How to Recognize When Your Loved One Is Dying

The dying process usually begins well before death itself. Sometimes, knowing the common steps in this process can help you know when a loved one is close to dying. There are particular physical, mental, and emotional changes that are signs of the end of life.

Death is a deeply personal journey, and nothing is certain or set in stone except for the outcome. There are many paths one can take, but the stages often seem similar.

This article looks at these steps in the journey of dying. It begins with what happens about one to three months before death, then during the last two weeks before death, and then the last few days of life. It is meant to help you know what to expect along this process.

mental and physical changes before death

Verywell / Cindy Chung

The Dying Process

Your loved one may have been ill for a long time, or they may have just recently learned that the end is near. But in either case, the dying process begins: a journey from the known life of this world to the unknown of what lies ahead.

Each person starts on a mental path of discovery, knowing that death will indeed occur and believing in their own mortality. Ultimately, they will leave their body.

There are milestones on this journey, though not everyone stops at them all. Some may hit only a few, while others may experience each one and take their time along the way. Some may take only days, while others travel a road for months. Here's how a journey begins.

One to Three Months Prior to Death

For many people, the dying process comes into view at about a month to three months before death. The process is fairly similar for all genders, although there are some differences.

Women may be more likely to revisit their lives and think of relational regrets. Men may be more likely to withdraw, not wanting to be seen as helpless or needy.

Mental and Behavioral Changes

As a person accepts their mortality and realizes that death is approaching, they may begin to withdraw. They are beginning the process of separating from the world and the people in it.

Your loved one may decline visits from friends, neighbors, and even family members. When they do accept visitors, it may be hard for them to interact and for you to care for them in the moment.

This is a time when a person begins to think about their life and revisit old memories. In evaluating their life, they may be sorting through any regrets.

Physical Changes

The dying person may experience reduced appetite and weight loss as the body slows down. The body doesn't need the energy from food that it once did. The dying person may be sleeping more now and not busy with activities they once enjoyed. They no longer need as much nourishment.

The body chemistry is naturally altered at this time, and that can mean a wonderful thing: It can cause a mild sense of euphoria, a feeling of happiness and well-being.

The dying person may become neither hungry nor thirsty. They are not suffering in any way by not eating, and it is an expected part of the journey they are taking.

One to Two Weeks Prior to Death

Families often find the dying process will move faster in the last week or two of life. This may frighten them, especially if they are upset by mental changes in their loved one.

At this point in the journey, you may want to "correct" a loved one if they say things that don't make sense. It's not advised that you do. It may be better to listen, and support them in their thoughts.

If they claim to see loved ones who died before, simply let them tell you. We don't have a way to know if they are hallucinating, or if our loved ones really see what we cannot. Just love them.

Mental and Behavioral Changes

This is the time when someone who is dying starts to sleep most of the time. Confusion is common and altered senses can be expected. It's possible that a loved one will experience delusions, like fearing hidden enemies or feeling invincible, and you may need to be patient and supportive.

The dying person may also have hallucinations. They see or speak to people who aren't there, including those who have already died. Some may see this as the veil lifted between two worlds.

The person may be restless, and pick at their bedsheets or clothing. Movements and actions may seem aimless and make no sense to others.

Physical Changes

The body is having a hard time maintaining itself, and your loved one may need help with just about any form of activity. They may have trouble swallowing medications or may refuse to take the ones they are prescribed. If they use pills for pain, they may need liquid morphine at this point.

The body may show certain signs that death is near. They include:

  • Body temperature that's a degree or more lower than normal
  • Lower blood pressure
  • An irregular pulse that may slow down or speed up
  • Increased sweating
  • Skin color changes, with pale or bluish lips and nail beds
  • Breathing changes, which may include a rattling sound and cough
  • Less or no talking
  • Sudden arm or leg motions

Days to Hours Prior to Death

Sometimes, the last couple of days before death can surprise family members. Your loved one may have a sudden surge of energy as they get closer to death. They want to get out of bed, talk to loved ones, or eat food after days of no appetite.

Some loved ones take this to mean the dying person is getting better, and it hurts when that energy leaves. Know that this is a common step, but it usually means a person is moving towards death, rather than away. They are a dying person's final physical acts before moving on.

The surge of energy is usually short, and the previous signs return in stronger form as death nears. Breathing becomes more irregular and often slower. Cheyne-Stokes breathing, rapid breaths followed by periods of no breathing at all, may occur. So may a loud rattle.

Again, these breathing changes can upset loved ones but do not appear to be unpleasant for the person who is dying.

Hands and feet may become blotchy and purplish, or mottled. This mottling may slowly work its way up the arms and legs. Lips and nail beds are bluish or purple, and lips may droop.

The person usually becomes unresponsive. They may have their eyes open but not see their surroundings. It is widely believed that hearing is the last sense to leave a dying person, so it is recommended that loved ones sit with and talk to the dying loved one during this time.

Eventually, breathing will cease altogether and the heart stops. Death has occurred, the journey is done, and the living must now continue on.

Summary

Many people wonder if they will recognize if a loved one is dying. There are often signs that begin a month to three months before death. Knowing these signs may help you prepare for your loved one's death, and bring comfort as you face these physical and mental changes.

A Word From Verywell

It's a difficult time but people are here to help you. Members of a hospice staff, a social worker, or clergy can help you recognize and understand some of the changes. They can offer support for you, and help you know how to support a dying loved one as much as possible.

Frequently Asked Questions

  • What are common signs of the end of life?

    Physical signs that someone is likely to die soon include:

    • Breathing changes, including shortness of breath and wet respirations 
    • Cold hands and feet 
    • Constipation
    • Decreased appetite and thirst
    • Delirium
    • Fatigue
    • Incontinence
    • Nausea
    • Pain
    • Restlessness


  • Why does someone lose their appetite near the end of life?

    As the body slows down to prepare for death, the metabolism slows down, and less food is needed. The digestive tract is also less active, so the person likely does not feel hungry.

  • How long after someone stops eating will they die?

    When a person near the end of life stops eating entirely, it is a sign that death is near. It can be as quick as a few days or up to 10 days. However, some people hang on for a few weeks after they stop eating.

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6 Sources
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  1. Hartogh GD. Suffering and dying well: on the proper aim of palliative care. Med Health Care Philos. 2017;20(3):413-424. doi:10.1007/s11019-017-9764-3

  2. Breitbart W. Agitation and delirium at the end of life: "We couldn't manage him". JAMA. 2008 Dec 24;300(24):2898-910, E1. doi:10.1001/jama.2008.885

  3. Harris D. Delirium in advanced diseasePostgrad Med J. 2007;83(982):525-528. doi:10.1136/pgmj.2006.052431

  4. Rome RB, Luminais HH, Bourgeois DA, Blais CM. The role of palliative care at the end of life. Ochsner J. 2011;11(4):348-52.

  5. Wholihan D. Seeing the light: End-of-life experiences-visions, energy surges, and other death bed phenomena. Nurs Clin North Am. 2016;51(3):489-500. doi:10.1016/j.cnur.2016.05.005

  6. Blundon EG, Gallagher RE, Ward LM. Electrophysiological evidence of preserved hearing at the end of life. Sci Rep. 2020;10(1):10336. doi:10.1038/s41598-020-67234-9