Even when someone close to you is terminally ill, the last few days of their life can be unexpected. You may notice some changes physically and in their thinking that indicate they’re close to death.
Everyone’s last few days of life are different, and it can be difficult to predict how and when someone will die. It can be helpful to recognise and understand changes that happen in the last few hours and days of life so you can continue to support your family member or friend who is dying.
Loss of appetite
It’s normal for people in their last few days of life to not have much of an appetite. Eventually people who are dying will stop eating and drinking. Although this can be distressing because eating and drinking are fundamental to our lives, it’s a normal part of the dying process. You can help to keep them comfortable by offering them small sips of water through a straw.
Sleeping a lot
In a person’s final few days or hours they will spend more and more time asleep. They may wake up for periods during the day and night and be able to spend some time talking, or just being with you. You may find they’re drifting in and out of consciousness. They may not be able to communicate much with you, but that doesn’t mean they can’t hear what you’re saying. Spend time talking with them, play their favourite music or just sit and hold their hand.
Changes to their breathing
During the dying process, a person’s breathing can become shallower, and there can be long pauses between each breath. They may not be able to swallow their secretions so their breathing may become noisier and sounds rattly. This is usually more distressing for people hearing it than for the person dying.
Changes in skin temperature and colour
A person’s hands and feet can start to feel cold, and their skin can become pale and uneven in colour.
Agitation, distress or anxiety
You may find they become agitated and confused; sometimes they might start to see and talk to people who aren’t there.
When death is near Hospice NZ
What to expect when someone important to you is dying The National Council for Palliative Care, UK
Changes in the last hours and days NHS Choices
Te Ara Whakapiri: Principles and guidance for the last days of life Ministry of Health NZ