Caring for an elderly loved one who is nearing the end of life is one of the most emotionally complex and deeply human experiences a person can go through. In Australia, with an aging population and increasing life expectancy, more families are facing the difficult reality of supporting a loved one through their final days. Understanding what to expect in the final stages of life — commonly referred to as the “active dying” phase — is essential not only for the emotional well-being of the caregiver, but also for the dignity and comfort of the person who is passing.
At Support Services Connect Australia (SSCA), we understand the overwhelming responsibility families face when trying to secure appropriate support and care during this critical time. That’s why we offer a free, expert-led care finding service in Melbourne, helping you connect with the right providers during every stage of aged care — including end-of-life care.
This article explores the key signs of active dying, the steps families can take to provide comfort, and how SSCA’s care finding service can guide you in making the best decisions for your loved one in their final chapter.
What Is Active Dying?
“Active dying” is a term used to describe the final phase of the dying process. While every individual’s experience is unique, there are common physical, emotional, and behavioral signs that indicate death is near. These changes typically begin a week or more before death and become more pronounced in the final days and hours.
Being aware of what is likely to occur can help caregivers and families manage their emotions, make informed decisions, and provide a peaceful and dignified environment for their loved one. This knowledge can also reduce unnecessary stress and help family members feel better prepared during this emotional time.
One Week or More Before Death
During this period, your loved one may start to exhibit both physical and emotional changes. Here are some signs to expect:
- Reduced Appetite and Thirst
One of the earliest changes in the dying process is a noticeable decrease in appetite and thirst. The body’s need for nutrition and hydration diminishes as biological functions slow down. Offering soft foods like jelly or pudding, or simply ice chips, may help prevent dehydration. Serving fluids between meals rather than with meals can also aid digestion and comfort.
- Changes in Communication
It’s common for the dying person to speak less or become more withdrawn. However, they may also have moments of clarity and wish to discuss past memories or even talk about seeing deceased family members. These episodes should be met with empathy and openness — simply listening can offer great comfort.
- Emotional Reconciliation
Some people use this time to tie up loose ends, express love, say goodbye, or even discuss funeral wishes. Don’t discourage these conversations — they can be healing for both your loved one and yourself.
About One Week Before Death
As the body continues to slow down, more pronounced signs of decline become visible. This stage is often marked by the following:
- Extended Sleep and Decreased Responsiveness
Your loved one may sleep for longer periods, with fewer moments of alertness. It’s normal for them to drift in and out of consciousness. At this stage, presence is more important than conversation. Simply sitting nearby and holding their hand can provide reassurance.
- Cognitive Changes
As oxygen to the brain diminishes, confusion, restlessness, and hallucinations may occur. They might appear anxious or begin talking to people you cannot see. Maintain a calm and reassuring presence, using a gentle voice and peaceful surroundings to help them feel safe.
- Less Frequent Urination
Because the person is eating and drinking less, their fluid output will decrease. This is a normal part of the body shutting down.
- Creating a Calm Environment
A soothing atmosphere can help ease this transition. Light a candle, play gentle music, or read from a favorite book. These small acts of care can offer immense comfort.
Two to Three Days Before Death
As death draws closer, physical signs become more evident and may include:
- Mottled Skin and Cold Extremities
Blood circulation weakens, leading to blotchy, purplish discoloration (known as mottling), particularly in the hands and feet. These areas may feel cold to the touch. Keeping your loved one warm with blankets and adjusting the room temperature can help maintain comfort.
- Non-Responsiveness
Your loved one may no longer respond to voice or touch. While this may be distressing, it is a normal part of the process. Continue to offer gentle reassurance. It’s widely believed that hearing is the last sense to go, so speak lovingly even if they don’t respond.
One to Two Days Before Death
This is typically the final phase of active dying. The body begins to shut down completely, and the signs become more pronounced:
- Irregular Breathing
Breathing patterns may become erratic. Long pauses between breaths, shallow breathing, or gasping is normal. This can be difficult to witness but is part of the natural process.
- Gurgling or Rattling Sounds
As your loved one loses the ability to swallow or clear their throat, fluid may build up, causing a gurgling noise. This is sometimes called the “death rattle.” While it may sound distressing, it usually doesn’t cause discomfort.
Raising the head of the bed, using a fan, or opening a window can help ease breathing.
- Focus on Comfort
Ensuring your loved one is as comfortable as possible is paramount. This may involve adjusting their position, providing medication for pain relief as prescribed by their doctor, or simply creating a peaceful setting.
When Death Occurs
When death arrives, there will typically be:
No breathing or pulse
A relaxed jaw or partially open mouth
Fixed pupils or partially open eyes
Loss of control over bodily functions
This moment can be overwhelming. Grief, relief, and even confusion may surface. Take your time. It’s okay to cry, sit in silence, or just be present. Each person’s grief process is unique.
You might notice a tear shed even after passing — a reminder of the depth of human emotion, even in the final moments.
How SSCA’s Free Care Finding Service Can Help
Whether you’re looking for in-home support, residential aged care, or respite options during the final stages of life, our experienced team listens carefully and matches your loved one’s needs with appropriate services. By guiding you through the process — including government funding options and provider choices — SSCA ensures that your focus remains on what matters most: being present with your loved one.
Conclusion
The dying process is profoundly personal, and while it can bring great sorrow, it also offers an opportunity to express love, gratitude, and peace. By understanding the stages of active dying and creating a compassionate environment, you can provide your loved one with the dignity and care they deserve.
You don’t have to go through this alone. Let SSCA’s free care finding service in Melbourne walk beside you during this deeply human experience. We’re here to help you make informed decisions, find the right care providers, and honour your loved one’s final journey with grace.
If you need assistance finding end-of-life care or a home care provider that understands your family’s needs, please contact Support Services Connect Australia today. Our team will help you find the right path — at no cost to you.