The process of dying is highly complex and varies greatly from person to person. However, there are some common physical changes that occur as the body begins to shut down in preparation for death. Understanding how long these changes take provides insight into what to expect during a loved one’s final days of life.
In most cases, the dying process begins slowly, with gradual physical changes over a period of weeks or months. Then, in the final 1-3 weeks of life, more rapid declines are common as major organ systems start failing. The actual time it takes for the body to fully shut down at the very end of life may be just minutes or a few hours for some people. For others, the final shut down may linger on for days or longer if the person is receiving supportive care or life prolonging measures.
What happens as the body shuts down?
As the body prepares to stop functioning, a number of processes occur:
– The dying person becomes increasingly tired, weak, and sleeps more. Routine physical activities like walking become impossible.
– Appetite is reduced and eating/drinking decreases. The body no longer needs nourishment.
– Brain function slows. Concentration, memory and alertness decline. Confusion and disorientation set in.
– Organs begin to stop working. The kidneys fail first, followed by the liver and then the lungs and heart.
– Body temperature lowers by a degree or more. Skin becomes cooler to the touch.
– Blood circulation reduces. The pulse becomes irregular and blood pressure drops. Hands and feet may feel cold to the touch.
– Skin changes color as circulation slows. A bluish tint develops around the mouth, fingers, toes and knees.
– Breathing changes. Long pauses in breathing or irregular patterns may occur. Congestion increases causing gurgling or rattling sounds as the dying person breathes.
– Vision is affected. Eyesight becomes blurry or dimmed. The dying person may report seeing people/things that aren’t visible to others.
– Hearing decreases. The dying person may seem unresponsive as they lose the ability to hear surrounding noises and voices.
Timeline of the dying process
The timeline for how long it takes for these changes to occur varies significantly based on the person’s overall medical condition. Here is an approximate outline of the dying process timeline:
2-6 months before death:
– Increasing health problems Require more assistance with daily activities
– More frequent doctor/hospital visits
– Weight loss and reduced appetite
– Increased tiredness, weakness and sleepiness
2-8 weeks before death:
– Minimal appetite and ability to eat/drink
– Limited ability to do any routine daily tasks
– Increased confusion and disorientation
– Urinary and bowel incontinence
1-3 weeks before death:
– Very minimal food/fluid intake as the body shuts down
– Significant physical weakness and inability to move
– Further mental decline – may not know close family members
– Difficulty communicating as concentration fades
– Increased periods of sleepiness
– Irregular breathing patterns develop
Hours to days before death:
– Unconscious and unresponsive to stimuli
– Little to no urine output and minimal bowel movements
– Shallow, irregular breathing with congestion
– Eyes fixed in a downward position
– Increased skin discoloration and coolness
What causes the final shutdown?
In the last hours and minutes of living, two key things happen:
First, blood circulation drops dramatically as the heart stops beating properly. This means oxygen levels fall far too low to sustain brain cell functioning.
Second, reflexes in the brain stem stop working. These control crucial involuntary functions like breathing, heartbeat and blood pressure.
Once blood flow and oxygen levels are too low, the brain dies. The brain stem reflexes that control breathing and circulation halt. This rapidly progresses to complete cardiac and respiratory arrest.
Within minutes after the heart stops beating, all brain function and brain stem reflexes are permanently lost. This leads to clinical death as the body fully shuts down.
How long does clinical death take?
Clinical death occurs within a few minutes after the heart stops functioning and blood circulation completely ceases. The specific duration depends on factors like the person’s overall medical condition leading up to death.
For terminally ill patients, clinical death usually happens within 2-6 minutes after the heart stops. Their bodies have already begun deteriorating during the dying process. The final cardiac arrest occurs rapidly since vital organs have already suffered severe declines.
In sudden unexpected deaths from injury, clinical death may take longer – up to 10-15 minutes after the heart stops. Their vital organs were otherwise healthy before the fatal event. The final shutdown takes more time without going through a gradual deteriorating process.
Rarely, some cases of clinical death can last even longer than 10-15 minutes if cardiopulmonary resuscitation (CPR) and resuscitating efforts are performed immediately after the heart stops. The goal is to revive the person before irreversible brain damage occurs.
What happens after clinical death?
After clinical death, the process of biological death begins. This refers to the body’s tissues actually dying and beginning breakdown of physical structures.
Here’s a timeline of the major changes that occur:
Immediately after clinical death – Loss of brain function and brain stem reflexes leads to complete unresponsiveness. Movement stops, pupils are fixed and dilated. The body “shuts down” as organs cease functioning.
Within minutes – Pallor mortis sets in as blood drains from capillaries causing skin to become pale and eyes to lose clarity. Algor mortis begins as body temperature starts dropping to match the surroundings.
1-3 hours – Muscle stiffening, known as rigor mortis starts as muscles contract due to chemical changes. Eyelids may be partially open as muscles stiffen.
3-6 hours – The body becomes very cold to the touch as temperature equilibrium is reached. Rigor mortis peaks and starts reversing.
8-12 hours – Fixed skin discoloration appears as blood settles due to gravity creating dark purple-black patches.
12-24 hours – Decomposition accelerates as cell membranes rupture and tissues begin to liquefy emitting gases and bodily fluids.
24-72 hours – Bloating increases rapidly as gas accumulates and skin blisters. Hair, nails and teeth may start loosening. Drainage leakage stains areas around mouth/nose.
The timelines varies based on factors like body size, ambient temperature, and presence of bacterial infection which accelerates the process. But within 24-72 hours, most of the body’s structures have begun breakdown.
Supporting bodily shutdown at end of life
The experience of a loved one’s body shutting down as they are dying can be emotionally difficult to observe and cope with. Hospice and palliative care providers play a crucial role in managing symptoms and keeping the dying person as comfortable as possible.
Knowing what changes to expect during the body’s shutdown process helps families and caregivers be prepared. Providing comfort, dignity and reassurance to those nearing the end of life is a meaningful way to support them during this transition. With proper care, the final shutting down of the body can be a peaceful release from suffering and entry into the next phase of the journey.
The dying process brings an incredible range of changes to the body as it gradually prepares to stop functioning. For terminal illnesses, this process generally unfolds over weeks to months before accelerating in the final 1-3 weeks of life. The medical term for the body fully shutting down is clinical death, which occurs within minutes after the heart stops beating. Even after clinical death, the timeline for biological breakdown of tissues can last 24-72 hours. Understanding what happens through each milestone and having end-of-life support eases the transition for dying individuals and their families. The mysteries around exactly how long it takes for the body to fully shut down will likely always remain. But learning more about the closing phases of life can help us approach death with reverence, empathy and compassion.