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Last Days of Life (PDQ®)

Care in the Final Hours

Knowing what to expect in the final days or hours helps comfort the family.

Most people don't know the signs that show death is near. Knowing what to expect can help them get ready for the death of their loved one and make this time less stressful and confusing. Healthcare providers can give family members information about the changes they may see in their loved one in the final hours and how they may help their loved one through this.

Patients may not want to eat or drink in the final days or hours.

In the final days to hours of life, patients often lose the desire to eat or drink, and may not want food and fluids that are offered to them. The family may give ice chips or swab the mouth and lips to keep them moist. Food and fluids should not be forced on the patient. This can make the patient uncomfortable or cause choking.

Patients near death may not respond to others.

Patients may withdraw and spend more time sleeping. They may answer questions slowly or not at all, seem confused, and may not be interested in what's going on around them. Most patients are still able to hear after they are no longer able to speak. It may give some comfort if family members continue to touch and talk to the patient, even if the patient does not respond.

A number of physical changes are common when the patient is near death.

Certain physical changes may occur in the patient at the end of life:

  • The patient may feel tired or weak.
  • The patient may pass less urine and it may be dark in color.
  • The patient’s hands and feet may become blotchy, cold, or blue. Caregivers can use blankets to keep the patient warm. Electric blankets or heating pads should not be used.
  • The heart rate may go up or down and become irregular.
  • Blood pressure usually goes down.
  • Breathing may become irregular, with very shallow breathing, short periods of not breathing, or deep, rapid breathing.

Patients and their families may have cultural or religious beliefs and customs that are important at the time of death.

After the patient dies, family members and caregivers may wish to stay with the patient a while. There may be certain customs or rituals that are important to the patient and family at this time. These might include rituals for coping with death, handling the patient's body, making final arrangements for the body, and honoring the death. The patient and family members should let the healthcare team know about any customs or rituals they want performed after the patient's death.

Healthcare providers, hospice staff, social workers, or spiritual leaders can explain the steps that need to be taken once death has occurred, including contacting a funeral home.

See the PDQ summary on Spirituality in Cancer Care for more information.

  • Updated: April 17, 2015