| Symptoms | |
| Patient has decreased need for food and drink as the bodily functions begin to slow down. | . |
| There may be difficulty in swallowing. | . |
| Gradually, the patient spends more time sleeping during the day and at times is difficult to arouse. This occurs through changes in the body’s metabolism. | |
| It is common for the dying person to become restless and to pull at the bed linens. | |
| The patient may become increasingly confused about time and place, and have trouble identifying familiar people. | |
| The patient may have visions of people and things not visible to others. | . |
| Incontinence may become a problem. The amount of urine may decrease, and it may be darker than usual. | |
| The patient’s respirations may sound moist, due to sagging of the tongue muscles and inability to clear throat secretions. | |
| Hearing and vision acuity may deteriorate. Hearing is thought to be the last of the senses to diminish. | |
| The patient may become cool to the touch. Often, this prompts caregivers to pile on blankets. However, most dying patients can not tolerate even slight weight on the feet and extremities. | |
| The skin will change in appearance from being uniformly pale to mottled, with colors varying from red to blue and purple. Mottling usually occurs first on the soles of the feet and over bony areas, such as the knees. The underside of the body becomes darker as blood circulation diminishes. These symptoms occur late in the dying process. Fevers are also common. | |
| Often, there is a change in the breathing pattern. There may be 10- to 30-second periods of apnea, which is very common in the final stage of life. | |
| Most of the time, the patient will be unable to respond to touch or sound. | |
| Pain and discomfort may increase, decrease, or stay the same as death approaches |
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