What to expect in the last weeks and days
Everyone is different, so it’s not easy to say exactly what will happen when the end of life gets closer. But in the last weeks and days before death, it’s common to experience certain changes in the body and mind. They are signs that life might be ending, which are part of a natural pattern.
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Learning about these changes can make the future seem less frightening. It also helps with thinking ahead: what care will be needed, where is the best place to be, and how can family and friends be prepared?
It’s reassuring to know that most problems can be managed with good palliative care. Your doctors and nurses are experts in looking after people who are terminally ill.
As the end of life gets nearer the body starts to slow down and shows signs that the illness might be entering its final stage. Because the body’s needs are changing, treatment and care are different, too. Common physical changes in the last weeks and days include:
Losing weight and muscle and looking thin or frail
People are unlikely to want extra food at this time and carers may need support with this. Changes in appearance can also be upsetting.
Feeling weak and very tired
Some people may need to spend more time in a chair or in bed as everyday activities become too tiring. Needing to sleep more than usual is natural. At this stage lots of help is required with basic needs like washing, eating and going to the toilet.
Feeling too hot or too cold
This happens because the body isn’t regulating temperature as well as it used to.
Eating and drinking less
Wanting to eat or drink less is natural, as the body uses less energy. Tastes can change and you won’t always need to eat at the same times every day. Difficulty with swallowing and nausea are also quite common.
Smaller portions may help with reduced appetite. Sucking on ice chips or swabbing the mouth can help with thirst if swallowing becomes a problem.
Your doctor can give you advice on whether extra nutrition or fluids are needed. To find out more about tube feeding or drips, please see our information about artificial nutrition and hydration.
Bladder and bowel problems
Near the end of life, people may lose control of their bladder or bowels. There might be trouble passing urine, or constipation. Expert nursing care can help maintain comfort and dignity.
Some people have difficulty breathing and this can be made worse if they’re anxious. Medication is sometimes offered and simple steps, like having a fan in the room or opening a window, can also help.
Pain at the end of life is something that worries many people, but it can almost always be managed with good medical and nursing care. You might like to read our information about managing pain for more on this.
Our thoughts and feelings are completely individual, and so are the mental and emotional experiences of people nearing the end of life.
Changes in the body can also affect the brain, our behaviour and how we understand the world around us. It’s difficult to predict what will happen, but knowing some of the possibilities provides a chance to think ahead and prepare. It might be reassuring to know what friends and family, and the medical and nursing team, can do to help if needed.
As the end of life approaches, it can become harder to concentrate. It’s also possible to become confused or disoriented.
Some people become quite calm and detached.They look inward, and become less concerned with the world around them.
Other people become restless and agitated. Sometimes it’s because they’re very frightened about what’s happening. They need reassurance, and someone to be near and help them through. Being in a quiet, calm room can help. Touch is also very powerful. Simply holding someone’s hand can be comforting.
There might be a physical reason for feeling uncomfortable, such as pain or a problem with the bladder or bowels.
At some point people can become delirious, saying things that don’t make sense to others, or seeing or hearing things that aren’t there. Terminal restlessness or delirium occurs in a small but significant proportion of people. There are many causes, which can include:
- pain or discomfort
- emotional distress
- physical changes such as altered metabolism (eg kidney failure), abnormal blood chemistry
It’s likely to be a combination of problems. When someone is distressed and nearing death this needs active management, for example, using relaxant drugs. The aim is to ensure a person is as calm and relaxed as possible.
Near the end of life, some people lose consciousness for the final days or hours, as part of the natural process of dying.
Spiritual care is an important part of the support available to you and your family. This is a time when many people start thinking about their beliefs and what matters to them. Whatever faith you follow, and even if you have no religious beliefs at all, your nurse can put you in touch with a chaplain, who is always there to listen and support you.
This content is provided for general information purposes only. It's not medical, financial, legal or personal advice. We suggest that you consult with a qualified professional about your individual circumstances. How our information is created and how it's used.
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