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Palliative care - what the final days are like

End of life - final days; Hospice - final days

What it is

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
  • Talk less
  • Moan
  • Have cool hands, arms, feet, or legs
  • Have a blue or gray nose, mouth, fingers, or toes
  • Sleep more
  • Cough more
  • 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.


Balducci L. Death and dying: what the patient wants. Ann Oncol

O'Leary N. Diagnosis of death and dying. In: Walsh D, Caraceni AT, Fainsinger R, et al., eds.Palliative Medicine

Rakel RE, Strauch EM. Care of the dying patient. Rakel RE, Rakel DP, eds.Textbook of Family Medicine

Update Date 5/11/2014

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