3 symptoms that often appear 24 hours before death

The last 24 hours of life are a delicate, emotional period for both the individual and their loved ones. While every journey is unique, certain signs commonly appear as the body begins to naturally shut down. Recognising these symptoms can help caregivers provide comfort and dignity, making those final moments more peaceful.

Understanding the changes isn’t about fear; it’s about awareness, compassion, and ensuring the person feels supported. From breathing shifts to changes in skin tone and responsiveness, these signs are the body’s way of conserving energy and preparing for the end, according to studies by Hospice Foundation of America and the National Cancer Institute. Being present, calm, and gentle can make a profound difference during this critical time.



Irregular breathing patterns in the final hours before death

One of the most noticeable signs that the body is nearing the end of life is a shift in breathing. According to reports by Hospice Foundation of America, breathing may become irregular, shallow, or labored. A common pattern is Cheyne-Stokes respiration, a cycle of deep, rapid breaths followed by moments of no breathing (apnea). This can be unsettling to witness, but it is a natural part of the dying process and not typically painful.

Some individuals may breathe with long pauses in between, while others may seem to gasp or sigh intermittently. These changes occur because the brain is no longer regulating breathing as it once did. Loved ones need to understand that, although the pattern may appear distressing, the person is often unaware or unbothered by these shifts, especially if they are in a deeply relaxed or unconscious state.



Skin and temperature changes before death

As the heart slows down and circulation decreases, blood flow is redirected to vital organs, leading to visible changes in the skin. You may notice:

• Mottling: Patchy, marbled discoloration, often starting on the feet, hands, or knees.
• Coolness in the extremities: Hands and feet may feel cold to the touch.
• Bluish or purplish tint: Lips, fingernails, or toes may take on a dusky hue due to reduced oxygen.

These signs are not indicators of discomfort, but rather the body conserving its remaining energy. They are part of the natural and expected process of the body gently shutting down.



Reduced responsiveness and withdrawal before death

In the final hours or day, many people become less responsive to external stimuli. They may:

• Stop speaking or responding to voices
• Keep their eyes closed most of the time or appear to look through people
• Appear to withdraw from their surroundings

This withdrawal is not a rejection of loved ones, but rather the body and mind turning inward in preparation for transition, according to studies by the National Cancer Institute. It can be emotionally difficult for families and caregivers, but it’s important to remember that hearing is often the last sense to fade. Speaking softly, offering calm presence, and maintaining a peaceful environment can still bring comfort.

Even if your loved one can’t respond, your presence matters. A familiar voice, a gentle hand on theirs, or soft music can bring immense peace during this time.



How to support your loved one before death
Being present during a loved one’s final hours is one of the most profound acts of care you can offer. Though the experience may feel overwhelming, there are simple, loving ways to provide comfort:


Stay calm and gentle
Your tone and demeanor set the atmosphere. Keep your voice soft and steady. Reassure them that they are safe and not alone. Even simple phrases like “I’m here with you” or “You are loved” can provide deep emotional reassurance.


Offer touch, if welcomed
A light touch on the hand, forehead, or shoulder can be grounding. Some people may respond to gentle hand-holding or a light massage. Always be respectful. If your loved one appears uncomfortable, try a different form of presence, like sitting quietly by their side.


Respect their space and rhythm
It’s okay if they don’t respond or seem distant. Allow them to rest without interruption, while maintaining a quiet, supportive presence. Avoid loud conversations or sudden movements, and instead offer a space of calm and peace.




Every individual’s end-of-life experience is unique. Some may speak or smile until the very end, while others become quiet and withdrawn. There is no “right” way to die, just as there is no single way to grieve. The most meaningful thing you can do is to be present, patient, and compassionate.

Witnessing these final moments can evoke a range of complex emotions, including grief, fear, tenderness, and even relief. Allow yourself to feel them without judgment. When the time comes, your loved one’s passing can be a peaceful, dignified, and love-filled transition, shaped by your gentle care and presence.

Remember, you don’t have to do this alone. Hospice teams, palliative care professionals, and spiritual counselors can support both you and your loved one through these final stages.




Also read| Drinking water before meals: A simple daily habit to control blood sugar naturally