Facing the death of a loved one is one of life’s most emotionally challenging experiences. When someone is terminally ill or in the final stages of life, their body begins to shut down in predictable ways. Recognising the signs that death may be near can help caregivers and family members prepare emotionally and practically, allowing them to offer comfort and support when it matters most. According to sources, this article outlines 11 physical and behavioural signs that may indicate a person is nearing death, what typically happens in the final hours, and guidance on how to cope during and after the loss.
Recognising the 11 signs of approaching death
Loss of appetite and thirst
In the days or weeks leading up to death, many people lose interest in food and drinks. This happens because the body is conserving energy and no longer needs as much fuel to function. The digestive system also slows down. A dying person may eat or drink very little or stop altogether.It’s important not to force them to eat. Instead, offer comfort by keeping their lips and mouth moist using a damp cloth, ice chips, or lip balm.
Increased sleeping and unresponsiveness
As death nears, people tend to sleep more and remain drowsy or unresponsive when awake. This increased need for sleep is the result of the body slowing down and conserving its remaining energy. Some individuals may enter a semi-comatose state in the final days.Even if your loved one doesn’t respond, they may still hear you. Gentle conversation, soothing music, or holding their hand can be comforting and meaningful.
Changes in bowel and bladder habits
Reduced food and liquid intake leads to decreased bowel movements and urination. Some people may become incontinent or stop passing stool altogether. While these changes can be difficult to witness, they are a normal part of the dying process.A catheter may be recommended if bladder control becomes an issue. Healthcare providers can help manage this with dignity and comfort.
Muscle weakness and fatigue
Simple tasks such as lifting a spoon, turning in bed, or even holding a hand, can become impossible due to muscle weakness. The body’s energy is directed toward vital functions, leaving little strength for physical activity.Support your loved one with gentle repositioning, cushioning, and assistance with daily care to prevent discomfort and pressure sores.
Vital sign fluctuations
Vital signs often become unstable or irregular in the final stages of life. These changes may include:
- Lowered blood pressure
- A weak or irregular heartbeat
- A faint or undetectable pulse
- Slower or laboured breathing
These physical signs indicate that the heart and lungs are slowing down as part of the natural dying process.
Cool or mottled Skin
Reduced blood circulation can cause the skin, especially on the hands, feet, and legs, to feel cold or appear blotchy with bluish or purplish patches. While the person may not feel cold, providing a soft blanket may offer comfort and warmth.
Breathing changes and noisy breaths
Breathing patterns often change in the last days or hours. It may become rapid, shallow, or irregular and then pause for long intervals (known as Cheyne-Stokes breathing). Some people may make gurgling or rattling noises, often called the “death rattle,” caused by fluid buildup in the throat.These sounds can be distressing to hear but are not necessarily painful. Adjusting the person’s position or using prescribed medication can ease breathing.
Pain or discomfort
Pain can increase near the end of life, particularly in people with chronic illness. Healthcare providers often adjust medications to keep the person as comfortable as possible. Look for signs of discomfort, such as grimacing or moaning, and alert the care team if adjustments are needed.
Social withdrawal and quietness
Many people nearing death withdraw from others. They may stop talking, avoid eye contact, or prefer to be alone. This withdrawal is not a sign of rejection but rather a way of focusing inward as the body and mind prepare to let go.Respect their need for quiet but continue offering your presence. A calm, reassuring voice and gentle touch can still provide comfort.
Mental confusion and restlessness
It’s common for dying individuals to become confused or disoriented. They may forget where they are, speak incoherently, or have trouble recognising familiar people. This may be due to changes in blood flow, oxygen levels, or medication.Reassure them with simple explanations and repeat information calmly. Identifying yourself and others by name and explaining what’s happening can reduce anxiety.
Hallucinations
Some people see or hear things that aren’t there, often deceased loved ones or spiritual figures. While this can be unsettling to witness, these visions are not necessarily frightening to the dying person and may be part of a peaceful transition. Avoid arguing with or correcting them. Instead, remain calm and supportive.
What happens in the final hours?
In the last hours of life, the body enters a state of total shutdown. Breathing may become extremely slow or stop for long intervals. Eyes may remain open but appear glazed or unfocused. There may be a final sigh or twitch, followed by stillness. Death is confirmed by the absence of a heartbeat, breathing, and muscle movement. In a hospital or hospice, staff will handle the confirmation and next steps. At home, you can take time to say goodbye before calling the funeral home.Even when expected, death brings profound grief. Everyone processes loss differently; some may cry, while others feel numb or angry. There’s no right or wrong way to grieve. Be gentle with yourself, take time to mourn, and don’t hesitate to lean on friends, family, or bereavement support groups for help. While nothing can truly prepare you for the loss of someone you love, understanding the physical and emotional signs of death can help you stay present, provide comfort, and create a peaceful environment during their final moments.Also Read: Is stress causing your neck pain? Simple tips to find relief
