In the last days and hours before death, many people have symptoms such as not drinking, breathing changes and skin changes. On this page, we describe what symptoms people might have at this time and what can help. This page is for family and friends of people living with a terminal illness or advanced old age.
We know it can be upsetting to think about the end of someone’s life or reflect on what has happened. And you might find some of the descriptions on this page upsetting or worrying. If you don’t feel ready to read this information just yet, you can come back to it at any time.
If you have any questions or need to speak to someone, you can call our free Support Line on 0800 090 2309 or email support@mariecurie.org.uk.
Changes in the last days or hours of life
There are normal changes that sometimes happen in the last days and hours of life as the body slows down. Not everyone will have these symptoms. And these symptoms can also be caused by other things.
Many of these symptoms do not usually cause the person pain or distress. If you think the person is uncomfortable or you’re worried, speak to their doctor, nurse or care home staff.
Loss of consciousness in the last days of life
People sleep more and need to rest as their body slows down. In the last few days of life, they might sleep for longer periods and seem less aware of what’s going on around them. They may still have some awareness of what is happening in the room. They may be able to hear what’s being said or feel someone holding their hand.
Drinking less or not drinking in the last days of life
In the last days of life, many people stop wanting to drink fluids or find it difficult to swallow fluids. This is normal and they should not be pressured to drink.
If the person feels thirsty and has problems swallowing, they can try:
- taking small sips if they can
- trying different cups
- sucking on ice chips or ice lollies if they can
- using a spray, dropper or syringe without a needle to keep their mouth moist.
You can help them with these things if they need help.
People sometimes ask about having fluids through a tube if the person is unable to swallow. If someone is expected to die soon, this may not help them live longer or make them feel better, and it can cause other problems. Their doctor or nurse can look at whether extra nutrition or fluids are needed and talk about the advantages and disadvantages of giving these.
Dry mouth in the last days of life
Many people have a dry mouth at this stage as they might be breathing more through their mouth and are drinking less. Sometimes people have a dry mouth as a side effect of medicines they are taking.
They can try:
- taking small sips of liquid, if they can
- sucking on ice chips or ice lollies, if they can
- using a spray, dropper or syringe without a needle to keep their mouth moist
- sucking on sugar-free chewing gum, mints or boiled sweets, if they can
- keeping their lips moisturised.
If they seem uncomfortable, speak to their doctor, nurse or care home staff. They might suggest a gel or spray that makes the mouth feel moist (called ‘topical artificial saliva’) or encourages the mouth to produce saliva.
Noisy breathing in the last days of life
Some people have noisy breathing if secretions (saliva of mucous) have built up in their throat and chest. This is normal and is not usually uncomfortable or painful for them. But it might be upsetting to listen to. Speak to their doctor, nurse or care home staff if you are worried.
Peeing less in the last days of life
In the last days of life, many people do not pee (urinate) very much or at all. This is normal. Some medicines can also make it harder to pee. If the person seems uncomfortable or you are worried, speak to their doctor or nurse. They might need a catheter (a small tube that drains urine into a bag) to help them pee.
Changes to skin in the last days of life
People with lighter skin tones might look slightly blue, especially their hands or feet. Their skin can become mottled (have different coloured blotches or patches).
For people with darker skin tones, blue can be hard to see. It may be easier to see on their lips, nose, cheeks, ears, tongue, or the inside of their mouth. Mottling is also harder to see on darker skin tones – it might look darker than normal, purple or brownish in colour.
These changes are normal when someone is approaching the end of life. If the person seems uncomfortable, you can use blankets or socks.
If any areas of their skin look sore or their skin colour changes on parts of the body they are lying on, they might have pressure sores. Tell their doctor, nurse or care home staff.
Getting support when someone is in the last days or hours of life
If you have any concerns about your family member or friend, speak to their doctor, nurse or care home staff.
This can be an upsetting and difficult time for you too. If you would like some extra support, you can call our free Support Line on 0800 090 2309 or email support@mariecurie.org.uk.