The dying process is unique to each individual, but in most cases there are common characteristics or changes that help us to know that a person is dying.

These fall into four main categories

• less need for food and drink
• withdrawing from the world
• changes in breathing
• changes which occur before death

Less need for food and drink

When someone starts the dying process, their body no longer has the same need for food and drink. The body’s metabolism slows down and the body can’t digest the food so well or absorb its goodness. People stop drinking and, although their mouth may look dry, this is not a sign that they are dehydrated. Gently moistening the person’s mouth with a damp sponge and applying lip salve will give comfort. It can be hard to accept these changes, even when you know the person is dying, as it’s a physical sign that they are not going to get better. You can still show that you care about your loved one by spending time with them and giving comfort by being there.

Withdrawing from the world

For most people, the process of withdrawing from the world happens gradually. People spend more and more time asleep and, when they are awake, they are often drowsy and show less interest in what is going on around them. This natural process can be accompanied by feelings of calmness and tranquillity.

Changes in breathing

Towards the end of life, as the body becomes less active, the demand for oxygen is much less. People who suffer from breathlessness are often concerned that they may die fighting for breath, but in fact breathing eases as they start to die. Breathing problems can be made worse by feeling anxious; the knowledge that someone is close at hand is not only reassuring, it can be a real help in preventing breathlessness caused by anxiety.

Just sitting quietly and holding your loved one’s hand can make a real difference. Occasionally, in the last hours of life, there can be a noisy rattle when the dying person breathes. This is due to a build up of mucus in the chest, which the person is no longer able to cough up. Medication may be used to reduce this and changing position may also help. The noisy breathing can be upsetting for carers, but it doesn’t appear to cause distress to the dying person