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This information prepares family, friends and loved ones for what to expect when someone is dying and planning care using an Individualised Care Plan for the Last Days of Life.
This guide is designed to help you understand and answer some of the questions you may have about your loved one or friend and their care.
When a person approaches the end of their life there are signs and symptoms that are common to most people. Each person is an individual, so there may be changes that happen to them that are not described in this guide. Please discuss any concerns or worries with the staff looking after your loved one or friend at any time.
Individualised Care Planning for the Last Days of Life
The doctors and nurses may talk to you about an Individualised Care Plan. This is simply the care that is being planned for your loved one or friend to ensure their needs are met as they approach the end of their life.
The plan includes symptom control, their need for food and drink, spiritual, emotional and social support. You will be fully involved throughout the planning and supported through this difficult time.
If at any time there are any questions then please speak to staff looking after your loved one or friend.
What happens when someone is dying?
There are some physical changes that may happen to a person when they are close to death, some of these may be distressing for families and friends. This information is aimed to reassure you they are not unusual.
If you do become overwhelmed, then please speak to a member of staff who will talk you through your concerns.
Information for relatives and friends
Everybody is unique and many people are very peaceful at end of life. They appear to slip into a deep sleep and gradually become unconscious.
Even if your loved one or friend may not be responding to you, they may still be able to hear you. By speaking to them and letting them know you are there, it may be comforting to both of you.
Anticipatory medications
These medications are used to control symptoms such as pain, restlessness, sickness and noisy breathing. They will be made available to use just in case they are needed. These will be discussed with you at the time.
Spiritual and religious needs
As your loved one or friend is dying, they may want particular practices carrying out, a faith leader to visit or something as simple as playing soft music.
These are completely individual to the person and if there is something that is important them, please mention it to a member of staff that is caring for them.
Reduced need for food and fluids
As a person becomes weaker the effort of eating and drinking may be too much and some help to do this might be appropriate. Your loved one or friend will be supported to take food or fluids for as long as possible.
At this stage the desire to eat or drink diminishes and eventually your loved one will stop eating and drinking and be unable to swallow tablets.
Regular mouth care is extremely important at this time and keeping your loved one or friends mouth clean and moist is essential.
Changes to skin and sensations
In the last few hours, your loved one or friend's skin may slightly change colour, it may become grey, white or even have a slightly blue mottled colour to it.
Their skin may become more sensitive or cold to the touch, this is due to reduced circulation. These changes are all normal parts of the dying process.
Changes in breathing
When in the final stages of life, a person’s body becomes less active and they require less oxygen. This may make their breathing more irregular and there may be either a long pause between each breath or it may become more rapid.
It may also become noisy, this is caused by a build up of fluid in their air passages as they are unable to swallow or reabsorb it. This may be upsetting for family and friends although it does not appear to be distressing for the person who is dying.
Final moments of life
The final moments for most people are very peaceful. Your loved one or friend's breathing may become more irregular and there are longer pauses between each breath, until it eventually stops.
The person’s body will relax completely and they may look very peaceful. It can be difficult to identify the exact moment when they die as there may be one or two last gasps after it was thought they had taken their last breath.
What happens after someone has died
Even when death has been expected, this is still a profound moment. You may feel that you would like to be alone with your loved one or friend or you may want to contact family and friends, if they are not already present.
This is totally individual and the staff caring for your loved one or friend will assist you with what you decide and support you to spend time with your loved one or friend after they die.
All staff are there to offer you care and support at this difficult and sad time. They can confirm your loved one or friends has died and can assist you with worries, concerns or questions.
What happens next
The GP will complete the medical certificate with the cause of death and send this to the Medical Examiner’s office.
The Medical Examiner will agree the cause of death and may contact you to give you the opportunity to ask any questions before countersigning the certificate, which is sent to the local registry office who will contact you to come in and register the death.
It is important to receive the death certificate before arranging a funeral with a funeral director in case there is further examination required by the coroner.
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Our patients matter
Mersey Care NHS Foundation Trust listens and responds to patients and their carers to help improve the services we deliver.
If you have any comments, compliments or concerns you can speak with a member of staff or contact our Patient Advice and Liaison Service (PALS) and Complaints Team
Telephone: 0151 471 2377
Freephone: 0800 328 2941
Email: palsandcomplaints@merseycare.nhs.uk
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Approval date: 24 July 2026
Review date: 23 July 2027
Version number: 1