What to expect in the last moments before death (2024)

FAQs

What happens in the last moments before you die? ›

In the hours before death, most people fade as the blood supply to their body declines further. They sleep a lot, their breathing becomes very irregular, and their skin becomes cool to the touch. Those who do not lose consciousness in the days before death usually do so in the hours before they die.

As the end approaches in two to three days, the active stage of dying begins. Common symptoms include unresponsiveness and a significant drop in blood pressure, indicating impending death.

The first organ system to “close down” is the digestive system. Digestion is a lot of work! In the last few weeks, there is really no need to process food to build new cells. That energy needs to go elsewhere.

But there is no certainty as to when or how it will happen. A conscious dying person can know if they are on the verge of dying. Some feel immense pain for hours before dying, while others die in seconds. This awareness of approaching death is most pronounced in people with terminal conditions such as cancer.

They Know They're Dying

Just as a woman in labor knows a baby is coming, a dying person may instinctively know death is near. Even if your loved one doesn't discuss their death, they most likely know it is coming. In some cases, the person may come from a culture or a family in which death is simply not discussed.

Withdrawal. The person may seem unresponsive, withdrawn, in a comatose-like state. They are detaching. It is a typical end-of-life symptom.

Because most patients are in a coma-like state, they are unable to actively swallow, and secretions may build up in the back of the throat. These respiratory secretions are also terrifyingly known as the death rattle and it begins for many patients about 24 hours before death. This symptom does not happen to everyone.

1 to 2 weeks before death, the person may feel tired and drained all the time, so much that they don't leave their bed. They could have: Different sleep-wake patterns. Little appetite and thirst.

Physical signs of dying

Facial muscles may relax and the jaw can drop. Skin can become very pale. Breathing can alternate between loud rasping breaths and quiet breathing. Towards the end, dying people will often only breathe periodically, with an intake of breath followed by no breath for several seconds.

Does it hurt when your body is shutting down? ›

No – not everyone gets pain in their last weeks, days or hours of life. Some people have no pain at all. However, we know that many people with a terminal illness do experience pain. For people who are in pain, there are different things that can help including medication, support and other practical things.

Purge fluid is foul smelling, red-brown fluid that may exude from the oral and nasal passages as decomposition progresses, as depicted in the image below.

Often before death, people will lapse into an unconscious or coma-like state and become completely unresponsive. This is a very deep state of unconsciousness in which a person cannot be aroused, will not open their eyes, or will be unable to communicate or respond to touch.

The most challenging aspect of witnessing a loved one's journey through hospice can be seeing them experience physical decline, emotional distress, and pain. It can also be difficult to accept that curative treatments are no longer an option and adjusting to a new focus on comfort measures only.

When a person is near the end of life their breathing rate and rhythm may change. Breaths may become shallow and slower. There may even be short periods of time when your loved will stop breathing for a few moments and the time between breaths may get longer as they come closer to death.

This difficult time may be complicated by a phenomenon known as the surge before death, or terminal lucidity, which can happen days, hours, or even minutes before a person's passing. Often occurring abruptly, this period of increased energy and alertness may give families false hope that their loved ones will recover.

The Seven Minutes of Neural Activity

This mysterious experience involves reliving memories in a dreamlike pattern, taking us on an introspective voyage that intertwines the past and present. Research suggests that in the final moments before death, the brain enters a heightened state of activity.

Often before death, people will lapse into an unconscious or coma-like state and become completely unresponsive. This is a very deep state of unconsciousness in which a person cannot be aroused, will not open their eyes, or will be unable to communicate or respond to touch.

Delirium is common during the final days of life. Most people have a lower level of consciousness. They may be withdrawn, be less alert, and have less energy. Some people may be agitated or restless, and have hallucinations (see or hear things not really there).