What Are 5 Physical Signs of Impending Death?

The signs that indicate someone is close to death include loss of appetite, increased weakness, labored breathing, changes in urination, and swelling in extremities. Other end-of-life signs may include sleeping more, increased pain, and becoming less social.

There are a number of signs that indicate someone is close to death. Some people may pass quickly, while others will gradually decline.

Five physical signs that someone might be close to death include: 

1. Loss of appetite

• Energy needs decrease as the body shuts down
• People often refuse to eat or will only take a few bites of food
• Toward the very end, people may have difficulty swallowing and will refuse liquids as well
• While it can be upsetting to see a loved one refuse to eat, it is part of the natural process of dying and it is helpful to have patience and understanding 

2. Increased weakness

• When people eat less, they have lower energy levels and increased weakness, so even simple activities such as having a conversation, changing clothing, or even sitting on the edge of the bed may be challenging 
• Movements may be very slow and people may require assistance to shift position 

3. Labored breathing

• Shortness of breath often occurs and can be described as “air hunger,” which is a fearful desire to breathe better
• The body feels it needs more oxygen, and this sensation can cause fear and anxiety
• Periods of fast, shallow breathing followed by slow, heavier breathing and moments without any breath at all (apneas) may occur, called Cheyne-Strokes respirations
• Excessive secretions in the mouth and throat can cause loud gurgling noise during breathing sometimes referred to as a “death rattle” 

4. Changes in urination

• Dehydration lowers blood pressure, which leads to decreased kidney function and decreased urine output 
• Eventually renal failure occurs
• Urine becomes concentrated
  • Brownish, reddish, or tea-colored
  • May have a very strong odor 
• Loss of bladder and/or bowel control may occur and eventually there is no urine output
• Kidney failure causes urine and other waste products to accumulate in the body, which causes decreased mental alertness
  • This will eventually result in a peaceful twilight state or comatose state

5. Swelling in extremities

• Fluid retention (edema) and swelling of the feet and hands occur as disease processes such as chronic heart failure, renal failure, and liver disease become unmanageable
• Fluid is not effectively pumped through the kidneys to be filtered and regulated
• In patients who are bed ridden, the hands and hips may also swell