What happens when someone is dying

Everyone is different so it’s hard to say exactly what will happen when someone is dying. But, there are some changes that are common in the last weeks and days before death.

Appetite

Eating and drinking less are signs that someone may be in the last weeks or days of their life. It may be hard to accept this is happening.

People often choose to eat and drink less as they get more unwell. This could be because they find the effort of eating or drinking too much or they are not hungry anymore.

The person may also need more help to take small amounts of soft food or sips of drinks they enjoy.

Eventually, the person will stop eating and drinking and will not be able to swallow tablets. It’s normal for a person who is dying to stop eating and drinking. They may not need their tablets anymore or medicines can be given in a different way.

If they stop drinking, their mouth may look dry. This does not mean they are dehydrated.

What can help

You can offer the person sips of water if they want something to drink and are able to swallow fluids.

You can also:

  • offer small sips of a drink or a drink from a teaspoon
  • moisten their mouth with liquid – use a small, soft toothbrush
  • apply lip balm
  • clean their teeth gently if they would like that

Your doctor or nurse may prescribe an artificial saliva product or a mouth gel. These can help to moisten the mouth and lips. Ask your nurse or carers to show you how to care for the person’s mouth and teeth.

Bladder and bowels

The person may lose control of their bladder or bowels. This happens because the muscles in these areas relax and don’t work as they did.

They may also have fewer bowel movements as they eat less. They may pass less urine and it may get darker in colour.

This may be upsetting for you and you may worry that the person feels embarrassed.

What can help

You can ask a nurse or carer to show you how to:

  • keep the person clean and comfortable
  • protect the bed

You can also ask the nurse or doctor for equipment to help. This could include incontinence pads or a catheter. This is a long thin tube that can be put into the person’s bladder to drain urine.

Breathing

When a person is close to death, their breathing changes. It may become shallower or there may be long pauses between their breaths.

Sometimes the person’s breathing may sound noisy or ‘rattling’. This may be because they aren’t able to re-absorb or swallow the normal fluids in their chest or throat. This can cause a rattling sound. The rattling sound may be upsetting to hear, but it doesn’t usually cause any distress to the dying person.

In the very last moments of life, the person’s breathing pattern may change. Breaths may become much slower and quieter before they stop altogether. A few people stop breathing and then take one or two final breaths.

A change in the breathing pattern is a normal part of the dying process.

What can help

If the person is anxious, it may help to sit with them so that they know you’re there.

If they’re breathless, it can help to have a small fan or open a window.

If their breathing rattles, it may be helpful to change the person’s position so that they’re on their side. Make sure that they agree first, or that they don’t seem too disturbed by being moved.

You can ask to be shown the best way to move the person. For example, ask about sliding sheets.

The doctor or nurse may also suggest medicines to help reduce the amount of fluid in the person’s chest or throat. This sometimes helps but doesn’t always take it away completely.

Healthcare professionals will focus on making sure the person is settled and comfortable. 

Eyes

The person may have their eyes closed more of the time. At some point, they may not open them again. Sometimes the person’s eyes are half open which can be upsetting.

What can help

If the person’s eyes are half open, your doctor or nurse may suggest some eye drops or ointment.

Bathing the eyes can help any dryness.

Skin

The person’s skin may feel cold and change colour.

Their hands, feet, ears and nose may also feel cold to the touch. This is due to reduced circulation.

Occasionally, a person’s hands or other parts of the body may swell a little. This isn’t usually painful or uncomfortable. Their skin may also become mottled and blue or patchy and uneven in colour.

Changes to the skin and body are all normal parts of the dying process.

What can help

It may be comforting to put gloves or socks on the person to keep them warm. You can also make sure they’re covered with a blanket or duvet.

Gentle massage may also help. The nurses or carers may be able to show you how to do this.

Sleep

The person may become much sleepier.

They are likely to spend more time sleeping, and will often be drowsy even when they’re awake. They may also drift in and out of consciousness.

It’s normal for a dying person to sleep more. They may become less interested in what’s going on around them and have less energy. But, this doesn’t necessarily mean that they’re no longer hearing what you say to them.

Some people become completely unconscious for a period of time before they die. This could be short, or as long as several days.

What can help

Even when the person is, or appears to be, sleeping or resting, they may still be able to hear you.

Don’t feel that you need to stop talking to the person. You can carry on speaking quietly and calmly to them as they may still be able to hear you. Take the opportunity to say the things that are important to you both.

You could also try letting them know you’re there in other ways like:

  • holding their hand
  • reading to them
  • playing their favourite music

Restlessness

The person may become more restless and agitated in the last few days of life. But, they may become more peaceful again before they die.

Sometimes they may appear confused and they may not recognise familiar faces. They may hallucinate, and see or hear people or things that are not actually there. For example, they may see pets or people who have died.

Restlessness and agitation can be caused by many things. For example it could be due to a physical problem like constipation or difficulty passing urine. Speak to the doctor or nurse caring for the person if you’re concerned about this.

If the dying person doesn’t recognise you, this may be upsetting. But, it’s not a sign that they feel differently about you. It’s more likely that they’re unable to tell what’s real and what’s not. This is especially true if they’re a bit sleepy and are drifting in and out of full consciousness.

What can help

If someone is distressed or confused, you can:

  • sit with them to help calm them
  • keep things as normal as possible to comfort them
  • speak clearly to them
  • remind them who you are and do this often if you need to
  • keep their surroundings calm with minimal changes in noise level
  • let them know the time of day (a clock can help)
  • try not to correct them if they say something wrong, or insist on them getting things right

You can also talk to the doctor or nurse if the person is distressed. They can check if there’s a treatable reason for their symptoms. For example, they may prescribe medicines to help settle the person’s anxiety or confusion.

Visitors

Relatives and friends may want to come and visit. This can be something that’s expected in your family.

It often helps to have someone else sit with the person. But, many visitors at the same time or in one day may be too much for a person who is close to death.

You can try to plan ahead for visitors and explain what they can do to help.

Last updated:
01 May 2024