Indeed, in recent years, we have learned that dehydration in the last days of life is often less of a problem than is over-hydration. Dry mouth and thirst are the greatest problems from decreased fluids in the last days of life. Decreased fluid intake also leads to electrolyte changes, including hypercalcemia. Lips may be kept moist with lightly applied creams. The mouth should be cleaned at least every eight hours.
Oral care is discussed in greater detail in the section on oral problems .
Respiratory Changes Changes in respiratory status are common in imminently terminal patients. There may be brief periods in which the person stops breathing, then starts again. Respirations may slow. Some people, especially those who are well-hydrated, have increased fluid in their lungs and difficulty managing the fluids, i.e., they may have difficulty coughing or swallowing effectively. Note, however, that oxygen is not a magic answer to difficulty breathing since using it tends to increase the need for it.