The journey towards the end of life can be a challenging and emotional time, both for the individual facing the end of their life and for their caregivers and family members. One aspect of this journey that may be unfamiliar to many is the presence of self-soothing sounds made by the patient during the transition and actively dying phase. These sounds can be puzzling and sometimes unsettling for caregivers and family members who have never witnessed them. This article will explore self-soothing sounds, why they occur, and how caregivers and family members can distinguish between self-soothing sounds and signs of .

What Are Self-Soothing Sounds?

When someone you love is sick, and near the end of their life, you may notice that they make sounds different from their usual voice. These sounds may include humming, moaning, sighing, or even singing. These are called self-soothing sounds, a way for the person to feel better and more peaceful during this hard time.

Self-soothing sounds are not a sign that the person is hurting or unhappy. They are a sign that the person is coping well and accepting the changes in their body. Sometimes, the person may not even be aware that they are making these sounds because they are in a deep state of relaxation or meditation. Other times, the person may try to communicate something to you, such as their love, gratitude, or farewell.

You do not need to worry or feel sad when you hear these sounds. They are a natural and normal part of the dying process, showing that the person is finding comfort and peace in their way. You can support them by being present, listening, and responding gently. You can also join them in making self-soothing sounds if you feel comfortable and if they seem to welcome it. This can create a bond of love and harmony between you and the person and help them feel less alone.

Self-soothing sounds are a gift that the person gives to themselves and you. They are a way of expressing their feelings, , and readiness to let go. They say, “I am okay, and you will be okay too.”

Why Do Self-Soothing Sounds Occur?

Biological Process: As the person gets closer to the end of their life, their body undergoes changes that make it harder for them to talk like they used to. For example, their breathing may become slower or irregular, their mouth may become dry, or their muscles may weaken. These changes can affect how they make sounds with their voice. Sometimes, they may be unable to form words or say things that don't make sense to you. This does not mean they are confused or unhappy; it just means their body is ready to say goodbye.

Comfort and Relaxation: When the person makes self-soothing sounds, they are not trying to tell you something or ask for something. They are simply trying to feel better and more peaceful. Making these sounds can help them relax their body and mind and cope with any emotions or thoughts that they may have. It can also help them connect with their inner self, spirituality, or higher power. These sounds are a way of expressing their feelings, their , and their readiness to let go.

Distinguishing Self-Soothing Sounds from Discomfort

Sometimes, it can be hard to tell if the person is making self-soothing sounds or if they are feeling uncomfortable. You may wonder if you should do something to help them or just let them be. Here are some ways to tell the difference between self-soothing sounds and signs of :

Self-Soothing Sounds

  • Regular Rhythm: Self-soothing sounds often have a steady and smooth pattern, like a song or a chant. They may sound like humming, moaning, sighing, or even singing. These sounds can help the person feel calm and relaxed.
  • No Signs of Distress: People usually look peaceful and happy while making these sounds. They may have a smile on their face or a serene expression. They may also close their eyes or gaze softly at something.
  • Lack of : Patients making self-soothing sounds are not restless or fidgety. They do not move around a lot or try to get out of bed. They are comfortable and content with where they are.
  • No Facial Grimacing: No sign of pain or discomfort on the person's face. They do not scrunch their eyebrows, squeeze their eyes shut, or bite their lips. They do not look like they are hurting or suffering.

Signs of Discomfort

  • Inconsistency: Discomfort-related sounds may be uneven and unpredictable. They may sound like groaning, grunting, gasping, or crying. These sounds can indicate that the person is feeling pain or distress.
  • Visible Distress: Patients in pain or discomfort may show signs of distress, such as grimacing, clenching their fists, or appearing agitated. They may also sweat, shiver, or flush. They may look like they are scared or unhappy.
  • Changes in Breathing: Discomfort can sometimes affect the person's breathing pattern, such as making it faster or slower, deeper or shallower, or louder or quieter. They may also cough, wheeze, or snore. These changes can signal that the person is having trouble breathing or swallowing.
  • Verbal Cues: Patients experiencing pain may use verbal cues or gestures to communicate discomfort. They may say things like “ouch,” “help,” or “stop.” They may also point to where it hurts or shake their heads. They may try to get your attention or ask for something.

Conclusion

When someone you love is very sick and near the end of their life, you may hear them make some sounds that are different from their usual voice. These sounds are called self-soothing sounds and are a way for the person to feel better and more peaceful during this hard time. They are not a sign that the person is hurting or unhappy. They are a sign that the person is coping well and accepting the changes in their body.

Sometimes, it can be hard to tell if the person is making self-soothing sounds or if they are feeling uncomfortable. You may wonder if you should do something to help them or just let them be. You can tell the difference by looking at some clues, such as how the person looks, how they breathe, and what they say. If the person looks peaceful, breathes smoothly, and says nothing or something nice, they probably make self-soothing sounds. If the person looks in pain, breathes hard, and says something that shows they are hurting, they probably feel uncomfortable.

Understanding self-soothing sounds can help you care for the person and make them feel loved. You can support them by being there, listening, and talking softly. You can also make self-soothing sounds with them if you want to and if they like it. This can make you and the person feel closer and less alone.

Self-soothing sounds are a gift that people give to themselves and others. They say, “I am okay, and you will be okay, too.”

Resources

Tip for Hospice Nurses: self-soothing vocalizations

Providing Comfort During the Last Days of Life with Barbara Karnes RN (YouTube Video)

Preparing the patient, family, and caregivers for a “Good Death.”

Velocity of Changes in Condition as an Indicator of Approaching Death (often helpful to answer how soon? or when?)

The Dying Process and the End of Life

The Last Hours of Life

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Gone from My Sight: The Dying Experience

The Eleventh Hour: A Caring Guideline for the Hours to Minutes Before Death

By Your Side, A Guide for Caring for the Dying at Home

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