Loss of appetite or refusal to eat
Sipping less fluid — or stopping altogether
Difficulty swallowing
⚠️ This is not starvation — it’s a natural part of the process. Forcing food or fluids can cause discomfort, bloating, or aspiration.
💡 What you can do:
Offer small sips of water, ice chips, or moist swabs for dry lips
Keep mouth clean and comfortable (use a soft sponge brush)
Honor their choices — eating is no longer about nutrition at this stage
Let go of guilt. Their body knows what it needs.
✅ 3. Altered Breathing Patterns
Breathing may become irregular, which can be unsettling to witness.
Common patterns:
Cheyne-Stokes breathing: Deep breaths followed by pauses (up to 30 seconds)
Shallow, slow breaths
Gurgling or “death rattle” (caused by saliva pooling — not painful)
🩺 These are normal in the final hours and usually mean death is near — within hours or days.
💡 What you can do:
Turn their head gently to the side to help secretions drain
Use suction or oral swabs if recommended by hospice
Stay calm — your presence brings peace, even in silence
Talk to their care team about medications to ease discomfort.
✅ 4. Coolness, Color Changes, and Reduced Circulation
In the final days, blood flow shifts inward to protect vital organs.
You may notice:
Hands and feet turning cool or bluish-purple
Skin mottling (blotchy, purplish patches on legs or arms)
Weaker pulse
✅ This is expected — not a sign of suffering.
💡 What you can do:
Cover them lightly — avoid heavy blankets
Do not rub cold limbs (can cause injury)
Keep the room peaceful and warm
Their focus is internal now — not on temperature.
❤️ How to Prepare — For Them and Yourself
Seeing these signs can bring up powerful feelings. You don’t have to have answers — just love.
Talk to the care team
Doctors and hospice nurses can explain what’s happening and manage symptoms
Ask about advance directives
Did your parent share wishes about resuscitation, hospitalization, or pain control?
Say what needs to be said
“I love you.” “Thank you.” “I forgive you.” Words heal hearts — theirs and yours
Invite siblings or close ones to visit
Farewells matter — don’t wait
Take care of yourself
Grief starts before death — rest, eat, lean on others
📌 Hospice care is not “giving up.” It’s choosing comfort, dignity, and support.
