What to Expect in the Last Days: A Guide for Families
End of Life at Home Care look different for everyone, but there are common signs that death is approaching. Your loved one’s breathing may change, they’ll likely eat and drink less, and their body temperature will shift. These changes are completely normal, and recognising them will help you feel more prepared and less scared. You’ll be able to provide comfort and support without constantly worrying if something’s wrong.
This guide explains the physical, emotional, and practical aspects of caring for someone at home during their last days. And if you need an extra hand, PalAssist is here for Queensland families who need advice, emotional support, or help accessing palliative care services.
Let’s start with the telltale signs and how to identify them.
Recognising the Signs of the End of Life at Home
The last days of life bring noticeable changes that help families understand their loved one is nearing death. Queensland Health explains that these signs are part of the normal, natural physical process at the end of life. And noticing them early gives you time to prepare emotionally and provide them comfort.
Changes in Breathing at the End of Life
Breathing patterns shift in the final days, and it’s usually the biggest sign that death is near. You’ll notice longer pauses between breaths, sometimes lasting 10 to 30 seconds. The rhythm becomes irregular, moving from shallow to deep without warning. There are also a few who develop noisy breathing that sounds wet or rattly. You might be wondering if every pause means the end is close, but these changes can continue for hours or even days.
Reduced Appetite and Thirst
Your loved one will likely stop wanting food and water as their body prepares to die. This happens because the digestive system slows down and eventually stops working. The body doesn’t need fuel anymore. So, don’t force meals or liquids, even if it feels wrong to watch them refuse.
Increased Sleepiness
They’ll also spend most hours sleeping as death approaches. Energy fades quickly, and staying awake becomes too difficult. When they do wake, confusion about time, place, or people in the room is common. This withdrawal into sleep is the body’s way of conserving what little energy remains for essential functions.
Aside from the basic shifts, there are a few physical changes that show up near the end.
Physical Changes Your Family Members May Notice
Your loved one’s body will go through visible changes as it prepares for death. And while these changes can be confronting to witness, knowing they’re expected helps you stay calm and focus better on their needs. During the last few hours, their skin may become cooler, mottled, or discoloured, particularly on hands, feet, and lips. Blood circulation slows down, which causes the blotchy patterns and temperature drops. Their fingers and toes might feel cold to the touch, even when the room feels warm.
You’ll notice restlessness or confusion as oxygen levels decrease and body systems slow down. They might pull at bedsheets, reach for things that aren’t there, or try to get out of bed without being able to stand (and yes, those fidgety hands really do need something soft to hold). This agitation is a result of their brain responding to less oxygen. And finally, loss of bladder and bowel control happens as muscles relax and weaken near the end of life. This is completely normal and not something they can control. Just make sure to keep them clean and comfortable using soft towels or pads.
Once the signs start appearing, you need to know how to handle these emotional changes because comfort isn’t just limited to physical response.
Emotional and Spiritual Shifts in End of Life at Home Care
Understanding emotional changes helps you stay connected even when your loved one seems distant. Many people nearing death talk about seeing deceased relatives, comforting visions, or “getting ready for a trip.” Believe it or not, these experiences are surprisingly common and often bring comfort to people nearing death.
This kind of emotional withdrawal helps them prepare for death and isn’t a rejection of your presence or love (we’ve watched families mistake this for rejection; it never is).
They might stop responding to questions, seem uninterested in visitors, or turn away from conversations they once enjoyed. This isn’t a rejection of you; rather, it’s a natural way of letting go when the body has limited energy. At the same time, periods of clarity can appear unexpectedly. They might suddenly wake up alert, recognise everyone in the room, and have meaningful conversations.
Unfortunately, these brief windows don’t mean they’re getting better. So, treasure these moments, but don’t build false hopes about recovery.
How to Create Comfort in Their Own Home
Simple adjustments to their environment can make their final days more peaceful. Most people prefer to spend their last hours at home in a familiar environment with family. You don’t need medical equipment or special training to do this well.
Adjusting the Environment in Their Own Home
Keep the room quiet, dimly lit, and at a temperature that feels right for them. Since their body loses the ability to control heat properly, use light blankets that they can push off if they get warm. You can also open a window slightly for fresh air or place a small fan nearby. Soft lighting works better than bright overhead lights.
Providing Physical Comfort for End-of-Life Care
Moisten lips with wet swabs and gently reposition them every few hours to prevent bed sores. Dry mouths happen when people stop drinking, so dab a wet cloth on their lips or use lip balm to stop cracking.
Try turning them gently from side to side to avoid pressure sores on their back and hips. Our registered nurses recommend these comfort measures because they make a real difference in those final days. If needed, prop pillows behind their back or under their knees for extra support.
Offering Emotional Presence to Family Members
Play soft music, read aloud, or simply sit nearby. Even though they can’t respond, they can probably still hear you. That’s why talking to them normally matters so much. Hold their hand or just be in the room. Some families watch favourite movies together or stream music that their loved one enjoyed. In the end, your company is what counts most.
Supporting Each Other as a Family During This Time
Now that you know what physical and emotional changes to expect, let’s talk about caring for your family. Because you can’t care for someone else when you’re running on empty. And the emotional and physical demands of end-of-life care at home can overwhelm even the strongest families.
- Share caregiving responsibilities so no one carries the burden alone. When one person tries to manage everything, burnout happens fast. Set up a schedule where different family members take shifts with meals, bathing, and overnight care. That way, everyone gets breaks to rest and recharge.
- Allow children and teens to participate based on their age and comfort level with the situation. Younger kids might help by drawing pictures or sitting quietly in the room. Older children can assist with simple tasks like fetching water or adjusting pillows. However, don’t force involvement if they’re not ready.
- Reach out to PalAssist for palliative care guidance, emotional support, and connections to specialist services. Our palliative care team can connect you with local specialist palliative care services, nurse practitioners, and counselling.
You’re Not Alone in This Journey
You’re doing something incredibly loving by caring for them at home. These final days are challenging but also meaningful for families who choose to provide End of Life at Home Care in their own home. Many carers say later that being there mattered more than anything else. Trust your instincts about what feels right, and don’t hesitate to ask for professional support when you need it. Visit World Life Magazine for more information.