What are the Signs of Death for Hospice Patients?
The process of death often starts subtly, imperceptible to those unfamiliar with the symptoms. By the time a loved one is clearly slipping away, death has already long begun.
There’s no right or wrong way to die or witness a loved one’s last moments. However, knowing the signs that death is approaching can help you and your family prepare, say your farewells and provide support to the dying.
Death is different for everyone, and symptoms can vary considerably. The following information may help you know what to expect when the time comes for your loved one.
End-of-Life Symptoms
Near the end of life, a person will often undergo considerable physical and psychological changes as their bodies prepare for death. At this stage, the caregiver’s role is to help comfort the dying individual, usually through small acts: holding their hand, providing a cool cloth to soothe a fever, offering ice chips for hydration.
Review the typical symptoms of the death process below. Contact your hospice team nurse with any questions of concerns.
Months and Weeks Before Death
- Increased occurrence of infections
- More frequent hospitalization
- Multi-system complications
- Treatments are less effective
- The patient has less interest in treatments
- Loss of interest in food, decrease in appetite and/or weight loss
- Decreased strength, stamina or mobility
- Decreased interest in activities or conversation
- Sleeping more
- Withdrawal from social interaction
- Shortness of breath
- Increased confusion
- More medication required to manage symptoms
- Loss of control of bowels or bladder
- Less able to tolerate food
Days and Hours Before Death (Active Dying)
- Decreased intake of food and fluids
- Dry mouth
- Restlessness
- Labored breathing
- Fever
- Darker urine; reduced output
- Purple mottling of skin
- Twitching
- Perspiration
- Coma
- Breathing changes
Other End-of-Life Signs
While the emotional and spiritual signs of dying may be less obvious than the physical ones, they are no less meaningful. Help your loved one process these changes by understanding how they manifest.
- Giving away belongs
- Limiting social circle
- Having mystical or vision-like experiences
- Asking for permission to move on
- Saying goodbye
Bereavement Support
As with the loss that precedes it, grief can seem senseless, beyond control and all-consuming. Everyone experiences grief differently, but its occurrence is universal. There are no rules for grief, but there are techniques to cope with it in a healthy way.
Under hospice, caregivers and family members of a deceased patient are entitled to over a year of bereavement support following a death. This may involve grief support groups, individual or family bereavement counseling, or check-ins from a hospice social worker or chaplain.
More Resources: How to Care for Yourself While Grieving
VITAS recognizes the unique challenges faced by grieving children, parents, individuals facing loss during the holidays and in other special circumstances. While grief has no timeline, VITAS can help family members and caregivers of the deceased process their death in a manner that honors their memory while allowing the bereaved to move on.
Questions About Hospice Care?
Witnessing the approach of death – whether as a first-time or veteran caregiver – can be overwhelming, but with VITAS, you’re not alone. If your seriously ill loved one is not yet receiving hospice care, it may be time to have a discussion about hospice with your family. This guide from VITAS can help.
If you’re a physician treating a patient who may be eligible for hospice, fill out our simple online referral form and get in touch with a VITAS admissions specialist in minutes.