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Physical Signs at the End of Life

Many families wonder and worry about the physical changes that will occur in the days and hours before death. As your loved one’s condition changes, their hospice nurse can provide guidance about what to expect and what end-of-life signs to look for. The hospice care team can help you understand these changes and keep your loved one comfortable in their final days.

Decline moves at a regular pace.

Death from disease is gradual and orderly. (Convulsions, a heart attack, or hemorrhage are unusual events, and not the normal pattern.) At first, your loved one may become less active and prefer sitting to walking around. Their appetite will start to decrease and they will likely prefer softer foods. Your loved one will become less interested in things that were important before.

Physical changes in the last days and hours.

There are some physical changes that signal the body has begun the process of shutting down and that the end of life is approaching. These end-of-life signs are not medical emergencies, but are expected and don’t mean that your loved one is suffering. In fact, most people are often unaware of the changes.

Your loved one may:

  • Not be hungry or thirsty
  • Spend most, or all, of their time in bed
  • Have decreased urine output, with urine becoming concentrated and tea-colored
  • Have cool skin, especially in the arms and legs, as circulation decreases. The skin may feel clammy, damp, or look bluish.
  • Gradually slip into unconsciousness. (This happens to many people.)
  • Experience hallucinations or become restless or anxious, which is caused by circulatory or metabolic changes
  • Have noisy breathing (producing a rattling sound) due to mucus collecting in the throat
  • Have changing breathing patterns that are unusually slow or unusually fast or a combination of both

Even when many of the above end-of-life signs and symptoms are present, it can be difficult to predict the amount of time any person has left. In the days prior to death, your loved one’s hospice nurse will begin to visit more often to help your loved one feel comfortable, supported, and cared for during their last days and hours.

Do you have questions about end-of-life care?