12 Signs That Someone Is Near the End of Their Life

How to help your loved one—and yourself—cope

It's terrible to learn that a loved one is reaching the end of their life. But knowing what to expect can make you more prepared for what will happen.

If you've hired hospice professionals (healthcare providers for people nearing the end of life), they can help make your loved one's last months, weeks, and days as comfortable as possible. They can also support you as you go through this difficult time.

This article will discuss 12 signs that a person is nearing the end of their life. It also suggests ways you can help your loved one cope with the final stages.



Elderly man with head resting on his hand

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Pain is probably the most feared symptom at the end of life. Dying of cancer is often painful, but this isn't true for every terminal illness.

Fortunately, there are many medicines that can effectively manage pain. Whatever the sickness is, the ability to recognize and help manage pain for your loved one is extremely important.


Shortness of Breath

Retired woman relaxing in living room
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Shortness of breath or breathing difficulties are among the most common symptoms at the end of life. Some amount of breathlessness is common in most people as they near death.

Luckily, there are a few simple and effective treatments that can bring quick relief, such as deep-breathing exercises, relaxation techniques, oxygen, and medications.



Anxiety & Depression in Old Age

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Anxiety is perfectly normal at the end of life. A person may experience pain or shortness of breath during the dying process. This is something that can be upsetting and scary.


Decreased Appetite and Thirst

Senior man reading newspaper at breakfast table

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As a person's body naturally shuts down and prepares for death, it no longer needs the calories and nutrition that food provides. Even though it's normal for people to refuse food and drink at the end of life, this can be upsetting for their families.

Since providing food is such a huge part of caregiving (and caring) it often feels strange for a loved one to care for the patient and not feed them.

The important thing to understand is that when someone is dying from a terminal illness, the desire for less food is something natural and does not really speed up the process of death. Most patients experience a dramatic decline in the desire for food.


Nausea or Vomiting

Senior man taking his pills
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Sicknesses, medications, and other treatments can lead to nausea with or without vomiting. This can be distressing for both you and your loved one. Nausea medications, fresh air, eating small meals, and limiting odors are among the treatments you can try to help your loved one manage these symptoms.



worried mature woman

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If you've ever been constipated, you know how uncomfortable it can be. Medications used to treat pain and shortness of breath can cause constipation. Other causes of constipation are not enough physical activity, decreased fiber and fluid intake, and the progression of the disease.

Constipation is a symptom you have to stay on top of to prevent it from becoming severe. Ask your loved one's doctor or nurse how best to manage it.



Careful grandson covering grandpa with blanket

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A dying patient may sleep a lot because they don't have enough energy. It may also be because the body is shutting down. Medications they take can cause drowsiness too.

Trouble sleeping is also common.


Drifting Away From Loved Ones

Senior woman embracing men, consoling, close-up

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As someone nears death, they naturally start to focus inward and separate from the world around them. This includes friends and family. On the other hand, others may crave closeness with those they love. Either way, try to respect and take care of their needs.


Delirium and Restlessness

Senior man asleep in bed

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Confusion, agitation, and inability to sleep can happen with some people at the end of life. Delirium (suddenly acting confused and disoriented) can be caused by the progression of the disease, less oxygen reaching the brain, or medications.

Sometimes constipation (trouble having bowel movements) or dehydration (not enough water in the body) may even trigger delirium.

The person may nervously pick at their sheets and clothing. They may even hallucinate and see people and things that aren't there. Let your healthcare provider know if your loved one is showing any of these behaviors.



Businessman stomachache

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Both urinary and bowel incontinence are common near the end of life. When you have incontinence, you can't control your urine or bowel movements.

This can be a result of surgery or illness, or because the person is simply too weak to use the bathroom. At the very end, when the muscles relax entirely, the patient will often release the contents of their bowels.


Cold Hands and Feet and Skin Mottling

Female legs in knitted socks

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Hands and feet may become colder and the skin may look blotchy and purplish (mottled). It happens because the heart is no longer able to pump blood as well. As a result, blood pressure goes down and the skin grows colder.

This mottling may slowly work its way up the arms and legs. The lips and nail beds can turn blue or purple too.


The "Death Rattle"

USA, Utah, Ogden, Senior man in hospital

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As uncomfortable as it is to call this symptom the "death rattle," it's a correct description. "End-stage wet respirations" is the medical term for saliva and mucus that build up in the airway when an individual becomes too weak to clear those secretions out.

The collection of mucus and fluids causes a rattling sound when the person breathes. This can upset family and friends who hear it. But most of the time, the patient isn't feeling any pain or suffering. 


When someone is nearing the end of life, they experience a variety of symptoms. Pain, shortness of breath, anxiety, incontinence, constipation, delirium, and restlessness are just a few signs that a loved one is going through the dying process.

A Word From Verywell

No one wants their loved one to die from a terminal illness. It's a frightening experience for everyone involved. Talking with your loved one's doctor and knowing what to expect can help you make them as comfortable as possible during the final stages of life.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Cancer Society. What to expect when a person with cancer is nearing death.

  2. Hendriks SA, Smalbrugge M, Galindo-Garre F, Hertogh CMPM, van der Steen JT. From admission to death: prevalence and course of pain, agitation, and shortness of breath, and treatment of these symptoms in nursing home residents with dementiaJournal of the American Medical Directors Association. 2015;16(6):475-481. doi:10.1016/j.jamda.2014.12.016

  3. Sandvik RK, Selbaek G, Bergh S, Aarsland D, Husebo BS. Signs of imminent dying and change in symptom intensity during pharmacological treatment in dying nursing home patients: a prospective trajectory studyJournal of the American Medical Directors Association. 2016;17(9):821-827. doi:10.1016/j.jamda.2016.05.006

  4. Glare P, Miller J, Nikolova T, Tickoo R. Treating nausea and vomiting in palliative care: a review. Clin Interv Aging. 2011;6:243-59. doi:10.2147/CIA.S13109

  5. Dzierżanowski T, Ciałkowska-rysz A. The occurrence and risk factors of constipation in inpatient palliative care unit patients vs. nursing home residents. Prz Gastroenterol. 2018;13(4):299-304. doi:10.5114/pg.2018.79809

  6. Hui D, Dev R, Bruera E. The last days of life: symptom burden and impact on nutrition and hydration in cancer patientsCurrent Opinion in Supportive & Palliative Care. 2015;9(4):346-354. doi:10.1097/SPC.0000000000000171

  7. Hosker CMG, Bennett MI. Delirium and agitation at the end of lifeBMJ. :i3085. doi:10.1136/bmj.i3085

  8. Hui D, dos Santos R, Chisholm G, Bansal S, Souza Crovador C, Bruera E. Bedside clinical signs associated with impending death in patients with advanced cancer: Preliminary findings of a prospective, longitudinal cohort studyCancer. 2015;121(6):960-967. doi:10.1002/cncr.29048

Additional Reading

By Angela Morrow, RN
Angela Morrow, RN, BSN, CHPN, is a certified hospice and palliative care nurse.