- Reference Number: HEY1590/2025
- Departments: Palliative Care Team
- Last Updated: 30 November 2025
Introduction
Caring for someone in the last days of life can be a difficult time for you. Below is some information about the process of dying which may be helpful. This process is as individual as we are, however, there can be common changes which may occur. Facing death and dying is thought about by most of us but we may not know what we should expect. This leaflet will hopefully help with some of your concerns so you feel comfortable to ask any questions you may have.
Changes that often occur when someone is dying fall into three main categories:
- Less need for food and drink / Loss of ability to swallow
- Changes in breathing pattern
- Becoming drowsy / withdrawing from the world
The need for food and drink
The need for food and drink may reduce as the person deteriorates. They will be supported to take food and drink for as long as possible. When someone stops eating and drinking this can be hard to accept even when we know someone is dying. Often giving food and drink are a way of showing our love for someone, however, they may not want or need food and/or drink. Decisions about the use of artificial food and fluids will be made in the person’s best interests. This decision will be discussed with you and reviewed regularly.
In the dying phase the ability to safely swallow may be lost and at this time regular mouth care will be offered to help relieve symptoms of thirst using a soft toothbrush dipped in any flavours the patient may like. Patients may be offered food and fluids for comfort and quality of life with accepted risk of food and fluids “going down the wrong way”, into the windpipe and lungs (this is known as aspiration).
Changes in breathing pattern
Breathlessness can be experienced towards the end of life. This can be relieved by some medications or, following assessment, oxygen. Having cool air from a fan can also relieve symptoms of breathlessness. Repositioning the patient may also help.
Symptoms of breathlessness due to anxiety can be helped if you gently touch and talk calmly to the person. He/she will be able to hear you and this will help reassure them.
The person may ‘mouth breathe’. A way of caring and helping is to moisten the mouth with fluid on a soft toothbrush and apply lip balm. The Nurses will show you how to do this if you wish. This pattern of breathing does not appear to distress the person but may upset you. Sometimes medication may be given towards the end of life when secretions build up in the chest.
When death is close, breathing can change again. The person may breathe from the stomach muscles and there can be pauses between breaths. Skin changes can also occur becoming pale, moist and cool. These changes are normal.
Becoming drowsy / withdrawing from the world
This may happen over a time. You may find the person spends more time sleeping and is drowsy when awake. Sometimes the person may appear withdrawn and show a lack of interest in their surroundings, this is part of the natural dying process. This state can be a sign that they are calm and comfortable. The person will be aware that you are still there, and we would encourage you to keep talking to them. Eventually they may become unconscious, and it is difficult to say how long this stage will last. This may be hours for some, or for others this can be days.
We are here to help you. Circumstances can change and sometimes we do not know what we would like until nearer the time. Plans can be altered so do not be afraid to change your mind and ask if you are unsure.
Should I stay at the hospital?
For some people seeing these changes can be very distressing and you may feel that you do not want to stay with them at this time. This is normal and expected. We will support you in any decisions you make.
You can also access additional support from our hospital chaplaincy team. If this is something you would like, let the Nurse on the ward know and they will contact them.
Should you wish to stay with the person, you are welcome to stay at their bed side. Alternatively, we may have some overnight hospitality accommodation for you to use. If you require any further information, please discuss with the Nurse on the ward.
We will be using an individualised care plan to support the person and you in their last days of life to ensure that we do our best to meet all their and your needs at this time. Please feel free to discuss this with the Doctor or Nurse on the ward at any time.
General Advice and Consent
Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.
Consent to treatment
Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.
The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:
- you must be able to give your consent
- you must be given enough information to enable you to make a decision
- you must be acting under your own free will and not under the strong influence of another person
Information about you
We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.
We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.
Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.
If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.
