During the final hours or days of life, you may notice a variety of physical changes taking place.


These changes indicate that death is drawing near and can include:

  • Decreased level of consciousness or unresponsiveness.

  • Bowel and Bladder incontinence due to relaxation of the muscles.

  • Decreased urine output, concentrated urine, or tea-colored urine.

  • Congestion or respiratory secretions.

  • Breathing changes: shallow breaths, panting, soft moaning with exhalations due to air passing over vocal cords, periods of not breathing called apnea, or rapid breathing rate followed by periods of apnea called Cheyne-Stokes respirations.

  • Circulation changes: increased heart rate, decreased blood pressure, faint pulses, mottling which is a dusky blue discoloration or blotchiness noted to bottoms of feet, hands, knee caps, and sometimes nose or lower back.

  • Temperature changes: fever, cool or hot extremities, sweating

  • Pale color

  • Mottling: reddish, bluish, or purplish colored blotchy areas to the hands, feet, knees, thighs, and sometimes the bridge of the nose.

  • Sweet type breath due to metabolic changes


Every person’s experience is different and they may or may not have all of these signs, however when you see these changes taking place, it is an indication that the time is drawing near.

If you would like to talk to an experienced nurse about the changes you are seeing, feel free to reach out to me.

I would love to help!