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Article reviewed by Emily Cross, Self-Employed Death Doula on March 7, 2025.
Dying is a journey we will all take someday, yet it remains one of life’s most mysterious and emotional experiences for both those facing it and their loved ones. Watching someone approach the end of life can elicit a mix of sadness, fear, love, and sometimes even relief that their suffering may soon end. While the final weeks and days can bring profound changes, both physical and emotional, they can also hold moments of unexpected beauty and poignance: a quiet smile, a sudden moment of clarity, or a final whispered “I love you” that lingers in memory long after they are gone.
Whether you are a caregiver, a friend, or someone facing your own mortality, this article will help you navigate the end-of-life stages with knowledge and compassion. For those seeking guidance in planning for the end of life, Aura’s End-of-Life Planning Guide offers practical advice on preparing for this phase of life with clarity and confidence.
Key takeaways:
The final stage of life is a personal journey that unfolds differently for everyone. While no two experiences are the same, certain physical, emotional and psychological changes are common in the weeks and days leading up to death. Learning about the facts and myths about death and these stages can help those facing the end of their life, caregivers, and medical professionals prepare, and provide the best possible care.
The process of dying doesn’t adhere to a strict schedule. It is shaped by factors like the person’s illness, what medical care they receive, and how their body responds to changing circumstances. However, most people nearing the end of life experience a fairly gradual transition, moving through early, middle, and late stages of progression.
When someone is living with a life-limiting illness, palliative care and hospice can provide invaluable support. While they both focus on keeping the person comfortable and improving their quality of life, they may come in at different stages depending on exactly what’s needed.
Palliative care is available at any stage of a serious illness, not just at the end of life. It is a broad term which can encompass hospice care, but focuses on:
Importantly, this type of care can be provided alongside their usual treatments, meaning a person can still receive chemotherapy, dialysis or other medical interventions while benefiting from palliative support.
Hospice care is a more intensive form of palliative care designed for people who are nearing the end of life. To qualify for hospice care, a doctor must certify that the person is expected to live six months or less if their illness follows its natural course. At this stage, the focus shifts entirely to comfort rather than cure. Some people may move on and off of hospice care if their condition stabilises or improves, while others may live longer than expected.
Hospice care aims to provide:
Hospice can be provided in the home, in a hospice facility, or in a hospital, depending on the family’s wishes and needs. It helps enable the person to spend their final months and weeks as comfortably and peacefully as possible.
Both palliative and hospice care aim to ease suffering. They not only address physical pain, but also the unique emotional and spiritual challenges that can come as someone approaches the end of life. The goal is always to help people find comfort, dignity, and peace in whatever way is most meaningful to them.
A death doula (or end-of-life doula) is a non-medical companion who provides emotional, sometimes spiritual, and practical support to both the dying person and their loved ones. They help families navigate the end-of-life process by:
The role of a Death Doula is to make sure that both the person dying and their family feel supported, prepared, and emotionally held during this sacred time.
Losing a loved one can be an overwhelming experience, but creating meaningful final moments can bring comfort to both the person who is dying and those left behind. Some families choose to share memories and express gratitude, offering words of love and reassurance. Others find solace in simply holding their loved one’s hand or sitting beside them in silence. Playing a favourite song or reading a loved passage can also bring a sense of calm during these final moments.
After losing a loved one, some families find comfort in hosting a celebration of life either alongside or instead of a traditional funeral. It can be a chance to come together, share stories, laugh, and remember the moments that made them special. Unlike traditional funerals, these gatherings can be as personal and unique as the person being honoured, creating a meaningful way to say goodbye and feel some closure.
Many people experience anticipatory grief, or mourning the loss before it happens. A death doula, hospice team, or therapist can help families process these emotions, ensuring they feel supported in the days ahead.
Recognising when someone is entering the final stages of life can be challenging. Doctors assess life expectancy based on factors like weight loss, decreased mobility and organ function decline.
Some early signs can include:
These changes may develop gradually, but when they become more pronounced, it can be a sign that a person is entering the last weeks or months of life.
As a loved one approaches the end of life, discussions about medical interventions may become necessary. Some people choose to put a Do Not Resuscitate (DNR) order in place, which instructs healthcare professionals not to perform CPR if their heart stops or they stop breathing. This is often part of a broader advance care plan that ensures their wishes for comfort and dignity are respected.
If your loved one hasn’t made their preferences clear, it can be helpful to speak with their doctor or palliative care team about the best course of action. Having these conversations in advance can provide clarity and reduce stress when difficult decisions need to be made.
In the last few weeks before death, the body begins to slow down in some noticeable ways. These changes can be hard to witness, especially for loved ones, but they are part of the natural process of dying. While every person’s journey is unique to them, there are some common signs that can help families and caregivers prepare for what will happen.
