When the mesothelioma victim begins to show signs of imminent death, it is the time to for the relatives and friends to come around to say final goodbyes to their loved one. One after the other, the family members and friends might spend time with the patient, holding hands, talking to the patient, or just sitting quietly by the patient.

It can also be a time to perform any religious rituals and other activities the patient desires before he/she passes on. It is a chance for many families and friends to express their love and appreciation for the patient and for each other.

This also the time to plan for what to do after the death of the patient, so that the family will not be confused about what to during this very emotional time. If the patient is in hospice, the hospice nurse and social worker will help you. If the patient is not in hospice, talk with your doctor about it so that you will know what to do at the time of death.

These are some of the symptoms that will be seen in a dying mesothelioma cancer patient:

1- Changes in body function

•profound weakness,usually the patient cannot get out of bed and has trouble moving around in bed

•needs help with nearly everything he or she does. May be unable to change positions without help

•less and less interest in food, often with very little food and fluid intake for days

•trouble swallowing pills and medicines

•more drowsiness--the patient may doze or sleep much of the time if pain is relieved. May be restless and pick or pull at bed linens. May be hard to rouse or wake. Anxiety, fear, restlessness, and loneliness may worsen at night

•cannot concentrate, has short attention span

•confused about time, place, or people

•limited ability to cooperate with caregivers

•involuntary movement of any muscle, jerking of hands, arms, legs, or face

2- Changes in consciousness

•more sleeping during the day

•hard to wake or rouse from sleep

•confusion about time, place, or people

•restless, may pick or pull at bed linen

•may talk about things unrelated to the events or people present

•may have more anxiety, restlessness, fear, and loneliness at night

•after a period of sleepiness and confusion, may have a short time when he or she is mentally clear before going back into semi-consciousness

3- Changes in metabolism

•less interest in food -- the patient has less need for food and drink

•mouth may dry out (see the next section on changes in secretions)

•may no longer need some of his or her medicines, such as vitamins, replacement hormones, blood pressure medicines, and diuretics (unless they help make the patient more comfortable)

4- Changes in secretions

•mucus in the mouth may collect in the back of the throat (This may be a very distressing sound to hear, but doesn't usually cause discomfort to the patient.)

•secretions may thicken due to less fluid intake and build up because the patient cannot cough

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5- Changes in circulation and temperature

•• arms and legs may feel cool to the touch as circulation slows down

•skin on arms, legs, hands, and feet may darken in color and look mottled (blotchy dark spots)

•other areas of the body may become either darker or paler

•skin may feel cold and either dry or damp

•heart rate may become fast, faint, or irregular

•blood pressure may get lower and become hard to hear

6-Changes in senses and perception

•vision may become blurry or dim

•hearing may decrease, but most patients are able to hear you even after they can no longer speak

7- Changes in breathing

•breathing may speed up and slow down due to less blood circulation and build up of waste products in the body

•mucus in the back of the throat may cause rattling or gurgling with each breath

•the patient may not breathe for periods of up 10 to 30 seconds

8- Changes in excretion

•urine may become darker and decrease in amount

•when death is near, the patient may lose control of urine and stool

Signs of irreversible death also known as "brain death"

-Cessation of breathing as the patients chest becomes still, not showing normal respiratory movements.

-Blood pressure becomes unrecordable

-Nil pulse in the blood vessels as the pulse stops

-Still immovable eyes with fixed wide gaze

-Open fixed pupils of the eyes, even in bright light

-Loss of control of bowels or bladder function as the muscles relax

After death it is all right if you sit with your loved one for a while. There is no rush to get anything done right away. Many families find this is an important time to pray or talk together and reconfirm their love for each other, as well as for the person who has passed away.

If the patient dies at home, caregivers are responsible for calling the appropriate people. Regulations or laws about who must be notified and how the body should be moved differ from one community to another. Your doctor or nurse can get this information for you. If you have a hospice or home care agency involved, call them. If you have completed funeral arrangements, calling the funeral director and doctor are usually all that you have to do.