Know What To Expect
Jump to a topic:

Understanding the Dying Process

Changes That May Occur

If you or someone you care about is facing a terminal illness, it’s important to learn about the dying process and understand the physical and emotional changes that can be expected in the final weeks, days and hours. Of course, everyone’s situation will be different, but managing pain and providing comfort is best achieved when everyone is tuned into the natural processes and sensitive to the needs of the dying person. 

Changes that May Occur

Just before a person dies, and as death is occurring, his body changes a lot. These changes can happen in the hours before he dies. Some changes happen two or three days or even months before he dies.

He may become unresponsive (as in a coma). Sometimes he may seem aware, and be "in and out" of consciousness.

He may become restless. He may talk to people who aren't there. He may seem like he is in pain.

Some people have involuntary twitches, which aren’t usually bothersome, but if so, medicines can help.

The dying person’s blood pressure may go down. His pulse and his breathing may slow. His skin may be blue or damp or cold.

Mucus may fill his mouth, causing a rattling noise. Turning the patient onto his side can make his breathing quieter. Removing mucus from the mouth may or may not help.

As death nears, his breathing may change. It may get faster for a while, then slow down. Or his breathing may be louder for a while, then get very quiet. If he is having a hard time breathing, medicines can help.

Output of stool and urine usually drops. The urine gets darker and he may wet his bed.

As the patient gets weaker or sleepier, he will communicate less. If you are sitting with a dying person, you need to take breaks. Sometimes, just stepping out of the room can reduce stress. If you wish to be with him when he dies, tell others involved so they can help you do that.

Text provided by:
Caring Connections
A Hope and Comfort in Grief Program
University of Utah Health Sciences Center
Caring Connections is sponsored in part by the Ben B. and Iris M. Margolis Foundation.

Related Resources

PDFicon.png Tool Kit for Advance Health Care Planning

A variety of self-help worksheets, suggestions, and resources to help with the end-of-life process. 

The Marie Curie Palliative Care Institute »
The Liverpool Pathway is an integrated care pathway that is used at the bedside to drive up sustained quality of the dying in the last hours and days of life.

Choosing Options, Honoring Options »
Helpful information to encourage meaningful conversations and advance care planning centered on personal choices for end-of-life.

Closure »
An initiative to change expectations for end-of-life with easy-to-access, simple-to-understand information and resources to make educated decisions about end-of-life care.