As heartwrenching as this time can be, there can also be beauty in death; in the quiet, in the final expressions of love, and in the way life gently fades, often surrounded by loved ones and friends.
As the body starts to conserve its remaining energy, even simple tasks like sitting up, talking, or keeping their eyes open for long periods can become exhausting. You may notice:
The mind also starts to slow down. Some days, they may seem alert and aware, while others, they may appear distant or confused. For those with dementia at the end of life, these changes may be more pronounced, sometimes with increased agitation, confusion, or difficulty recognising loved ones. As the disease progresses, communication may become limited, but gentle reassurance, familiar music, or simply being present can still provide comfort.
Cognitive shifts can look like:
It’s common for someone nearing the end of life to turn inward. They might not engage in conversations the way they used to, preferring silence or rest. This doesn’t mean they don’t care… it’s simply that their body and mind are preparing to let go. You may notice less interest in having visitors over, or having long conversations. You might observe them settling into distant or faraway looks, as if they are deep in thought, or experiencing moments of emotional clarity, where they suddenly express love and gratitude, or even a final wish.
The body no longer needs as much energy, so eating and drinking will naturally decrease over time. This can be one of the hardest things for loved ones to accept, as the instinct is to encourage food for strength or pleasure. But forcing meals can cause discomfort, and even prolong the natural process of dying. Instead, it can help to:
At this stage, comfort is more important than anything else. The best thing you can do is be present: hold their hand, speak softly, and reassure them they are not alone. Some people may seem to prefer solitude instead, and that’s okay. Trust your instincts and consider what feels right based on what you know about them.
Some ways to help include:
These final weeks can be highly emotional, but they are also a chance to create meaningful moments, express love, and simply be together in whatever way feels right.
In the final day or two of life, the body begins to shut down completely. These changes can happen quickly, and while they may seem unsettling, they are a natural part of the dying process. Pain management becomes a priority, and hospice teams, caregivers, and even death doulas can play an essential role in ensuring a peaceful transition.
One of the most noticeable shifts is in breathing. It may become irregular, with long pauses in between breaths. Sometimes, there will be a rattling or gurgling sound. This happens when fluid collects in the throat because the body is too weak to clear it. It might sound disturbing, but it doesn’t mean they are struggling. A loved one’s touch, a calm presence, and a peaceful environment can be more comforting than anything else at this stage.
As the body slows down, the heart isn’t pumping as strongly, and blood flow to the hands and feet decreases. You may notice cooler skin, especially on the fingers, toes, and nose, or mottled or purplish patches on the legs or arms. A gradual relaxation of the muscles will sometimes give the person a peaceful, or stoic look.
Keeping them covered with a soft blanket can help, but extreme warmth isn’t necessary. These changes are a sign that the body is conserving energy for the final moments.
It’s common for someone to drift in and out of awareness, sometimes not responding at all. They may seem to be asleep for hours or even a full day, only stirring slightly if spoken to. However, hearing is believed to be the last sense to fade, so speaking softly, playing familiar music, or simply being there for support can still bring comfort.
In these final hours, there can be moments of confusion or restlessness, distress, or anxiety that can occur in the final days of life, sometimes referred to as ‘terminal agitation’. If your loved one experiences these symptoms, we understand this may seem unsettling, but it’s important to remember it is a natural part of the dying process and does not necessarily mean they are in discomfort.
Alternatively, the person may also display periods of lucidity or peace, mumble a bit, reach for something unseen, or speak to loved ones who have already died. Some families find these moments beautiful, as if the person is being gently welcomed to the next stage. At other times, there may be a surprising moment of increased energy—where they wake up, recognise loved ones, or even say a final few words. While this doesn’t happen for everyone, it can be a precious opportunity to say goodbye or relay something important to you.
This stage isn’t about medical care anymore, it’s all about comfort. Sitting beside them, holding their hand, gentle touch and letting them know they are not alone is what matters most. You don’t need the perfect words, just being present is enough.
Some ways to help include:
Eventually, breathing slows to just a few breaths per minute, until it stops completely. This moment can feel overwhelming, but many families describe it as peaceful, as if their loved one simply drifts away.
No matter how it happens, know that you did everything you could. Your presence, love, and care made all the difference in their final days.
At Aura, we understand how heavy this time can feel. The company was born following Paul Jameson’s terminal diagnosis. In those moments, he realised that nothing mattered more than ensuring his family would be surrounded by clarity, unwavering support, and care when he was no longer there. Aura is built on the heartfelt belief that every customer deserves the same level of care, respect and compassion that we would want for our own loved ones.
Our at-need funeral services and funeral plans are designed to provide comforting guidance and practical support, helping families navigate their loved one’s final goodbye with ease and reassurance. Whether you need a simple direct cremation or a more personalised send-off, our experienced, industry-leading team of Aura Angels is here to handle every detail with care. Please don’t hesitate to reach out and speak to us should you have any questions.
