Over the past few weeks, you may have seen many changes in your loved one. He or she may sleep longer, have less energy, eat less, or withdraw from family and friends. This is normal as a person gets closer t​o the end of life.

Not knowing what to expect can be stressful. This information tells you what your loved one may go through in the final days, and how you can help. Everyone is different, and not all of these things will happen to your loved one. But if they do, this information can help you be prepared.

What to Expect

Sleeping a lot

• Some people may sleep longer and be harder to wake up. A time may come when they don’t respond to you at all and seem to be in a coma-like state.
• Plan to talk to your loved one when he or she is most alert.
• Let your loved one sleep when he or she wants to.
• Keep visits short or simply sit quietly at the bedside.

Eating and drinking less

• As the body starts to slow down or shut down, it’s normal for a person to feel less hungry and less thirsty, or not be hungry or thirsty at all. They may also have a hard time swallowing.
• Offer small portions of food and do not force-feed your loved one.
• Keep the mouth moist with moist swabs and use lip balm.
• If you have questions about how much fluid your loved one should get, ask your doctor or nurse.

Feeling confused or restless

• Some people feel confused, restless, or agitated. They may:
  • try to climb out of bed
  • grab at things
  • see things that aren’t really there
  • say or do things that aren’t normal for them
• These can be natural symptoms or they could mean that medical help is needed.
• Some people need to work through personal issues. Others have a hard time letting themselves go. You can:
  • tell your loved one that he or she is safe and cared for
  • listen if your loved one wants to talk about personal things
  • give your loved one permission to let go of life

Breathing changes

• The rate and depth of breathing may change. Breathing may stop for 10 to 45 seconds at a time. This is a normal part of dying.
• People usually don’t need extra oxygen.

Heartbeat changes

• The heart is trying to keep up, and it may not beat regularly.
• Checking the blood pressure does not help and can make the person uncomfortable.

Bowel and bladder problems

• Losing bowel or bladder control is common.
• As the body shuts down, it may make less or almost no urine.
• Your loved one still needs bowel care to prevent constipation and discomfort, even if he or she isn’t eating.

Chest congestion

• The heart and lungs are stressed, and you may hear wet-sounding breathing as saliva collects at the back of the throat. To help, health care staff may:
  • turn your loved one to help clear saliva
  • raise the head of the bed a little
  • give medicine if the problem is causing stress

Skin changes

• It’s natural for the body to direct most of its blood to vital organs. This causes skin to become bluish grey and/or blotchy looking.
• Arms and legs may become cool but this shouldn’t make your loved one feel uncomfortable.

Twitching muscles

• As muscles are getting less oxygen, they may start to twitch.
• Some medicine could also cause muscle twitching.

Eye problems

• The eyes may become dry, stay open, or have a white film over them. They may not be able to focus well.
• Eye lubricants, gentle cleansing, and closing the lids may help.

Temperature changes

• A higher than normal temperature is common.
• Giving lukewarm sponge baths, applying cool facecloths to the forehead, or using a fan can help.
• You can give medicine to lower fever and make your loved one more comfortable.

Being with Your Loved one

Just being with your loved one is one of the best ways to give comfort and support. You don’t need to say anything special. There are a lot of things you can do:

• When your loved one wants to talk, chat about happy times and laugh together.
• Don’t be afraid to talk about ordinary things in your life.
• If your loved one wants to be touched, try holding hands or giving a hug or a gentle massage to the hands and feet.
• Hold hands even when your loved one is sleeping.
• Use a low-intensity light in the room.
• Remember that even though your loved one isn’t responding, he or she may still be able to hear you. Be aware of what you say.
• Do as much or as little physical care for your loved one as you wish. Nursing staff can show you what to do.

More tips

• If the person is in a facility or hospice, decorate the room with photos, keepsakes, a favourite quilt, or pillows.
• If the person is being cared for at home, think about where to put the bed. Some people like to see outside. Others like to be close to people. Some want quiet and privacy.​​​​​​​​