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The definition of death has changed over the centuries. For decades, the primary sign of death was the stopping of the heart, however, new technologies in the 1960s introduced the idea of brain death. As long as the brain survived to operate essential functions, there was a chance of revival of the patient. Medicine determined that death was not merely an event, but a slow process as the body shuts down.
Loss of Appetite
Digestion becomes difficult and painful. This difficulty will cause the patient to refuse all but the blandest foods. Saliva production will reduce greatly, making the mouth, throat and lips dry out. Near the end, the patient may only be capable of swallowing water or ice chips.
Eventual dehydration and lack of nourishment will reduce the energy of the patient, resulting in extreme fatigue. There will be times where the patient will sleep most of the day and be difficult to wake up. During the times that the patient is awake, he will seem distant out of sheer exhaustion.
As death nears, higher brain functions begin to fail. The person may forget where she is, who she's speaking to, get frustrated and confused that she can't remember certain things or may even speak to people not in the room. The person may imagine being somewhere else or may have two conversations at once: one with people in the room and one to people not there.
As the blood circulation slows, the body will draw blood from the outer extremities, such as fingers and feet, in order to protect more vital organs, much like what happens during hypothermia. The person's feet and hands will turn cold. Also to note that as blood is drawn from the skin to the organs, the pale or ashen color of the person's skin will begin having blots of purple, blue or red. The first signs of this blotting most often appear on the soles of the person's feet.
Since little food reaches the body, urination reduces as well. When the patient does urinate, the urine will appear brownish or reddish. This is also caused by the kidneys beginning to shut down due to the loss of blood pressure.
The patient may have a breathing pattern known as Cheyne-Stokes respiration, where there is a long inhalation followed by a long pause then a long exhale. Breathing will become irregular and be ragged and loud from excessive phlegm. Some people and doctors call this ragged breathing the "death rattle."