have passed? I know when the time comes for me to die is the true and only way when I will know.. What about my dreams, I wish I could speak to her and other loved ones and hear them too, speak and see them.. I also, fear what seems to me, another contradiction of " The dead no nothing until the Lord comes back to this planet" and it also freaks me out when I hear (first Christian will rise from their graves).. to me, that sounds like some kind of horror movie of Zombies which I was so petrified as a child and even now.. Wasn’t Christ buried in a tomb? Please help me to try and understand or make some kind of sense of this..
Hi Barbara,
Thank you so much for your reply. Yesterday I purchased your 4 booklets (in English) on my Kindle. If only I could have read them before seeing my father die. You explain things so well. I feel that it helped me make “ the closure”. Some people doesn’t feel the need to know what happened but I did. Now most of my questions are answered and I know that he made a good job to find his path to death.
Your booklets should be available in hospital in France for friends and family. Understanding death help you to understand life a little bit more. Being there when my father passed away was a special moment. Hard to watch but i know that he felt our love . In your book you talk about how protective a dying person can be with the loved one.
The night my father was passing away we were there with my mother, my older sister, me (I’m 33) and my little sister (23).
One hour before he died my mother felt that she had to bring back my little sister home. Even though my father was unconscious she felt that he wanted her away. She said to my father “I bring back the little one. Wait for me I come back”.
She left for 1 hour. My father was breathing very fast and his heart was pumping. He was fighting very hard.
When she came back, 5 minutes later he decided to leave.
I think he didn’t want my little sister to be there for his final moment but he wanted his wife more than anything else.
Thank you again for your words and your books. It helps so much.
Take care.
Laura
Hi Laura, about your father’s last moments, from what you describe he did a very good job of getting out of his body. Nothing abnormal or pathological happened. You described perfectly the way people die. Now to address your specific questions: the fish breathing, most people in the hours to minutes before death breathe just like a fish. You used the exact words I use to describe how a person breathes. There is often a facial expression change followed by a couple of long spaced out breaths—just what your dad did. What was he experiencing? I believe he could hear you and was slightly aware (even with dementia) of you being there but all was perceived as if from afar, like when you just wake up from a dream and aren’t fully awake. He could hear you and was aware, though dimly, of your love and the music. It is important to know that dying is not painful, disease causes pain. Dying just looks painful to us the watchers. Think of the little chick that works to get out of its shell. Your father was working to get out of his shell of a body. You might find my booklets Gone From My Sight (I have it in French) and The Eleventh Hour helpful in understanding those last few months, weeks, days and hours. My blessings are with you.
Hi Barbara. I came across your blog and what I read here helped me to understand better the process of dying but I still have some questions. I’m a French native speaker so I apologize if I make some grammatical mistakes.
My father died 4 months ago at the age of 65. He had been in a psychiatric hospital for 6 month. He suffered from vascular dementia and a very bad and irregular type 1 diabetes. His dementia made is diabetes go very low and sometimes so high that even the blood sugar reader couldn’t say how much sugar he had in his blood. Finally after a very serious hypoglycemia he caught a pneumonia that his body and his mind couldn’t fight anymore.
6 weeks after the beginning of his pneumonia his saturation / oxygen level suddenly dropped.
The medical team, in accordance with us, had the help of a palliative team few days before his death to give him confort. Oxygen through the nose and morphin patches.
They call us at 2 pm on Friday saying that he was living is final hours. He was already unconscious and didn’t move, blink of anything. He only had a rapid labored breathing that kept intensifying during the night. It was hard to watch but his facial expression didn’t move. We touched him. Talked to him. Played his favorite music. Dimmed the lights. At 3am55 on Saturday morning his chest suddenly dropped. He had 3 or 5 last exhalation with like 20-30 seconds in between. Like a fish looking for air. His eyes opened a little bit during these last breaths. Suddenly his skin turned white and everything stopped. We knew he was gone.
I wish we could have been more informed and prepared because I’m still having flashes of these final moments. The unit where he died wasn’t totally equipped to deal with dying people but they did their best.
I keep wondering : did he suffered during his last hours of agony ? The fact that he was already non conscious makes me think that in a way he was already part gone. Half between life and death.
What are the last “fish like” breathing ?
Air expelled from the lungs ?
I hope he heard that we we surrounded him with love.
We kept holding his hand. He was very warm. At the moment we both let his hands for a minute his chest collapsed.
His dementia has been very painful to watch and in a way we know that he his in a better place know.
Thank you in advance for your information.
Have a lovely day
Laura
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