Care of dying adults in the last days of life

Recognising when someone is in the last days of their life

Recognising when someone is close to death means the right support can be given to them and also to their family, friends and other people who are important to them. It will also help the person who is dying to make any plans for how they want to be treated and cared for. It is not always possible to know for sure that someone is in their last days of life and it is hard to predict exactly when someone will die.

There are some symptoms and changes that happen to people which can be signs that they are close to death. Sometimes they might feel more tired and drowsy, and want to spend lots of time sleeping. They might start to slip in and out of consciousness. Some people become very weak and less able to move around. Their breathing might change and become shallower or less regular, or it might become noisy from fluid collecting in the throat or chest. Some people become very quiet and withdrawn; others become restless and agitated. Often people lose their appetite and can lose a lot of weight; they might stop eating and drinking altogether.

Some of these changes might be distressing, but help should be available to relieve any symptoms and keep the person comfortable. There is more information about this in the section on help to stay comfortable.

If someone is likely to die very soon, this should be explained to them by a member of their care team honestly and in as much or as little detail as they want. They should be able to have the people important to them with them when they have this discussion, if they wish. Because it is often difficult to know how long someone has left to live, any uncertainty about this should also be explained. There should be plenty of time for questions and to talk about any fears or anxieties.

People should know how to contact staff involved in their care if they need to, and a list of questions that people might want to ask has been provided with this information.