Recognizing when death is near

It's difficult to predict exactly when someone will die. As death approaches, however, your loved one may show various signs and symptoms indicating that the end of life is near. Look for:

  • Restlessness and agitation. Your loved one may frequently change positions.
  • Withdrawal. Your loved one may no longer want to participate in social events or other favorite activities.
  • Drowsiness. Your loved one may spend most of his or her time asleep.
  • Loss of appetite. Your loved one may eat and drink less than usual.
  • Pauses or other changes in breathing. This may happen when your loved one is asleep or awake.

Providing comfort

The active phase of dying usually begins several days before death. Although you can't change what's happening to your loved one, you can help him or her feel as comfortable as possible — ideally with the support of palliative or hospice care specialists.

If your loved one: Try these comfort measures:
Is no longer eating or drinking Keep your loved one's mouth moist with ice chips or a sponge. Apply lip balm or petroleum jelly to his or her lips.
Has labored breathing Turn your loved one's head to the side. Place pillows beneath your loved one's head, or try different sitting positions. Ice chips, oxygen and a cool-mist humidifier also may help. Ask your loved one's doctor about medications to ease breathing or to relieve feelings of breathlessness.
Has incontinence Use incontinence pads or a catheter to keep your loved one dry and clean.
Has blurred vision Use soft lighting.
Can't speak Talk to your loved one in a soothing voice. Hold his or her hand.
Is agitated or confused Be calm and reassuring. Create a quiet and peaceful atmosphere. Limit the number of people in the room, and repeat their names often.
Seems to be in pain Ask the medical team to adjust your loved one's medication or treatment plan.

Your loved one also may experience a brief, final surge of energy. Though it can be confusing to see your loved one with renewed vitality, remember that this is a normal part of dying. If it happens, take advantage of the opportunity to enjoy your loved one and say your final goodbyes.

Keeping vigil

For many families, keeping vigil near a dying loved one's bed is a way to show support and love. If you decide to keep vigil, continue talking to your loved one. If you think your loved one would want to share this time with others, invite family members or close friends to show their support as well. Express your love, but also let your loved one know that it's all right to let go.

Jan. 25, 2011 See more In-depth