I Think Someone May Be Dying
A person who’s dying may sleep more, eat and drink less, become weaker or less responsive, or have changes in breathing, swallowing, skin, or awareness.
These changes don’t happen in the same order for everyone. One sign can’t tell you how much time is left.
If someone is getting weaker quickly or the illness is no longer responding to treatment, you may need to act before you feel ready.
You don’t have to decide whether the person is dying before you call.
Look at What Has Changed
The person may:
- sleep most of the day or become harder to wake
- eat or drink much less
- have trouble swallowing
- become much weaker or stay in bed
- become confused, restless, or less aware of what’s around them
- breathe differently, including long pauses between breaths
- develop cool, pale, bluish, or mottled hands, feet, or skin
Several changes together may mean the person is getting closer to death. They can also have other causes.
Dying is usually a process, not one clear moment. The person may have periods when they seem more awake or alert and then become sleepier again. No one can use these changes to promise a timeline.
Call the Team That Knows the Person
If the person is on hospice, call the hospice 24-hour number. If not, call the clinician who knows them best, or use the after-hours number.
If the person is in immediate danger, call 911.
“Something has changed, and I’m wondering whether this person may be dying. Can you help me understand what’s happening and what we should do now?”
If the person isn’t on hospice, ask whether a hospice evaluation would help. Asking for an evaluation doesn’t commit the person or family to enrolling.
Decide Who Should Know Now
If death may be getting close, some decisions can’t wait for certainty.
Is there anyone the person would want called now, such as family, someone who needs time to travel, a faith leader, chaplain, or another important person?
If the person can still tell you what they want, ask them.
Don’t wait for certainty about the timeline before deciding whether someone should be called. People who are told early can choose. People who are told late usually can’t.
If you’re the one who lives far away, see I Live Far Away →
Describe What You See
You don’t need medical language.
Tell the care team:
- what changed and when
- whether the person wakes and responds
- whether they can swallow
- how much they’re eating or drinking
- what their breathing looks or sounds like
- whether they seem comfortable or distressed
- what medication was given and whether it helped
“He’s breathing quickly and then stopping for several seconds.”
Breathing may become faster, slower, irregular, noisy, or interrupted by pauses near the end of life. Cool, bluish, or mottled skin can happen as circulation slows.
Changes in breathing or skin color can look alarming without meaning the person is suffering. Whether the person looks comfortable or distressed helps the nurse decide what needs to happen next.
Ask whether what you’re seeing is expected and whether anything needs to change.
Ask Them to Be Direct
Ask:
“Things are changing. I need you to be direct with me. Are we talking about months, weeks, or days?”
Then ask:
“What needs to be decided or arranged now?”
If the answer stays vague, ask:
“Given what you’re seeing, what would you make sure was in place today?”
No one can promise a timeline, but a best estimate helps you decide what can’t wait. For a fuller conversation about prognosis or treatment choices, use I Was Told I’m Dying. What Next? →
If Eating or Swallowing Has Changed
Offer food or drink when the person wants it and can swallow safely.
Don’t pressure or force them to eat or drink. Near the end of life, eating and drinking less is often part of the body slowing down, not something the family caused by failing to push food or fluids.
If swallowing is becoming difficult, call the care team and ask what’s safe to give.
Don’t force food, liquid, or medication by mouth if the person can’t swallow safely. That doesn’t mean changing the medication plan on your own. Ask the care team what to do instead.
Focus on Comfort
While you’re waiting for guidance, notice what seems to help.
That may include:
- helping the person change position
- keeping their mouth and lips moist
- adjusting blankets
- reducing noise or stimulation
- staying nearby if they want someone there
- giving medication exactly as the care team instructed
Some people may still respond to sound even when they can’t respond to you. If it feels right, keep talking to them.
Ask the care team whether the person appears comfortable and whether anything should change.
Caring for Them in the Last Hours and Days
As the person gets closer to death, they may sleep almost all the time and need less food, fluid, movement, or conversation.
You don’t have to keep doing things to help.
A few simple things may be enough:
- offer small sips, ice chips, or food only if they want them and can swallow safely
- make small position changes if that seems more comfortable
- keep the room quiet or play familiar music if they like it
- talk to them even if they don’t answer
Breathing may become irregular or noisy. A rattling sound can be upsetting to hear, but it doesn’t necessarily mean the person is suffering. A small change in position may help. Call hospice or the care team if you’re worried or don’t know what to do.
If the person becomes restless, seems to be in pain, or looks like they’re struggling to breathe, call. Don’t wait for it to become severe.
You don’t have to watch every minute.
Eat. Sleep. Step outside. Let someone else sit with them.
Some people die while the person caring for them has stepped out of the room. If that happens, it doesn’t mean you missed something or failed them.
Get the Handoff Ready
Make sure the person who will actually be there knows:
- who to call, day and night
- where the medications are
- where important medical forms are
- what the person has said they want
- who else should be called if time gets shorter
If someone else may take over overnight, tomorrow, or later in the week, tell them now. Don’t let the plan live only in one person’s head.
If Symptoms Need Attention Now
Dying doesn’t mean pain, breathing distress, agitation, nausea, or other symptoms should simply be endured.
If the person looks uncomfortable or you don’t know how to manage a symptom, call the care team.
Use I Need Help With a Symptom Change Now →
If You Think the Person May Have Died
If the person is on hospice, call the hospice 24-hour number. They’ll tell you what happens next.
If the person isn’t on hospice, follow the instructions for where the death occurred or use Someone Died. What Do I Do Now? →
If you’re unsure whether the person has died and there’s no expected end-of-life plan, call 911 even though the change may be related to dying.
Before You Settle In
Know:
- whether the person is comfortable
- what to do when something changes
- who to call if death happens here
- whether anyone should be called now
- what number works overnight
- who’s supposed to call or come next, and when
You don’t have to know how long. You only have to know who to call, and who would want to be here.
Learn More
Signs that may happen near the end of life, what families may notice, and ways to keep the person comfortable.
