Symptoms and Signs at End of Life
Understanding what to expect in a loved one's final days can ease the fear of the unknown for families.
Every patient's journey is different, but hospice nurses see certain patterns repeat across the dying process. Knowing what to expect at each stage — and calling your hospice nurse when something changes — is one of the most reassuring things a family can do.
Weeks Before Death
Increased sleep, refusal of food, withdrawal from social interaction, and use of metaphorical language are common. Physical symptoms can include fatigue, weight loss, difficulty swallowing, and abdominal swelling.
Days Before Death
The pulmonary system deteriorates, often causing congestion and the characteristic "death rattle." Breathing becomes irregular, fluctuating dramatically in rate. Patients may experience hallucinations, sometimes describing conversations with deceased loved ones.
24 Hours Before Death
Extended sleep periods dominate, with sensory decline except for hearing, which is believed to remain intact the longest. Skin becomes increasingly mottled, blood pressure drops further, and restlessness can increase due to reduced oxygen reaching the extremities.
Final Hours
Circulatory and pulmonary systems fail progressively. Body temperature drops, hallucinations may intensify, and breathing becomes gasping or stops entirely.
End of Life FAQ
Download a free guide for more on what to expect.
End of Life: Helping with Comfort and Care — a 76-page guide from the National Institute on Aging that we share with every family — covers comfort care, hospice, advance directives, and the decisions along the way.
Or call us any time at (248) 516-3978.