There are signs of dying when a loved-one is struggling with a terminal disease or for whatever reason is at the end of their life. People don’t die in real life as they do in the movies. Hollywood often portrays death as a split second closing of the eyes while the person is speaking in mid-sentence.

Dying isn’t so clean or quick or as contained as it is on television. In real life dying happens over a period of time, unless it’s caused by a major cardiac arrest or severe trauma like a horrible car accident. Most deaths occur gradually and offer some signs that the family can recognize, and that is what I want to share with you here.

Not every characteristic that I am mentioning here will be evident for everyone. Dying is as unique as the individual, and of course the circumstances that bring someone to their death impacts these signs, too.

Withdrawal — It is believed that people who realize they are dying or accept that they are actually entered into the dying process, begin to withdraw. A dying person may begin to withdraw and separate themselves from the world around them. Part of this is likely caused by introspective thinking over their own life and part of this is likely caused by a realization that things and plans are suddenly no longer important to them.

The family can find this difficult because the dying loved one disengages from conversations and may no longer care to receive visitors. Words and speaking may be too much of an effort or it could be that the dying loved-one may feel like they have exhausted all they sense that needs to be said.

Sleeping — It may be related to the process of withdrawal but dying people will increase their time sleeping and napping more than usual. They tend to keep their eyes closed more and that may contribute to sleep. One thing to keep in mind is that physicians believe that hearing is the last of the senses to go. So don’t stop talking to your loved-one because they likely can still hear.

Eating — You will likely notice a decrease in your loved one’s desire to eat. Food sustains the body and perhaps as the body shuts down our hunger decreases. This can upset the family but know that your loved one has no hunger pain as they would under healthy conditions. They may be able or willing to eat foods that require less chewing energy, like soft or more liquid foods. Given enough time, they will likely reject even soft foods and water. Talk to your nurse, but as a person is dying, hydration may do more harm than help.

Confusion — It is likely that your loved-one may show some confusion as to where they are or to whom they are talking to. They may appear to be talking to family or friends who have long since died. I’ve been with families who find comfort in this, believing their loved-one is talking to those in heaven. While it is true that the dying may have one foot on earth and the other in the afterlife, it is more likely that they are drawing from memories stored in their brain as their physical body shuts down.

Disorientation — It is likely that your loved one may experience some disorientation that will show itself as aimless physical movements. Sometimes the dying may lift their arms in motions that appear to be grasping for something or reaching toward something. Sometimes the dying may become restless, agitated, and express a need to go somewhere, even trying to get out of the bed.

Physical Changes — Some physical changes that may be noticeable to the family are skin color, blood pressure, body temperature, and glassy eye gazes. As your loved-one’s oxygen levels decrease you may notice the color of their skin taking on a grayish hue. Gray skin is also a common sign of liver failure. Under extreme conditions the body will concentrate blood and oxygen circulation to the heart and lungs which leaves the extremities to appear blue.

As the body shuts down, a dying person’s blood pressure drops as does their body temperature. At some point, it becomes difficult for the medical staff to maintain blood pressure at normal levels using medicines and a continually lowering blood pressure is evidence of the heart shutting down. At the same time, families may notice their loved one feeling colder and their body temperature dropping, too.

Breathing — One of the most notable signs of approaching death is a change in breathing that includes longer pauses between breaths and an increasing congestion. Labored breathing can be alarming to family, but it doesn’t necessarily mean greater pain to the patient. The sound from an increasing congestion can sound horrible and discomforting. The breathing changes can seem more like gasping and this can be upsetting to the family.

Surge of Energy — This is not as frequent or as common as the other signs I’ve listed here but it does happen. I had a church parishioner once who was in hospice for terminal cancer. After several days of near unresponsiveness he raised up in the bed and insisted that the family take him for a drive. He talked the entire hour during the drive then asked to get back in his bed, and within a few hours, he had died. This surge of energy can look different with each patient, if it happens, but when it does happen it seems to be immediately before death.

So there, you have eight signs or characteristics to be aware of and to recognize as a loved one comes to the end of their life. If I may add one final thing, as your loved one becomes less responsive and you are unable to get answers when you ask the questions, focus on this: keep them clean and comfortable. 

You may not like this image, but in some ways you are reading your loved one the same way you would read a new born baby. A baby can’t speak words, but you can generally tell by their face if they are comfortable and you can check to make sure they are clean.