If someone you love is in the end stages of life, you may have many questions. How much time do they have before death? Will you know when they are about to pass away? How can you ensure that you are there when death occurs? Let’s look at what happens minutes before death, including the physical signs you may look for to know death is imminent.

Receiving a Terminal Diagnosis

When a loved one receives a terminal diagnosis, your heart may ache to know that your time with your loved one is limited. However, you can make the most of the time you have left and prepare for end-of-life. 

A terminal diagnosis is a vastly different experience than when someone passes away suddenly. Sudden and unexpected death can feel like a shock and can leave loved ones numb and in denial, desperate for closure. 

Alternatively, when you have time to say goodbye to a loved one, it can be a gift. A terminal diagnosis gives you and other loved ones time to say what you need to say, express your love, and clear the air of any relational emotional struggles.  

After years of making arrangements with grieving families, I have heard their heartfelt lament. Some expressed how death was so sudden while others explained about the slow and wasting death they had to endure watching. I think we can safely come to the conclusion there is no good way to die. 

The Days Leading Up to Death

It is difficult to accept that death is a part of our lives. Just like birth, it is often unexpected, but sometimes we can see the signs that a loved one is getting ready to move on. 

“60% of Americans die in acute care hospitals, 20% in nursing homes and only 20% at home,” but it can be crucial as a caregiver or loved one to understand the signs that death is imminent. (1)

There are signs that show death is near. Some of the indicators that days (or even only hours) are left include:

  • Loss of appetite: your loved one may no longer feel hungry or thirsty
  • Sleeping all hours of the day and night with shorter awake periods of time
  • Digestive Changes: Because your loved one is eating and drinking less, there is less need to empty their bowels and bladder. Their system is also weakening and may show less control over these functions. 
  • Restlessness or Agitation: In the last few weeks before death, the body of your loved one is dealing with illness and medications that may have side effects. They may seem more agitated or irritated even at small changes. They may ask for alone-time more often. This is not a rejection of you; it’s just a need for peace and quiet.
  • Exhaustion that keeps them from wanting to move out of bed or talk anymore
  • Less need for company or companionship 

Physical Signs that Death Is Imminent

A person who is on their deathbed generally begins to show signs of impending death. The last few hours before the end, they may frequently sleep, and even when awake, show signs of not being entirely there. It is common in the last stages of illness for your loved one to feel confused about reality. They may experience hallucinations or delusions. They may imagine being with loved ones who are long gone or even believe they are in a different time and place. You may overhear conversations they have with someone they “see” who is not physically present.

Your loved one’s eyes may stay closed even when awake. Alternatively, they may have their eyes open but seem to not “be there” in the room with you. Because they don’t seem to be completely awake anymore, their posture may look relaxed as if they are sleeping, even if their eyes are open. 

Lower blood pressure can cause their skin to look very pale, and they may stop and start breathing as though it is no longer necessary. 

Changes in Vital Signs

In the last few hours of someone’s life, medical professionals notice that their vital signs change. Because the body is slowly shutting down its operations, measurable signs of life can change. 

  • Lower temperature 
  • Changed breathing patterns
  • Loss of consciousness
  • Lower blood pressure
  • Slower or irregular heart rate

As the body dies, the systems shut down, and eventually, vital signs show that the individual is gone. At this point, you may sense that the person is gone or observe that their eyes are no longer seeing anything.

Being There for Your Loved One

It is normal to want to “be there” for your loved ones as they pass away. However, hospice nurses often note that their patients prefer privacy while dying. Hospice patients sometimes hold onto life while their family remains close and then pass away when the family steps out of the room. Some patients may seem ready to die but keep holding on to life for the sake of loved ones. In other cases when a loved one is far away and not able to immediately get home some will hold off death until they can see them again. It seems almost unbelievable but it does happen.

As the hold of reality loses its grip on a dying individual, many no longer seem to need real people to connect with. According to Pallimed, often “Family members will sit vigil for days without eating or sleeping… However, companionship while dying is a personal preference. We have those patients who die in the middle of the night. We hear stories about the loved one who just stepped out for five minutes and the patient died.” 

You may want to “be there” for your loved one’s death, but they may not need you at the moment of death. As long as you spend a reasonable amount of time with your loved one, it is not your fault if they choose to die while you are not at their side. It may be for the best that you stepped out during that moment.

We Can Help

If your loved one faces a terminal illness and you need guidance on how to move forward, contact us at Renaissance Funeral Home. We create memorable events to honor and remember your loved ones after they pass on. Whether you’ve decided to make a preplan for your own memorial or are considering plans for a loved one, we are here for you. Our experienced funeral directors work within your budget to create a beautiful time of remembrance for family and friends to come together to grieve and celebrate the individual’s life. Remembering your loved one well lets everyone grieve and begin to move forward into a place of new hope.



  1. https://palliative.stanford.edu/home-hospice-home-care-of-the-dying-patient/where-do-americans-die/ 
  2. https://www.medicinenet.com/does_a_dying_person_know_they_are_dying/article.htm