Medical News Today: What are the signs that someone is close to death?

If a person or loved one is elderly or has a terminal illness, knowing death may be near is often difficult to deal with or comprehend. Understanding what to expect may make things a little easier.

This article explores 11 signs that death is approaching. It goes on to look at the signs that indicate a person has died and discusses how to cope with the death of a loved one.

How to tell if death is near

When a person is terminally ill, they may be in hospital or receiving palliative care. It is important for their loved ones to recognize the signs that death may be near. These signs are explored below.

1. Decreasing appetite

older man being fed in a hospital bed, decreased appetite may be a sign of death
A decreased appetite may be a sign that death is near.

As a person approaches death, they become less active. This means their body needs less energy than it did. They stop eating or drinking as much, as their appetite gradually reduces.

If a person is caring for a dying loved one who loses their appetite, they should let them eat when they feel hungry. Offering them ice pops helps them to stay hydrated.

A person may completely stop eating a few days before they die. When this happens, it helps to keep their lips moistened with lip balm, so that they are not uncomfortable.

2. Sleeping more

In the 2 or 3 months before a person dies, they may spend less time awake.

This lack of wakefulness is because their body’s metabolism is becoming weaker. Without metabolic energy, a person will sleep a lot more.

If a person is caring for a dying loved one who is sleepy, they should make them comfortable and let them sleep. When their loved one does have energy, they should encourage them to move or get out of bed to help avoid bedsores.

3. Becoming less social

As a dying person’s energy levels are reduced, they may not want to spend as much time with other people as they once did.

If a dying person is becoming less social, their loved ones should try not to be offended.

It is not unusual for a person to feel uncomfortable letting others see them losing their strength. If this is the case, it is advisable to arrange visits when the person dying is up to seeing someone.

4. Changing vital signs

As a person approaches death, their vital signs may change in the following ways:

  • blood pressure drops
  • breathing changes
  • heartbeat becomes irregular
  • heartbeat may be hard to detect
  • urine may be brown, tan, or rust-colored

A person’s urine color changes because their kidneys are shutting down. Seeing this and the other changes in a loved one may be distressing. But these changes are not painful, so it may help to try not to focus overly on them.

5. Changing toilet habits

Because a dying person is eating and drinking less, their bowel movements may reduce. They may pass less solid waste less often. They may also urinate less frequently.

When they stop eating and drinking completely, they may no longer need to use the toilet.

These changes can be distressing to witness in a loved one, but they are to be expected. Speaking to the hospital about a catheter for the person may help.

6. Weakening muscles

In the days leading up to a person’s death, their muscles may become weak.

Weak muscles mean the individual may not be able to carry out the small tasks that they were able to previously. Drinking from a cup or turning over in bed may no longer be tasks they can do.

If this happens to a dying person, their loved ones should help them lift things or turn over in bed.

7. Dropping body temperature

Older couple holding hands
A drop in body temperature may mean there is very little blood flowing to the hands.

In the days before a person dies, their circulation reduces so that blood is focused on their internal organs. This means very little blood is still flowing to their hands, feet, or legs.

Reduced circulation means a dying person’s skin will be cold to the touch. Their skin may also look pale or mottled with blue and purple patches.

The person who is dying may not feel cold themselves. Offering them a blanket is a good idea if a relative or friend thinks they may need one.

8. Experiencing confusion

When a person is dying, their brain is still very active. However, they may become confused or incoherent at times. This may happen if they lose track of what is happening around them.

A person caring for a loved one who is dying should make sure to keep talking to them. Explaining what is happening around them and introducing each visitor is important.

9. Changing breathing

A person who is dying may seem like they are having trouble breathing. Their breathing may suddenly change speed, they might gasp for air, or they may pause between breaths.

If a person caring for a loved one notices this, they should try not to worry. This is not usually painful or bothersome when being experienced by the dying person.

It is a good idea to speak to the doctor for advice if someone is concerned about this change in breathing pattern.

10. Increasing pain

It may be difficult to come to terms with the unavoidable fact that a person’s pain levels may increase as they near death.

Seeing a pained expression, or hearing a noise that sounds pained, is never easy.

A person caring for a dying loved one should speak to the doctor about options for pain medication to be administered. The doctor can try to make the person who is dying as comfortable as possible.

11. Hallucinations

It is not unusual for a person who is dying to experience some hallucinations or distorted visions.

Although this may seem concerning, a person caring for a dying loved one should not be alarmed. It is best not to try to correct them about these visions, as doing so may cause additional distress.

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How to cope in the final hours

In the hours before a person dies, their organs shut down and their body stops working. At this time, all they need is for their loved ones to be around them.

A person caring for a dying loved one in their last hours should make them feel as comfortable as they can.

It is a good idea to keep talking to a dying person right up until they pass away. They can often still hear what is going on around them.

Other signs of death

White roses on a wooden background
After a loved one has died, support from family and friends may help people to cope.

If a dying person is attached to a heart rate monitor, those around them will be able to see when their heart has stopped working, meaning that they have died.

Other signs of death include:

  • not having a pulse
  • not breathing
  • no muscle tension
  • eyes remaining fixed
  • bowel or bladder releasing
  • eyelids partially shut

When it is confirmed that a person has died, their loved ones may want to spend some time at their side.

Once they have said goodbye, the family should make contact with a funeral home. The funeral home will then remove the person’s body and prepare for their funeral.

When a person dies in the hospice or hospital, the staff will contact the funeral home on the family’s behalf.

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How to cope after a loved one has died

Even when it is expected, the death of a loved one is never easy to cope with for those who were close to them.

It is essential that people give themselves the time and space to grieve. They should also seek support from friends and family.

Every person deals with grief in a different way. But there are some common feelings and experiences that people may want to share. For this reason, bereavement support groups may be useful.

Support groups help people explore their grief in a consoling environment with other people facing a similar experience. There are a range of support groups to explore listed on the website

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