A medic specialising in end of life care has revealed exactly what happens to the body in the hours, minutes and seconds leading up to death.
Dr Kathryn Mannix, a consultant in palliative medicine at Newcastle Hospitals NHS Trust, has described a fascinating cascade of ‘shutdowns’ which cause characteristic changes to breathing, appetite and sleep.
Changes to nail colour and skin temperature are also telltale signs that the end is near.
Although patients may be slipping in and out of consciousness, studies show the brain is still able to compute sounds and sights.
Dr Mannix said one of the first things to go in a dying patient is their appetite.
This is normal and related to a dying body needing less energy as biological processes begin to slow down.
However, she added that while patients may not be able to stomach a full meal, they can still enjoy a ‘taste for pleasure’ and favourite treats may still be welcome.
Those on the brink of death will also have a severe lack of energy — even if they’re struggling to stay awake.
Writing for BBC Science Focus, Dr Mannix said: ‘Sleep gradually makes less impact as the body winds down towards dying.’
A medic specialising in end of life care has revealed exactly what happens to your body as you die
She added: ‘What looks like sleep, though, gradually becomes something else: dipping into unconsciousness for increasing periods.’
As death becomes imminent, the heart will begin to beat less strongly, leading to a drop in blood pressure.
This causes the skin to cool down. Meanwhile nails to turn a dusky shade as blood circulation becomes sluggish.
‘Internal organs function less as blood pressure drops. There may be periods of restlessness or moments of confusion, or just gradually deepening unconsciousness,’ Dr Mannix said.
Dr Mannix clarified that science hasn’t been able determine how much of what the body ‘hears’ at this time is comprehensible to the dying brain, although studies have shown some information does get through.
‘We don’t know how much sense music or voices make to a dying person,’ she said.
Another change that occurs in the final moments is changes in how you breathe.
Scientists have previously recorded the brain activity of a 87-year-old male epilepsy patient while he was dying from a heart attack
‘Unconscious people’s breathing follows automatic patterns generated by the respiratory centre in the brain stem,’ Dr Mannix said.
‘Because they’re unaware of their mouth and throat, dying people may breathe heavily, noisily or through saliva in the back of their throat, yet without apparent distress.’
She added that as the end approaches the rate of breathing will change, from deep to shallow, from quick to slow to, finally, stopping entirely.
With the supply of oxygen cut off death comes swiftly as organs shut down, with the heart ceasing to beat entirely minutes later.
What happens in the brain during these last moments of earthly existence is a hotly contested topic.
One study, detailing the results of a brain scan of an 87-year-old man who died while undergoing the test, suggested aspects of his life may have ‘flashed’ before his eyes.
Co-author of the study Ajmal Zemmar, a neurosurgeon at the University of Louisville in the US, said: ‘The brain may be playing a last recall of important life events just before we die, similar to the ones reported in near-death experiences’.
Other cases, where people have returned from clinical death, where their heart and breathing stop, also suggest the brain can experience something in these moments.
Some have previously told MailOnline of out-of-body experiences such as seeing bright lights at the end of a tunnel or meeting deceased relatives.
While evidence of what happens in brains after clinical death is still being explored, exactly why so many people have similar experiences remains an issue of contention among experts.
Some theorise changes in the brain allow the ‘brakes’ to come off the system, which opens our perception to incredibly lucid and vivid experiences of stored memories from our lives.
However, this is only one theory and other experts dispute this.
Maria Sinfield, a hospice nurse, previously told MailOnline one of the most common things people say and do towards the end.
The nurse, from Lancashire, has worked for end of life charity Marie Curie for a decade and seen first-hand what patients experience in their last days.
‘Some people have things they want to do or say that they haven’t done,’ she said.
Ms Sinfield added: ‘I recall one particular patient who was upset because they needed to speak to a family member who they’ve not spoken to for some time, but we were able to get that family member to them.
‘They were really distressed prior to 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, where people have called out to dead loved ones as if they are in the room with them.
‘From a very personal point, I was with my dad when he died and he called out for his mum and dad as though they were there,’ she said.
