Signs That Are Present When Someone Is Dying

You’ve probably been there a few times, although given the emotional nature of the thing, it’s likely that you weren’t taking notes. Hospice workers, on the other hand, do take notes, so here are some things you might want to know, and if anything makes the next time even a little easier, that’ll be good:

Last stages

Here are the discussed signs of the “active dying” phase:

• Increasing unconsciousness:
  • The person will be mostly unresponsive most of the time.
  • Eyes may be open or partially open but not making eye contact.
  • Mouth will likely remain open due to muscle relaxation.
• Cessation of food and water intake
  • The person will likely not eat or drink for several days.
  • This is a natural process and does not cause suffering per se (e.g. thirst, hunger).
  • Dryness of mouth, however, can be treated with a little moistening, for comfort.
• Changes in breathing
  • Breathing patterns will change and may be irregular.
  • This is a natural metabolic response, and is not a sign of distress.
  • Terminal secretions (“death rattle”) may occur:
    • A gurgling sound caused by saliva buildup due to loss of swallowing reflex.
    • Not painful or distressing for the person.
    • Can be managed by repositioning or using medication to dry secretions.
• Skin color changes / mottling:
  • First appears on fingers and toes (purple or gray discoloration).
  • May spread to knees, nose, or other extremities.
• Temperature fluctuations:
  • The body loses its ability to regulate temperature.
  • Person may feel hot but be cold (or vice versa).
  • Fevers are common—cooling measures and/or Tylenol can help.

A person in discomfort may appear restless, have a furrowed brow, or show physical agitation. If on the other hand they appear peaceful and unresponsive, they are almost certainly not in distress. At such times, it’s best to focus on just keeping them clean and comfortable.

For more on all of these, see:

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Want to learn more?

You might also like to read:

Managing Mortality: When Planning Is a Matter of Life and Death

Take care!