Is this person dying now, and what should I do?
They may be dying now if they are much sleepier or cannot be woken, are no longer eating or drinking, have changed breathing, have cool or mottled skin, pass very little urine, or seem confused, restless or less aware of you.
They may be dying now if they are much sleepier or cannot be woken, are no longer eating or drinking, have changed breathing, have cool or mottled skin, pass very little urine, or seem confused, restless or less aware of you. These changes can happen in the last hours or days of life, but they can also have other causes that may need treatment.
If you are unsure, contact the person's palliative care team, GP, nurse or aged care staff. If the death is expected and there is a care plan, follow that plan. If the change is sudden, frightening, painful, or not covered by the plan, ask for help now.
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.
Signs that death may be close
No single sign proves that someone is dying right now. It is usually the pattern that matters. Common signs include:
- sleeping most of the time, or being hard to wake
- needing help with all care
- no longer wanting food or drink
- trouble swallowing tablets, food or fluid
- passing little or no urine
- breathing that is noisy, irregular, very shallow, or has long pauses
- cool hands or feet, mottled or blotchy skin
- confusion, restlessness, agitation or seeing things that are not there
- drifting in and out of consciousness.
These signs are common when the body is shutting down. They can appear over days, or sometimes over a few hours. Some people have many of them. Others die with fewer warning signs.
What you can do first
Look at the care plan, medicine chart or after-hours instructions, if there is one. Many people who are expected to die at home or in aged care have a plan that says who to ring, what medicines are available, and when to call an ambulance.
Make the person comfortable. You can:
- speak calmly and tell them who is there
- adjust pillows or help them change position if this has been shown to you
- keep the room quiet, with gentle light
- moisten their mouth if their mouth is dry
- offer small sips only if they are awake enough and can swallow safely
- avoid forcing food, drink or tablets
- stay with them, or ask someone trusted to sit with you.
If the person cannot speak, watch their face, body and breathing. Frowning, grimacing, groaning, tense muscles, pulling away, agitation or sudden distress may mean they need review.
Who to contact
If the person has a palliative care team, contact them first unless the situation is life-threatening. If they are in hospital, hospice or aged care, call the nurse or staff member. If they are at home and do not have a palliative care team, call their GP, local after-hours medical service, healthdirect on 1800 022 222, or the number in the care plan.
Ask direct questions:
- "Do you think they are dying now?"
- "What changes should I expect in the next few hours?"
- "What should I do if their breathing changes?"
- "Which medicines should be used, and when?"
- "Who do I call overnight?"
- "If they die at home, what do I do next?"
It is reasonable to ask these questions more than once. Families often need information repeated when things are changing quickly.
When to get help now
Call the palliative care team, GP, nurse or aged care staff urgently if the person has new or worsening pain, severe breathlessness, repeated vomiting, choking, agitation that is not settling, bleeding, a fall, a seizure, or any change that worries you.
Call 000 if the person has a life-threatening emergency and there is no plan saying this is an expected part of dying, or if the death is sudden and unexpected. If the person is expected to die at home and has a documented plan, an ambulance may not be needed. Follow the plan and contact the doctor or palliative care service when you are ready.
If you do call an ambulance, tell the call taker and paramedics that the person is receiving palliative or end-of-life care. Have any advance care directive, resuscitation plan, medication chart or doctor letter ready if you can find it.
If you think death has occurred
Death has occurred when breathing has stopped, the person cannot be woken, there is no heartbeat or pulse, and their pupils are fixed. Their mouth or eyes may be open. Their skin may become pale, cool or waxy.
For an expected death at home, there is usually no need to hurry. Contact the person's doctor or palliative care team when you are ready. If they are in a facility, tell staff. If the death was not expected, call 000.
You may also want to read
- What is an advance care directive?
- How can I tell if someone is dying?
- Is what I'm seeing normal dying, or are they suffering?
- How long does someone have once these changes start?
- Are they suffering when breathing becomes noisy, irregular or stops for periods?