Written by Sophie Bebeau on Tue Jun 17 2025.
Thinking about the death of someone we love is profoundly difficult. For caregivers, this emotional weight can feel even heavier. If you're among the millions caring for an aging family member, you may wonder how to recognize the signs that the end-of-life stage is approaching.
While these questions are never easy, understanding the common signs can offer clarity during an uncertain time. More importantly, it empowers you to support your loved one with compassion and comfort, ensuring their final moments are filled with peace and dignity. You are not alone on this journey—many have walked this path, and support is available every step of the way.
It's very common for loved ones to naturally decrease food and fluid intake, sometimes months before death. This is an instinctual way the body conserves energy. Do not force them to eat or drink. Instead, focus on offering small, comforting sips or bites if they show interest. If you're concerned about discomfort from lack of nutrition, consult your medical team about soft diets or other options.
As the body prepares for death, increased tiredness and lethargy are common. Create a comfortable, peaceful sleeping environment, and plan any activities or quality time during their more awake periods.
Incontinence can be a challenging symptom, especially if it's new. Know that it's very common at the end of life. Your priority is to keep your loved one clean and comfortable. Many adult incontinence products are available; work with your loved one to find what works best. Consider a local caregiver support group for shared experiences and advice on this sensitive topic.
Urine output and color will likely change, often decreasing significantly or stopping completely hours or days before death. Consult your healthcare team regarding any concerns or the need for catheterization.
You may also notice red or purple splotches spread across their skin, called mottling, due to a decrease in blood circulation. Comfort is key. Provide a comfortable resting area for your family member with soft, warm blankets, and have them dress in loose, soft clothing. Lotion dry patches of skin with gentle, unscented lotion or healing ointment.
Sudden, involuntary muscle twitches are common as the body loses muscle control. These "myoclonic jerks" are generally not painful to the dying person, but they can be unsettling to witness. Medications are available to minimize these movements and enhance comfort.
Effective pain control is paramount when caring for a dying loved one. Pain levels vary, so communicate openly with your medical team. Always administer prescribed pain medications as directed, discussing their effectiveness and any side effects. You can also explore complementary therapies like massage, music therapy, or mindfulness techniques to enhance comfort.
Eyesight may become blurry or dark, and blinking can decrease, leading to dry eyes. Keep the room softly lit to reduce strain and use eye drops to prevent irritation.
In the days and hours before death, breathing often becomes shallow, irregular, and may even pause for several seconds or minutes. You might also hear gurgling or rattling sounds as it becomes harder to clear the throat. While these sounds can be distressing for families, they typically do not cause pain or discomfort to the dying person. To ease breathing, try sitting your loved one up at a 45-degree angle if comfortable, and discuss oxygen therapy with your healthcare team.
While their body is doing the difficult physical work of preparing for death, your loved one may also experience profound psychological and emotional experiences while dying. In the months before death, it’s not uncommon to see increased withdrawal from life and a limiting of social interaction. In the more active stages of dying, hallucinations or visions may occur. This is a normal part of the dying process and is not cause for alarm. Allow your loved one to have these moments without discounting or interfering with the experience. If a dying loved one seems distressed by hallucinations or visions, comfort and reassure them. It can be helpful to give reassurance to your loved one that it is okay to “let go” and remind them of the meaningful relationships and experiences they had during their life.
In the final hours or moments of life, specific physical and emotional signs often appear. A dying person's eyes may become glassy, glazed, or remain partially open and unfocused. Breathing often becomes highly irregular and may include a distinctive gurgling sound (often called the "death rattle") due to relaxed throat muscles and fluid buildup. It's also common for individuals to experience vivid hallucinations or speak as if they are in another place or time. These changes are a natural part of the dying process. If possible, stay nearby and provide your calm, compassionate presence; it can offer immense peace during these final moments.
The final stages of the dying process are emotionally taxing, and it can be difficult to tell if your loved one has passed. Your hospice or healthcare team will confirm the time of death. Generally, you can expect some final gasping breaths, and the eyes and mouth may remain open.
Planning beforehand for religious or spiritual rituals, music, or mementos can bring a sense of emotional readiness for both the dying individual and those present. Experiencing the death of a loved one can be challenging, but understanding these signs can help you feel better prepared to provide compassionate care during this profound time.
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Read More >Sophie Bebeau is a writer, graphic designer, poet, and multidisciplinary artist living in Green Bay, Wisconsin. When she’s not writing or making things for the internet, she can be found cross-stitching, writing poetry, and snuggling on the couch with a cup of tea and her husband, son, and dog, Buttercup.
