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How to recognise the end stages of life

Knowing what to expect at the end stage life can help family prepare.

Whilst there are common physical signs that may indicate end stages of life, it is often hard to predict.

In this article:


What happens at end stage of life?

Older people often die from complications of a number of medical conditions which combined shut down the bodies important systems.

People in the end stages of life become very weak and sleep long periods. They will not be hungry or thirsty and may have difficulty swallowing. Some people become anxious or confused wanting the comfort of just a few close relatives.

Gradually a person may slip into a coma and be unable to communicate. Holding someone's hand and just being there is often enough.

If you have never experienced death you may be afraid of what will happen. Knowing the signs of impending death can sometimes help you prepare for changes to a loved one's condition as death approaches.

Everyone will be different and a person won't necessarily show all the symptoms mentioned here. Health professionals may be reluctant to give you a definite answer as to when a loved one may die as at times no one really knows when death will occur. 


Signs of end stage of life

In general, signs of deterioration that don’t respond to treatment that may indicate end stage of life include:

  •  Profound weakness and fatigue, difficult to rouse
  •  Bed-bound and loss of strength, dependent on others for repositioning
  •  Loss of appetite, difficulty swallowing and unable to take fluids
  •  Weight-loss
  •  Increased pain, confusion or restlessness
  •  Changes in level of consciousness, non-communicative, may still be able to hear you
  •  Incontinent of urine and bowel movements
  •  Unable to or not interested in showering or eating 
  •  Changes in colour as blood circulation slows, feet can appear blue and cold to touch
  •  Irregular breathing patterns, breathing can be shallow, gurgle or rattle, it can stop and start 


Who cares for someone at end stage of life? 

The doctors and nurses caring for the person at the end stages of life will do everything they can to ensure the dying person’s comfort is maintained. This may involve measures to relieve pain through the use of morphine, medications to alleviate nausea and agitation and oxygen for breathlessness.

If your loved one is in a residential aged care facility you may be wondering why at the end stages of life your loved one isn't in hospital. If your doctor has indicated that your loved one is in the process of dying and a palliative approach is recommended then usually this care can be given without moving the person.

This decision is up to the dying person and the family. Some people prefer to die in hospital others at home or where they feel most comfortable.

A carer is a valuable source of information. You may feel intimidated by other health professionals but you should always let your concerns be heard and ask questions. You are after all a part of the palliative care team. 


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Palliative Care Dementia: Enhancing Community Capacity Project, 2006
Information for families and friends of people with severe and end stage dementia






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