Signs that someone is in their last days or hours of life

Everyone's experience of dying is different and it can be difficult to know when a person is reaching the last few days of their life. It's important to be able to recognise the common signs of dying, so the person you're caring for can receive the best possible care in their last days of life, and those around them can be prepared.

This information is for health and social care professionals. You can use our My Learning form to reflect on how this page has helped with your continuing professional development. Download the form.

We also have information for the public on the final moments of life.

The last days or hours of a person's life are sometimes called the terminal phase. This is when someone is 'actively dying'.

Everyone's experience of dying is different, and some people will die suddenly or unexpectedly. But there are often signs that can help you to recognise when someone is entering the terminal phase. These include:

You might also notice a change in their skin. People with lighter skin tones may look slightly blue or their skin can become mottled (have different coloured blotches or patches).

On 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 may look darker, purple or brownish in colour.

It can be difficult to know whether someone is entering the last days of their life. If you're unsure, ask a more experienced colleague for advice.

If a patient shows signs that they're entering the terminal phase, speak to the district nurse, GP or palliative care team. They will speak to colleagues, the patient and the people around them to decide whether the patient is entering the last days of life and what care they need.

Some conditions can cause the signs and symptoms of dying but can be treated. Be aware of reversible causes of decline, which may include:

If you think the patient may have any of these conditions, tell their GP or specialist nurse, who will arrange assessment and treatment.

Keep monitoring the person regularly (at least every 24 hours) to make sure they're settled. Talk to the GP or district nurse if there are any changes in their symptoms.

Even when someone has been living with a terminal illness for a while, it can be a shock for the patient and the people around them when they reach the last days of their life. It's important to be honest and reassuring when you're speaking to the patient and those important to them.

The best person to speak to the patient and the people close to them is a health and social care professional who is confident and experienced. It can help if they have had time to build a relationship with the patient. If you do not feel comfortable doing this, ask a colleague to help. You can learn the communication skills needed to speak to patients at the end of life through training, experience and feedback from colleagues.

Check whether the patient has recorded their wishes in a care plan or other document. If they haven't discussed their wishes with anyone, offer them the chance to do this as soon as possible.

Some family members and friends may experience grief before the patient dies. This is called anticipatory grief.

You may find our guides on specific conditions, which include targeted information about signs of dying, useful: