Palliative care

End of life - final days; Hospice - final days

If a loved one is dying, you may have a lot of questions about what to expect. Every person's end of life journey is different. Some people linger, while others pass quickly. However, there are some common signs that the end is near. It can be helpful to know that these signs are a normal part of dying.

I Would Like to Learn About:

Palliative care is a holistic approach to care that focuses on treating pain and symptoms and improving quality of life in people with serious illnesses.

Hospice care helps people with illnesses that cannot be cured and who are nearing death. The goal is to give comfort and peace instead of a cure. Hospice care is usually free to Medicare recipients and covered by most commercial insurance plans. Hospice care provides:

Support for the person and the family
Relief of the person's pain and symptoms
Help for family members and loved ones who want to stay close to the dying person

Most hospice patients are in their last 6 months of life.

The Final Days of Life

For a while, signs that death is near may come and go. Family and friends may need help understanding the signs that mean a person is close to death.

What you Might see

As a person gets closer to death, you will see signs that their body is shutting down. This may last anywhere from a few days to a couple of weeks. Some people go through the process quietly, while others may be more agitated.

The person might:

Have less pain
Have trouble swallowing
Have blurry vision
Have trouble hearing
Not be able to think or remember clearly
Eat or drink less
Lose control of urine or stool
Hear or see something and think it is something else, or experience misunderstandings
Talk to people who are not in the room or who are no longer living
Talk about going on a trip or leaving
Talk less
Moan
Have cool hands, arms, feet, or legs
Have a blue or gray nose, mouth, fingers, or toes
Sleep more
Cough more
Have breathing that sounds wet, maybe with bubbling sounds
Have breathing changes: breathing may stop for a bit, then continue as several quick, deep breaths
Stop responding to touch or sounds, or go into a coma

What you can do

You can help make loved one's final days more comfortable both physically and emotionally. Your efforts will help to ease your loved one's final journey. Here are ways to help.

If you do not understand what you see, ask a hospice team member.
If you think the person would want to see other family and friends, let them visit, even children, a few at a time. Try to plan for times when the person is more alert.
Help the person get into a comfortable position.
Give medicine as directed to treat symptoms or relieve pain.
If the person is not drinking, wet their mouth with ice chips or a sponge. Apply lip balm to ease dry lips.
Pay attention to signs that the person is too hot or cold. If the person is hot, put a cool, wet cloth on their forehead. If the person is cold, use blankets to warm them. Don't use electric pads or blankets, which could cause burns.
Apply lotion to soothe dry skin.
Create a soothing environment. Keep a soft light on, but not too bright. If the person has blurry vision, darkness can be scary. Play soft music that the person likes.
Touch the person. Hold hands.
Talk calmly to the person. Even if you get no response, they can probably still hear you.
Write down what the person says. This may help comfort you later.
Let the person sleep.

When to Call the Doctor

Contact a member of the hospice team if your loved one shows signs of pain or anxiety.

References

Arnold RM, Kutner JS. Palliative care. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 3.

Colvin LA, Fallon M. Pain and palliative care. In: Penman ID, Ralston SH, Strachan MWJ, Hobson RP, eds. Davidson's Principles and Practice of Medicine. 24th ed. Philadelphia, PA: Elsevier; 2023:chap 8.

Shah AC, Donovan AI, Gebauer S. Palliative medicine. In: Gropper MA, ed. Miller's Anesthesia. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 52.

Review Date: 3/11/2024

Reviewed By: Frank D. Brodkey, MD, FCCM, Associate Professor, Section of Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Health Content Provider

06/01/2025

A.D.A.M., Inc. is accredited by URAC, for Health Content Provider (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics. This site complied with the HONcode standard for trustworthy health information from 1995 to 2022, after which HON (Health On the Net, a not-for-profit organization that promoted transparent and reliable health information online) was discontinued.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2024 A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.