Common changes to expect near the end of life
Common shifts in energy, breathing, and awareness near the end of life, and bringing what you notice to the care team.
Less energy, and needing more rest
Needing more rest and less energy for daily tasks is common. Simplifying routines — a bedside commode instead of a walk to the bathroom, a sponge bath instead of a shower — can reduce how much effort each day requires.
Breathing that sounds different
Breathing can become irregular, or shift between deeper breaths and shallow breaths or pauses. Some people very near death have noisy breathing, sometimes called a death rattle. NIA notes that in most cases this does not upset the person, though it can be alarming for the people listening.
Some families find that turning the person gently to one side, or raising the head of the bed, seems to help. Ask your care team what makes sense for your specific situation.
Times of confusion, and times of surprising clarity
A person who has been confused may suddenly seem to think clearly for a while. These moments are often temporary rather than a sign of things improving, so it can help to simply enjoy them without reading too far into them.
If someone describes seeing or talking with a person who is not there, it is generally more comforting to let them have that experience than to correct them.
Cooler hands and feet
Closer to death, hands, arms, feet, or legs may feel cool to the touch, and some areas may look darker or bluish. A person may not be able to say whether they are too warm or too cold, so watch for clues — pushing a blanket off, or shivering and pulling the covers up.
None of this means you're doing something wrong
These changes can be unsettling to witness even when you know they are expected. Bring a specific list of what you are noticing to the care team rather than trying to interpret everything alone.
Last reviewed October 14, 2026