How can I tell if someone is dying?
You may be able to tell someone is dying by looking at the whole pattern of change.
You may be able to tell someone is dying by looking at the whole pattern of change. They may spend most of the day asleep, stop eating and drinking, have trouble swallowing, pass less urine, become confused or withdrawn, need help with all care, and have breathing that becomes noisy or irregular.
These signs often mean death may be close, especially when the person already has an advanced illness. But timing is uncertain. A doctor, nurse or palliative care team can help you understand what the signs mean in this person's situation.
General information: This page gives general information for people in Australia. It cannot tell you exactly what is happening in one person's situation. If you have concerns about a symptom, medicine, treatment decision or change in someone's condition, contact their doctor, palliative care team, nurse or other treating health professional.
Common signs in the last days or weeks
As a serious illness progresses, the person may become weaker and need more help. They may stay in bed or a chair most of the day. Walking to the toilet, showering, turning in bed or sitting up may become hard.
They may sleep for long periods. They may talk less, lose interest in visitors, or seem less aware of what is happening. This can be hard to watch, but it often reflects the body's energy falling.
Eating and drinking usually reduce. The person may only want small tastes or sips, or may refuse food and fluid. This is common near death because the body uses less energy and the digestive system slows. It does not always mean hunger or thirst.
Swallowing may become unsafe. Coughing with food or drink, holding food in the mouth, drooling, a wet voice, or being too sleepy to swallow are reasons to ask for advice.
Changes that may happen closer to death
In the last hours or days, breathing can change a lot. It may be fast, shallow, noisy, rattly, slow or irregular. There may be pauses where the person does not breathe for a while. These pauses can be very distressing for family, but they are common near death.
Hands, feet, fingers or toes may feel cool. Skin may look pale, grey, bluish, mottled or blotchy. Urine may become much less, darker or stop. The person may lose bladder or bowel control.
Some people become restless, confused or agitated. They may call out, pick at the sheets, try to get out of bed, or talk to people who are not there. This may be delirium and may need treatment, especially if the person is distressed or unsafe.
Some people have a short period where they seem more awake or talkative after being very sleepy. This can happen near the end, but it does not always mean they are getting better.
Signs that death has occurred
Death has occurred when breathing has stopped, the person cannot be woken, there is no heartbeat or pulse, and the pupils are fixed. The mouth may fall open. The eyes may be partly open. Skin may become pale, waxy or cool.
If the death was expected and the person was at home, there is usually no need to call an ambulance. Contact the doctor or palliative care team when you are ready. If they are in hospital, hospice or aged care, tell staff. If the death was sudden or unexpected, call 000.
Ask the team to explain the pattern
It is reasonable to ask the treating team:
- "Do these changes mean they are dying?"
- "Are we looking at hours, days or longer?"
- "What symptoms should we watch for?"
- "What should we do if they cannot swallow?"
- "What signs mean they need medicine or urgent review?"
- "Who do we call after hours?"
The team may not be able to give an exact time. They can usually explain whether the pattern is consistent with dying and what comfort care should look like.
When to get help now
Contact the palliative care team, GP, nurse or aged care staff if the person has new pain, severe breathlessness, distress, choking, repeated vomiting, fever, bleeding, a seizure, a fall, or agitation that is not settling.
Call 000 if the person has a life-threatening emergency and is not expected to be dying, or if there is no care plan and you are unsure what to do. If the person is expected to die and has a written plan, follow that plan and contact the listed service.
You may also want to read
- Is this person dying now, and what should I do?
- How long does someone have once these changes start?
- Are they suffering when breathing becomes noisy, irregular or stops for periods?
- They've stopped eating and drinking. Are we starving or dehydrating them?