Breathing patterns may also change. Some individuals develop periods of rapid breathing followed by brief pauses, a pattern known medically as Cheyne-Stokes respiration. Others may breathe more slowly or produce a rattling sound caused by secretions collecting in the throat because they are no longer swallowing normally. Although these sounds can be distressing for family members, they do not necessarily mean the person is experiencing pain.
Changes in circulation are also common. Hands and feet may become cool, skin may appear pale or mottled, and blood pressure often decreases. These changes occur because the heart gradually directs blood toward vital organs. Some people also become less responsive or drift in and out of consciousness. Even when they cannot speak, many experts believe hearing may remain intact until very late, so gentle conversation and reassuring words can still provide comfort.
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