Hospice Care: Symptoms of Approaching Death

Your hospice team's goal is to help prepare you for some of the things that might happen as your loved one gets close to the time of death. No one can predict exactly when a terminally ill person will die. But certain symptoms mean that the time is getting close. Not all of these signs will appear at the same time, and some may never appear at all. All of the signs described are ways the body prepares itself for the final stages of life.

• Your loved one may sleep more and might be more difficult to wake up. Hearing and vision may decrease.

  What to do: Always act as if your loved one can hear you.

• There may be a slow decrease in the need for food and drink. Your loved one will say they don't have an appetite or isn't hungry. This is the body's natural response to the dying process. The body is indicating that eating and drinking are no longer helpful—food and fluid can't be used correctly anymore.

  What to do: Allow your loved one to choose when and what to eat or drink, even if this means taking in very little or nothing at all. Your loved one will likely handle liquids more easily than solid food.

• Your loved one may become more confused or restless, or experience visions of people and places.

  What to do: Remind them of the time and the day and who is there with them. Be calm and reassuring.

• Your loved one's hands, arms, feet, and legs may become cooler, and their skin may turn a bluish color with purplish splotches.

  What to do: Use blankets for warmth. Don't use an electric blanket or heating pad.

• Irregular breathing patterns may occur. There might be a space of time (10 to 30 seconds) when your loved one will not breathe at all. This is called apnea. There may be phlegm or increased secretions in the throat that cause a gurgle or rattle with breathing. This doesn't cause pain but can be scary and upsetting for the caregivers.

  What to do: Position your loved one on their side, with their head raised.
• Your loved one may lose control of their bladder or bowels.

  What to do: Change pads or diapers as needed. Keep the person's skin and body clean.

Contact your hospice team, or healthcare provider, at any time if you have questions or concerns about changes in your loved one.