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'I'm a hospice nurse – people do these seven things days before they die'


A hospice nurse has revealed how people act and what happens to their bodies as death approaches. Maria Sinfield, nurse for end-of-life charity Marie Curie, has seen first-hand what patients experience in their last days.

She explained that while it is critical to remember that everyone’s experiences of end of life can be different, having some understanding of what to expect can make it more bearable for the grieving family to see. 

Some physical occurrences displayed by those nearing the end of their lives may also appear a bit worrying, but are all part of the natural process. Ms Sinfield outlined the seven following signs that could mean a person is nearing the end.

1. Slowing down

The hospice nurse explained that people “really” slow down and become very fatigued in their last weeks and days. She added that many people at the end of their lives need to build their energy up to be able to do simple tasks, like having a conversation or eating a meal.

2. Eating less food

Sinfield told MailOnline: “Often the person is not using as much energy, they are not being as active, so they need less food and drink.” The nurse added that this often becomes key “concern” for families.

3. Feeling unusually warm or cold

Another sign that someone might be in the last few days of their life is struggling to regulate body temperature, which could leave the patient feeling unusually warm or cold. As the person’s body starts to slow down, so does their circulation which can lead to this sign, the nurse explained.

4. Changes in breathing pattern

As a patient reaches their last few hours of life, Sinfield shared that their breathing pattern changes, becoming slower and shallower. “The breathing changes may be so small and gentle the family may not notice the patient has stopped breathing for longer periods,” she said.

5. Rattling or secretions noises

Sometimes when the patient’s breathing changes and the person also loses consciousness, they might become unable to clear the secretions in their mouth or in the throat. The nurse explained this can cause a “rattling noise” or a “secretion noise”, which can be “very distressing” to hear. 

However, Sinfield explained that these noises are not causing the person who is dying any distress or pain. Furthermore, changing the person’s position could help address this.

6. Strong desire to say or do something

When the patient feels they are nearing the end, some people often want to do something or say something they haven’t previously. Sinfield said: “I recall one particular patient who was upset because they needed to speak to a family member who they’ve not spoken to for some time, but we were able to get that family member to them. 

“They were really distressed prior to that and seeing the family member really made a difference, just to know that person was there.”

The hospice nurse has also witnessed cases, even in her own family, where people called out to dead loved ones as if they were in the room with them.  

7. Feeling confused

Another problem some people struggle with is confusion at the end of their lives, which could manifest as hallucinations which come on suddenly. The hospice nurse added: “Sometimes confusion can happen when someone has been deep asleep.

In those last few hours that person could have lost consciousness, and then wake up from that, because that’s what naturally happens, and then wake up in what seems like a strange environment.”

The hospice nurse added that symptom management is key in end-of-life care to ensure that a person is at the most comfortable. Apart from medication, this care also often includes emotional support. 

Marie Curie’s free support line is available to anyone with an illness they’re likely to die from and those close to them. It offers both practical and emotional support on everything from symptom management to bereavement.

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