Signs of approaching death

It is important that staff communicate what to expect as the person enters the dying phase. Below are signs of what you may typically expect in the normal dying process.

Signs of approaching death Advice
Sleeps more and difficult to wake at times Plan conversation times for when the person seems more alert.
Loses appetite and may ‘forget’ to swallow Offer small servings of favourite foods or drink without forcing. At this time the body has minimal needs.
Becomes confused about time or may not recognise familiar faces Speak calmly. Remind the person of the day, time and who is in the room.
Becomes restless, pulls at bedclothes, has visions of people or things that aren’t really there. They may develop a fixed stare Leave a soft light on in the room and ensure a calm and consistent environment. Provide reassurance and avoid physical restrictions where possible. Even if the person cannot respond, don’t assume they can’t hear you – hearing is the last sense to be lost.
Loses control of bowels or bladder This does not usually occur until death is close. The amount of urine will decrease or stop as death nears. The district nurse can advise on how this can be managed.
Secretions collect at the back of the throat and sound like a rattle This is because the person cannot swallow saliva but does not mean they are uncomfortable.Turn the person on their side or raise the head of the bed. Sometimes medication can be given to help – ask the district nurse or your community nurse.
Arms and legs cool as the circulation slows down. Sometimes one side of the body will be warm and the other cold. Face becomes pale and feet and legs adopt a purple-blue appearance. Breathing becomes irregular and even stops for short periods. The pulse becomes fast and irregular Use just enough coverings to keep the person comfortable.

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