Understand what happens to our body in the final moments of life

Death is often seen as a sudden event, but experts explain that, in most cases, it is a gradual process. The human body goes through a series of physical and sensory transformations in the moments before the end of life, in a sequence that can last hours or even days.

This happens because, in the periods before death, the organism begins to reduce its vital functions. Appetite and thirst decrease, and drowsiness becomes more frequent, as the body starts to save energy.

Breathing, in turn, becomes more irregular, alternating between deep cycles and long pauses. In many cases, a sound known as the "snore of death" appears, resulting from the accumulation of secretions in the throat and lungs, as the cough reflex no longer works perfectly. Despite impressing those who follow it, this phenomenon is generally not uncomfortable for those in their last moments.

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"The "death snore" is caused by the accumulation of secretions in the throat and the difficulty of swallowing in unconscious patients, as, even in this situation, we produce a large amount of saliva. It generally does not cause suffering to the patient, as at this stage the level of consciousness is very reduced. The medical team can use measures such as repositioning the body, light aspiration of the airway or administering medications that reduce secretions, aiming to bring more comfort. These measures will especially help to reduce the anguish of family and acquaintances who witness the scene", details Daniélle Amaro, oncologist.

Even when consciousness appears to be absent, hearing is often preserved until very near the end. This is why palliative care doctors and nurses recommend that family members continue talking to the patient, as there is evidence that they can hear words and sounds around them.

"The likely explanation is that the auditory system is more resistant to changes in the body in this process than other senses, such as vision, which require greater effort from the brain. Therefore, talking to the person, playing meaningful music or simply being present in affectionate silence can continue to be perceived by them", explains Polianna Souza, geriatrician.

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In some rare cases, so-called terminal lucidity occurs: patients in a weakened state are surprised to recover, for a few minutes or hours, the ability to speak, interact and even recall memories, as if there were a brief farewell before definitively shutting down the body.

"There are neurological hypotheses, such as electrical brain discharges or transient chemical changes, but there is no scientific consensus. From a clinical point of view, it is a moment of great significance for family and friends, as it can allow for goodbyes and reconnections", adds Daniélle Amaro, oncologist.

Although this chain of biological events may seem harsh, doctors point out that many of the signs of the end of life are not necessarily painful. The natural dehydration that occurs during this period can trigger the release of substances that generate a feeling of well-being, making the transition less painful than one might imagine.

"There are some substances that different tissues and cells release that can help make the person more sedated and even reduce the transmission of pain a little. And there are some endorphins that have effects similar to opioids that are also being secreted at this time when the body is slowing down its metabolism", adds Edison Iglesias Vidal, geriatrician and director of the Brazilian Society of Geriatrics and Gerontology in São Paulo.

When the heart finally stops and breathing stops, the sequence of changes known after death begins. The muscles relax completely, the jaw may drop and the eyelids partially close. A few minutes later, the skin begins to lose color. With the blood no longer circulating, it accumulates in the lower regions of the body, forming purplish spots.

A few hours later, the muscles stiffen, generating so-called rigor mortis, which lasts 12 to 18 hours before disappearing again, leaving the body flaccid.

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Source: CNN