Most people will show signs of restlessness, agitation or delirium during the last few days or even weeks of their life. This can take many forms. They may have difficulty finding a comfortable position. They may pick at their clothing or blankets. You may notice them twitching, fidgeting or waving their arms. Some people seem to be reaching upwards, as if to be lifted.
Hallucinations and delirium
Delirium is a mental state where the person seems confused or dis-oriented, not recognizing the room, or familiar people. Hallucinations are common (hearing or seeing things that others do not see). Unless the visions are upsetting to the patient, nothing really needs to be done. People in the last week or so often seem to speak to relatives or friends who have already passed on. Usually these are positive and comforting exchanges. There is no need to intervene. Action is only required if the patient is at risk of causing harm, to themselves or others.
Irritability
Emotionally, the patient may become irritable or paranoid. A normally calm individual may have mood swings and get quite angry.
As a family member, it can be distressing to watch a loved one behave so differently. Between 25-85% of terminally ill patients experience one or more of these symptoms, so in some ways it’s quite normal. Restlessness, agitation and delirium are often the result of organ systems, such as the kidneys, shutting down. Or dehydration as the patient loses interest in food or water. It is simply part of the last few days or weeks.
