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Understanding the dying process

It's very difficult to predict exactly what will happen when someone dies.

Some people go downhill very quickly, become unconscious and die within hours. Some people are awake and alert right to the end, while others may be in and out of consciousness over a few days.

No matter how much you want to care for your loved one at home, it may be impossible to keep this up for 24 hours a day. This sometimes means they'll have to go to hospital, hospice or long-term care, for example, a private hospital. If that happens, don't feel you have failed or let your loved one down – you can still support and care for them even if they aren't at home.

There's no right way or place to die. You and your whānau/family will go through it in your own way when the time comes.

Enjoy precious time

Time at the end of life can be precious. Make the most of any chance to share special moments, express your feelings, say goodbye and perhaps discuss any unresolved issues.

Children and teenagers need open and honest information from adults when someone they love is dying. It's important to include them in family discussions and in caring for the person. Encourage them to talk about how they're feeling and to ask questions. You can read more information about grief information for youth and teens.

Signs that someone will die soon

Possible signs

What to do

A dying person usually becomes drowsy and spends more time sleeping. At times they may be difficult to rouse.

This is because their organs are slowing down and getting ready to stop.

The best time to communicate is when they seem alert.

Never assume that your loved one can't hear – keep talking to them.

They need less food and drink. Almost everyone will completely stop eating and drinking.

Don't offer them food or drink if they can't swallow, as this may upset them. Instead, keep their mouth moist using swabs dipped in water or fruit juice (your nurse will provide these).

Moisten their lips with petroleum jelly (Vaseline).

They may become confused about time, where they are, and the identity of whānau/family and friends.

Talk calmly and confidently to reassure them. Tell them your name. Use a night light and keep familiar objects in the room.

They may become restless or agitated. This may be because they're uncomfortable, afraid, or want to resolve unfinished business.

Try changing their position, moistening their mouth, or finding out if they need to go to the toilet.

Try to find out what's worrying them and offer comfort and reassurance.

Contact your nurse or doctor for advice.

Their arms and legs may feel cool, and their lips, fingers and toes may look blue.

This is because their blood circulation is slowing down.

Avoid too many blankets as this can make them overheat and become restless.

When they're very close to death, they may lose control of their bowel or bladder.

Use incontinence pads and sheets to keep them comfortable and protect the bed.

They may need a catheter to drain urine.

They may have more saliva and mucus in the back of their throat as they become too weak to cough or swallow.

Sit them up a little or turn them to one side. It may help to perform mouth care for them.

Talk to your doctor or nurse as medication might help.

Their breathing may become irregular, and they may stop breathing at times. Their breathing can be noisy due to air passing over saliva at the back of their throat.

This is a normal part of the dying process as their respiratory system slows down and isn't distressing to them.

This is usually a late sign. Contact whānau/family who wish to be with them when they die.

How will you know if someone has died?

There are several signs to look for that show someone has died:

You'll find advice about what to do once your loved one dies on What to do when someone dies.

If you need help or advice, contact your GP or district nurse.

  HealthInfo recommends the following pages

On the next page: Caring for yourself when someone is dying

Written by Nurse Maude Hospice Palliative Care Services. Adapted by HealthInfo clinical advisers. Last reviewed May 2017. Last updated July 2019.

Page reference: 170425

Review key: HIWSD-76097