Indicators that a child is dying

As previously stated, one of the greatest barriers to good end of life care in not recognising that the child is actively dying. In the terminal stage, there will be noticeable physical, behavioural and emotional changes. In addition, events can speed up rapidly as the child’s condition deteriorates and symptoms may worsen. There will be a need to start assessing more frequently than before.

The key then to good end of life care is thorough assessment and planning for the worst case scenario’s while still hoping for the best.

Indicators that the child will die soon may include the following signs:

Physical Signs

Behaviourial and Emotional Signs

Long periods of sleep

Decreased urine and stool output

Deteriorating vital signs such as: 

Low oxygen saturation

Slower or altered breathing

Bradycardia (slow pulse)

Not wanting to eat

Loss of interest in surroundings

Decreased interaction with family and staff

Clingy or withdrawn behaviour

Lethargy or sudden increased awareness

Not wanting to be left alone

Talking about “going home”

Talking of angels, lights or dead relatives

Talking or drawing pictures of vehicles or journeys