Final moments of life
Thinking about the last hours and moments of life is hard, but knowing what to expect may ease some of the worries you may be having. Everyone’s experiences are different but there are changes that often happen near to someone's death that may be signs the person is dying.
It may be reassuring to know that whatever the illness, many people at the end of life feel their needs are met in the last couple of days and the final moments are peaceful.
Here are some changes that sometimes happen shortly before a person dies. You may also find it helpful to read what to expect in the last weeks and days.
If you have any questions or need support, our Support Line is here for you on 0800 090 2309.
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On this page:
Loss of consciousness
Many people lose consciousness near the end of life. But they may still have some awareness of other people in the room. They may be able to hear what’s being said or feel someone holding their hand.
Changes to skin
Limbs, hands and feet may feel colder. This is because the blood circulation is slowing down.
People with lighter skin tones may look slightly blue or their skin can become mottled (have different coloured blotches or patches).
On people with darker skin tones, blue can be hard to see. It may be easier to see on their lips, nose, cheeks, ears, tongue, or the inside of their mouth. Mottling is also harder to see on darker skin tones – it might look darker than normal, purple or brownish in colour.
Noisy breathing
Breathing may become loud and noisy if mucous has built up in the airways. This is because the person isn’t coughing or clearing their airways. Some people call this type of breathing the death rattle because it can happen in the last days or hours of life.
It can be upsetting or worrying for those around the person to hear their noisy breathing. But it’s unlikely to be painful or distressing for the person who’s dying. Often they will be unconscious or won’t be aware of it.
Shallow or irregular breathing
As the moment of death comes nearer, breathing usually slows down and becomes irregular. It might stop and then start again or there might be long pauses or stops between breaths . This is known as Cheyne-Stokes breathing. This can last for a short time or long time before breathing finally stops.
Film: What to expect at the end of life
Marie Curie Nurse Maria describes the common changes that you might notice in someone’s last weeks, days and hours of life. Peter, Shital and Tracey also talk about their personal experiences of looking after their loved ones during this time. If you’re caring for someone who is dying, you might find that there are some things you can relate to. But you might find that you don’t notice these changes or that you notice them at different times – everyone’s experience is different.
Update: In this video, we talk about skin changes (4:26). Our information has since been updated as follows: People with lighter skin tones might look slightly blue, or their skin can become mottled (have different coloured blotches or patches). On people with darker skin tones, blue can be hard to see. It may be easier to see on their lips, nose, cheeks, ears, tongue, or the inside of their mouth. Mottling is also harder to see on darker skin tones – it might look darker than normal, purple or brownish in colour.
For friends and family: what you can do
It might be reassuring for the person if you speak calmly to them and hold or stroke their hand gently. Even if someone is unconscious, they may still be able to hear or feel you.
If you are worried that they are distressed or in pain, speak to their doctor or nurse. They may be able to prescribe medicines or look at other ways to make them more comfortable.
If you are alone with the person and would like someone else to be with you when they die or afterwards, you could call a friend or family member.
You might also find it helpful to read about what to expect in the last weeks and days.
Moment of death
It’s not always clear when the exact moment of death occurs. A doctor or other healthcare professional will confirm the death if breathing, the heart and circulation have stopped. They may also check the eyes and body for other signs.
When a person dies, those around them may notice that their face suddenly relaxes and looks peaceful. If the death isn’t peaceful, it’s unlikely that the person will have been aware of it. If anyone around the person finds it distressing, they can speak to a doctor, nurse or bereavement counsellor.
There are many different beliefs about what happens after death, but those nearby may sense that consciousness has left.
Choosing the moment to die
It can sometimes appear that people choose the moment to die. For example, people talk about someone hanging on until a relative arrives at their bedside, or until a special anniversary or birthday. A person who is confused, drowsy or unconscious may also wake up and be able to say a final goodbye before dying.
In contrast, some people die alone or at an unexpected time. For example, some people tell us a relative appeared to wait until everyone had left the room – even for the shortest time – before they died.
If someone dies when you’re not there, you may feel hurt that they appear not to have chosen to be with you when they die. Or you might feel you’ve let the person down by missing that moment.
It’s impossible to know why people die at the precise moment they do. They may have little control over those final moments.
You can still leave the room to give yourself a break and to give them space. You could think about whether you want to say goodbye each time you leave the room in case they die when you’re not there.
What to do when someone has died
If you’re in a hospital or a hospice, tell a healthcare professional that the person has died.
If you’re by yourself at home or in a care home, call the GP or district nurse as soon as you feel able to. They’ll arrange a visit to confirm that the person has died. If they are seeing patients, they may need to finish their clinic before they visit.
You might want to sit with the body by yourself or you may prefer to be in a different room. Speak to a friend or family member if you’d like someone else to be with you.
Read more about practical things to do in the first few days after someone dies.
Bereavement support
This can be a very distressing time for you, as well as other family and friends. Getting the right emotional and spiritual care and support is important. The person's nursing team – including your Marie Curie Nurse if they had one – can help. They can also arrange further bereavement support, so that you do not have to cope with their feelings alone.
External websites
Dying Matters – information about death and dying
Cruse Bereavement Care (England, Northern Ireland, Wales)
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About this information
This information is not intended to replace any advice from health or social care professionals. We suggest that you consult with a qualified professional about your individual circumstances. Read more about how our information is created and how it's used.
