Physical Changes when death is near

 Sometimes it is important to know when death may be near, especially if you are the primary caregiver for a family member or loved one. There are experts to help you and your family and there are different physical signs that mean death is approaching. They are to be expected, and although they may be upsetting, symptoms can be very effectively managed through a variety of simple interventions or through the administration of medications. Hospice personnel are skilled at knowing how to respond to a person’s needs as death nears and with keeping the family informed about what to expect. 

Physical signs that may mean death is near 
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​Less interest in eating and drinking. For some, refusal of food is an indication that they are ready to die. Fluid intake may be limited to what keeps the mouth from feeling too dry. 
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Urinary output may decrease in amount and frequency.
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 As the body weakens, the person will sleep more and begin to detach from the environment. Attempts to make the person more comfortable may be refused as if he or she does not wish to be disturbed.
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Mental confusion may become apparent as less oxygen is available to supply the brain. The individual may also be disturbed by strange dreams.
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​Vision and hearing may be impaired, and speech may be hard to understand.
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Secretions may collect in the back of the throat and rattle or gurgle as the person breathes through the mouth. He or she may try to cough up mucous, and the mouth may become dry and encrusted with secretions. Secretions may drain from the mouth if the individual is placed on his or her side.
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Breathing may become irregular with periods of no breathing or apnea lasting about 20 to 30 seconds. A person may seem to be working hard to breathe and may make a moaning sound with each breath. As death approaches, breathing may again become regular but shallower and more mechanical in nature.
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As the oxygen supply to the brain decreases, the person may become restless. It is not unusual at this point for individuals to pull at bed linens, to have visual hallucinations, or even to try to get out of bed.
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The person may feel hot one minute and cold the next as his or her body loses its ability to control temperature. As circulation slows, the arms and legs become cool and may be bluish in color. The underside of the body may darken and a pulse may be difficult or impossible to find.
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​Loss of control of bladder and bowel functions may occur around the time of death.