If you have a loved one who has recently entered hospice care or is going to, you may have only a few months, or even weeks, to say goodbye. During this time, they may exhibit changes in their behavior, diet, mood and much more. Unfortunately, many people are unprepared to adequately care for their loved ones because they don’t know what to expect from the dying process


In the days before death, a series of physiological changes will occur. Their pulmonary system will start to degrade and the will become congested, leading to a tell-tale “death rattle.” Their breathing will also exhibit fluctuations, as they may begin to respirate up to 50 times per minute or as little as six. When exhaling, they may “puff” their lips. They may also begin to cough more frequently, but in general, the congestion itself is painless.

During their last days, your loved one may begin to experience hallucinations in which they talk to people who aren’t there or who have also died. It is important to maintain a close eye on your loved one if they begin exhibiting these symptoms. There is no guarantee for how long they may have left, and some people pass through this process faster than others.

Some common symptoms those a few days from death experience include:

A drop in blood pressure
The body temperature changes frequently
Skin changing color or becoming blotchy
Erratic sleeping patterns
Fewer bowel movements
Less urination
Decreased appetite and intake of fluids


During the last 24 hours of your loved one’s life, much of your loved one’s time will be spent sleeping. While awake, they will have difficulty interacting with you because many of their senses may be failing. However, their hearing should remain, and may be the only way they can experience the world. You can use a normal speaking voice when talking to them. Many of the physical changes they have experienced for the past few months will become more pronounced.

  • A sudden burst of energy that slowly fades
  • Their skin becomes increasingly mottled and blotchy, especially on the hands, feet and knees.
  • Further drop in blood pressure
  • Inability to swallow
  • Less urine
  • Increased restlessness, due to a lack to oxygen to the limbs
  • Labored breathing
  • Increased congestion, including possible fluid secretions


In the final hours of life, your loved one’s body will begin to shut down. Their circulatory and pulmonary systems will slowly begin to fail. This may lead to falling body temperatures, but may also cause sudden outbursts. Your loved one will also experience greater difficulty interacting with the outside world. They may not be able to see you and may be unresponsive when you try to communicate with them. However, their hearing may yet remain intact. They may still be able to understand you, even if they cannot respond.

Some symptoms a person may experience during this time include:

Glassy, teary eyes that may be half-opened
Cold hands
Weak pulse
Increased hallucinations
Sleeping and unable to be awoken
Breathing is interrupted by gasps, or may stop entirely


Eventually, your loved one will pass away, but it can be difficult to tell at first if this has happened. It’s not uncommon for a person to be unresponsive throughout the dying process, and it is easy to think that your loved one is simply asleep or unconscious when in fact they have died. If you suspect this is the case, call your hospice nurse, who can provide you with further instructions. Special procedures must be followed when removing our loved one’s body from your home.

Here are a few tell-tale signs that indicate when your loved one has passed away:

They begin to gasp, then slowly take several more breaths relatively far from one another
Their eyes and mouth open
They cannot be awakened


Hospice care allows you to share your loved one’s most difficult journey with them, which can make it easier for you and them to obtain closure. Providing a high quality of life should be your main focus, which may be easier early on when you can still participate in a range of activities together. To properly care for them later in the dying process, make sure they are hydrated and fed without forcing anything on them. It will be normal for your loved one to become somewhat dehydrated during their final days. You may also have to clean them and move them to avoid bedsores.

Maintaining good communication with your loved one can help you provide them with the best possible support during their last days. In doing so, you may find that you both may want to spend time alone. This can help both of you cope with the dying process and allow you to better appreciate the time you have together. Your loved one can also let you know of any medical care they wish to receive or refuse should they become unresponsive.