Imminent death means that the person’s decline in health is irreversible and they are likely to die in the coming hours, days, or weeks.
This is also referred to as 'actively dying' or 'entering the terminal phase'.
A person’s overall energy and strength declines as their disease advances. The signs that commonly indicate that a person is dying are caused by the body slowing down, the illness and/or treatments.
Everyone's experience of dying is different and it can be difficult to know when a person is reaching the last few days of their life.
Timely recognition that a person may be imminently dying and clear communication of that possibility enables the person to receive the best possible care, and those around them to be prepared and supported.
If a person dies peacefully without needless suffering, the family and carers have the best opportunity to see the death as a good death and have fewer difficulties as they grieve.
It is common for a person approaching the end of their life to spend increased time in bed and sleep for longer periods of the day. In the last few days of life, some people can change quickly from being reasonably independent to sleeping all of the time.
The signs that a person is entering the terminal phase include:
As a person approaches death, their pattern of breathing will often change, and may include:
There may be significant uncertainty about whether a person is entering the last days of life or stabilising or if there is potential for even temporary improvement. This may be due to inconsistent signs or symptoms or the fluctuating course of the person’s condition. Discussing with colleagues with more experience of providing end-of-life care may be helpful.
Preparing for the last days of life should happen before active dying starts. This can be part of advance care planning, care planning and/or triggered when signs of deterioration are recognised.
Preparing for the last days of life includes discussions around preferred place of care and of death.
For patients who are at home and want to die at home, this may mean assessing the needs of the person, family and carer and arranging access to support services and the contact details of out-of-hours services for advice or assistance. Equipment (e.g. hospital bed) may be ordered and medications prescribed by a GP or nurse practitioner.
Use the CarerHelp Resources
If the family or carers feel unable to provide care, timely admission to a hospital or palliative care unit may help the person, family and carers experience a 'good death'.
It is helpful for the family to know who to contact once the death has occurred as this can facilitate a smooth liaison with a funeral home.
This information was drawn from the following resources:
To to Last days and hours of life on the Marie Curie website
Watch the video - Quality care in the last days of life
Access more Recognising Dying Resources
Page updated 26 April 2023