How do I know death is imminent?

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Adding breathing irregular...fast then slow or shallow, periods of apnea where they stop breathing for more then 10 seconds repeatedly, increased breathing rate, ive seen up to 40 breaths a minute, agonal breathing (sometimes called fish out of water breathing...very end of life), rattled breathing and no not everyone mottles
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My dad had a very different experience with his last few days. He was off food and liquid for 15 days. Normal range is 5-10 days. Here were his signs:
-stopped opening his eyes
-stopped gripping my hand
-face became sunken
-wet rattling breathing
-facial gestures stopped
This went on for a few days. The Hospital staff could no longer predict his eventual passing. I went back to work on the 15th day and I got the call at 7:50 that morning.
My advice is to say everything you want to say and then say goodbye. Tell your loved one that you will be okay and that it is okay to let go.
It is the hardest thing I’ve ever had to do, but I think I am at peace now because I left nothing unsaid.
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First, my thoughts are with you at this time. I hope you are okay, as well as those who may be with you at the end of your loved one's journey.

I wish I could remember some of the signs, since it only was 18 months ago when I watched my father's partner leave. He was in a hospital for 6 days, and then released into at-home hospice, but he was only at home for 14 hours. He was in a hospice facility for the last 14 hours.

I had the little booklet and the folder from Hospice describing the process... and basically what I learned is that there are as many "signs" as there are people. I didn't know Gene was dying - I mean, actively dying - because he didn't match my expectations. I wish I had realized well before that long night at home that everyone has their own journey, although we all end up at the same destination.

So looking back now... the lack of appetite or thirst in the few days before he died, and more sleeping was a sign he was leaving us. Hallucinations - sometimes he recognized me, other times, he actually told me to get out of the house because he didn't recognize me, other times, he was talking to someone or something out there... constant picking at his sheets and skin in agitation. He'd just grab my arm and hold on with enough strength that I had bruises. Sometimes holding his hand would calm him down. A sudden burst of energy at the very end - once he was at the hospice facility, clean, and medicated, I went back to their house to talk to my father and get him to come see Gene. Apparently, he managed to get out of bed and out of his room! He hadn't walked in a week! It's apparently common for some.

I don't remember his skin mottling, but apparently, it is common. I remember the "fish breathing" in the last couple of hours, and it was so irregular. His hands were cooling too. At this point, I just started talking to him and letting him know it was okay to go. My father refused to be there, so it was just me, and I just told him about everyone who called, who loved him, and that they all said he could go if he wanted. And then he was gone - very quietly. I only noticed his hand was cooling suddenly actually then noticed his chest was no longer rising.

It wasn't awful or scary at the end (my biggest fear). It was peaceful.

Again, my condolences through this difficult time. May there be peace for your loved one as they transition. May you find peace during the process.
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Is there always skin mottling?
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Skin mottling as well. This usually begins in areas like the feet. Blood is being shunted to the major organs during the process of dying . My mom felt warm from the waist up but below her waist her skin was mottled & warm.

My thoughts are will you during this terrible time.
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Bodily functions slow down; if there is urine output it will be dark; nail beds can turn a translucent light shade of blue due to lack of oxygen circulating; a person may be unresponsive and appears to be asleep; sometimes a person acquires a very light shade of yellowish skin tone due to the liver failing or a person can have no color at all; extremities can feel cold to the touch again due to inadequate blood supply.

Not everyone experiences all of these things but when some or all do occur death is imminent.
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They stop eating anything and sleep almost all the time.
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