Dying is a process. Sometimes the process takes time. For a while, signs that death is near may come and go. Family and friends may need help understanding the signs that mean a person is close to death.
What you might see
As a person gets closer to death, the person might:
Have less pain
Have trouble swallowing
Have blurry vision
Have trouble hearing
Eat or drink less
Lose control of urine and stool
Hear or see something and think it is something else, or experience misunderstandings
Talk to people who are not in the room
Talk about going on a trip or leaving
Have cool hands, arms, feet, or legs
Have a blue or gray nose, mouth, fingers, or toes
Have breathing that sounds wet, maybe with bubbling sounds
Have breathing changes: breathing may stop for a bit, then continue as several quick, deep breaths
Stop responding to touch or sounds, or go into a coma
What you can do
If you do not understand what you see, ask a hospice team member.
Let family and friends visit, even children -- a few at a time.
Help the person get into a comfortable position.
Give medicine to treat symptoms.
If the person is not drinking, wet his or her mouth with ice chips or a sponge.
If the person is hot, put a cool, wet cloth on his or her forehead.
Keep a light on. If the person has blurry vision, darkness can be scary.
Play soft music that the person likes.
Touch the person. Hold hands.
Talk calmly to the person. Even if you get no response, he or she may still hear you.
Write down what the person says. This may comfort you later.
Let the person sleep.
When to call the doctor
Call the doctor if your loved one shows signs of pain or anxiety.
O'Leary N. Diagnosis of death and dying. In: Walsh D, Caraceni AT, Fainsinger R, et al., eds. Palliative Medicine. 1st ed. Philadelphia, PA: Elsevier Saunders; 2008:chap 177.
Rakel RE, Strauch EM. Care of the dying patient. Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 8th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 5.
Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.