Dying can be a gradual process, including when someone has a serious illness. If someone is receiving good care, it can be quite a peaceful time — a time during which the body lets go of life. What happens varies between people, but this article describes how people’s bodies generally change as they die.

What is the physical process of dying?

In most people who are dying, the body’s normal systems start to operate more slowly. The heart beats a little more slowly, or with a little less force, and so blood is moved around the body more slowly. This means the brain and the other organs receive less oxygen than they need, and do not function as well.

When the brain receives less oxygen than it should, the way the person who is dying thinks and reacts to situations is also affected. The hormones (produced by the brain) are also affected, which influences the way in which other organs function.

What happens in the weeks before death?

Most people who are dying feel tired. They may want to sleep more often, or for longer periods. They may want to talk less, although some may want to talk more.

They may want to eat less or eat different foods since their stomach and digestive system are slowing down.

Someone who is dying may also lose weight and their skin might become thinner. The body now finds it hard to regenerate skin cells, as well as other organs, in the way it used to.

What happens in the days before death?

In the days before their death, a person’s control over their breathing starts to fail. They may breathe more slowly for a while, then more quickly, and so their breathing becomes quite unpredictable overall. Fluid can start to gather in their lungs, and the breathing can begin to sound quite ‘rattly’. They might cough, but not very deeply.

Some people have a burst of energy in the 24 hours before they die, sitting up and talking normally for a short period.

Often, people’s skin colour changes in the days before death as the blood circulation declines. They can become paler or greyer or their skin can become mottled.

With the loss of oxygen to their brain, they might become vague and sleepy. Some people have hallucinations and talk to ‘people’ who aren’t there. Some become unconscious a few days before they die.

What happens in the 24 hours before death?

Someone who is close to death will spend most of the time asleep. They may not be able to communicate when they are awake because their senses are failing. However, they may still be able to hear, so speak to them normally.

Physical signs that death is near include:

• a sudden burst of energy
• mottled and blotchy skin, especially on the hands, feet and knees.
• blood pressure decreases
• they cannot swallow
• less urine
• restlessness
• difficult breathing
• congested lungs

What happens in the hours before death?

In the hours before death, most people fade as the blood supply to their body declines further. They sleep a lot, their breathing becomes very irregular, and their skin becomes cool to the touch.

Those who do not lose consciousness in the days before death usually do so in the hours before.

Most people are very calm at this time, although some may be agitated, especially if they are finding it hard to breathe.

Other symptoms in the hours before death include:

Some symptoms a person may experience during this time include:

• glassy, teary eyes that may be half-open
• cold hands
• weak pulse
• hallucinations
• being fast asleep
• gasping, or periods where breathing completely stops

What happens when someone dies?

In time, the heart stops and they stop breathing. Within a few minutes, their brain stops functioning entirely and their skin starts to cool. At this point, they have died.

The signs that someone has died are:

• there is no breathing or heartbeat
• they cannot be woken up
• their skin is pale and waxy
• their eyelids might be half open
• their pupils are fixed
• their mouth may fall open

What happens after someone has died?

You might feel all sorts of emotions, from grief that they are gone to relief that their pain is over, and any number of emotions in between. Take your time — it’s fine to just sit with the person who has died for as long as you need to.

If the death occurs in a hospital, nursing home or hospice, then the facility will take care of all the initial next steps for you.

Resources and support

For more information and support, try these resources:

• the different ways death can be defined
• how to cope before and after someone dies
• planning for the end of life, and how thinking about death can make life easier (advance care planning)
• Griefline — Call 1300 845 745, Mon to Fri, 8am to 8pm (AEST)