Offering Comfort Through the Stages of Death and Dying

Death is not a subject that is easy to discuss. Yet, it’s something we all must face someday. If you have a loved one who is nearing this time, it can be helpful to know what to expect throughout the stages of death. While the timeline of death may vary, there are three stages of death that most people will experience. Knowing these stages can help you to be helpful and supportive during this difficult time.

The Physical Stage

The first stage that a person will experience is the physical stage. This stage involves a wide variety physical signs and symptoms that manifest themselves as the body prepares for death. While not everyone will experience these symptoms, it’s likely they will experience some combination of several of them.

Loss Of Appetite

As a person approaches the end of their life, their need for energy declines. Foods that were once a source of enjoyment are now difficult to consume and digest. They will prefer foods that are easier to eat and blander in flavor. When this occurs, it’s best to cater to their requests and help them to slowly consume small amounts of food.

Excessive Fatigue And Sleeping

The person may begin to sleep for many hours throughout the day and night. If a person has lost their appetite, it will cause their metabolism to slow down. As the metabolism slows, the body feels an increasing need to sleep. If your loved one is manifesting these symptoms, it’s best to allow them to rest. Try to avoid the desire to wake them as they need this sleep.


As the metabolism slows, you may notice your loved one’s extremities are cool to the touch. This is due to a decrease in blood circulation. When this occurs, the body is attempting to conserve its energy and direct the blood flow to the vital organs.

This decrease in circulation will cause a person’s extremities to be cool to the touch. You may also notice their skin looks paler or even has a slight blue tint.

If your loved one’s skin feels cool to the touch, add an extra blanket to help keep them from getting too chilled.

Urine Decrease

When less food and drink is being consumed, the need to urinate will lessen. A significant drop in blood pressure will also affect this, as the kidneys will be forced to shut down. The urine that is produced will be a dark brown or reddish color due to the lack of hydration. This can be alarming but is a common part of the stages of death.

Change In Breathing Pattern

Breathing patterns change from slow and even to choppy and irregular. This can sound alarming to others, but typically the dying person is completely unaware of this change in their breathing pattern. You may identify their breathing pattern as Cheyne-Stokes respiration. This is characterized by a loud, deep inhalation followed by a pause.

Focusing on the person’s overall comfort during this time is key. Keeping their head slightly elevated and well supported will help.

Increased Weakness

The decline in food consumption and energy levels will cause a person to find even basic activities to be extremely difficult. Things that were once simple like changing their head position or moving an extremity may be impossible. The person may find this to be very frustrating, especially if they are still very mentally alert.

It’s best when this occurs to help in every way possible. This may mean helping them to find a more comfortable position in bed or offering to feed a bit of food or sip of water.

Swelling Of The Feet And Ankles

The kidney’s job is to process bodily fluids. When the kidneys can no longer do this, the body pushes fluids as far from the heart as possible. This causes a swelling of the feet and ankles. In some cases, you may notice a person’s face or hands appear to be puffy as well. Swelling of the extremities is one of the primary signs that death is near.

When you identify this symptom, seek to make your loved one as comfortable as possible. Slightly elevating their feet can help reduce this swelling. However, it’s important to consult a doctor before doing so.

Knowing how to properly care for your loved one is important in preserving their quality of life for as long as possible. The following video is helpful in further describing these symptoms and how to help.

The Mental and Emotional Stage

A second stage a person experiences in preparation for death is the mental and emotional stage. This stage of changes can occur simultaneously with the physical changes. As a person processes the reality of facing death, they can experience a wide range of mental and emotional symptoms. It can be difficult for friends and family members to witness this stage. Seek to offer support and acceptance as they work through these mental and emotional changes.

Confusion Or Disorientation

When a person’s organs begin to fail, they can experience a change in higher-order consciousness. When this happens, they will experience feelings of confusion and disorientation. They may be unable to keep track of time or remember where they are. Family and friends who they know and love may seem like strangers at times.

It’s best when this occurs for friends and family to continue speaking to the person just as they normally would.


As a person prepares to face the reality of death, you may notice they seem to detach from the people and places around them. This is their attempt to begin letting go. They may appear to be withdrawn or unresponsive to activity around them. However, these symptoms do not indicate that they cannot hear what is going on in the room.

Continue to speak to your loved one as you normally would, as this can be of great comfort to them. The ability to hear is often the last sense for people to lose. This means your loved one is likely to hear you speak even up until a moment or two before they pass away. Your words of love and comfort can be heard even if they are unresponsive.

Mental Restlessness

When the brain experiences a decrease in oxygen, it can manifest itself in mental and physical distress. You may observe your loved one to be repeating the same phrase over and over, or tossing and turning in bed. This can indicate mental discomfort. Something may be bothering the person, causing them to be unable to experience peace in letting go.

Anti-social Behavior

As a person prepares to be released, they may not want to be around many people. They might stop responding to questions or simply turn their head away when spoken to. This can be difficult for the friends and family who seek to interact with their loved one for as long as possible. However, this is a natural part of the stages of death.

The Spiritual Stage

This stage is the most varied of the three stages of death. Spirituality is something that each person experiences in a unique way. This stage is not defined by a large list of symptoms. However, many people do have several specific spiritual experiences as they move throughout the stages of death and dying.

Visions And Hallucinations

The person may tell you they have visited places that cannot be seen or spoken to someone who has passed away. These experiences of visions and hallucinations are one of the latest signs of death. The person is beginning the process of detaching from life. These visions help lessen their fear in the transition. Support your loved one by listening to what they say.

Desire To Make Peace

As a person nears the end of their life, they may experience a desire to find meaning in the life they have lived. This can manifest itself in through a need to right any wrongs or resolve disagreements with family or friends.

If your loved one is experiencing these feelings, it’s best to be open to these conversations. This will help them move into the final stages of death and give them peace in letting go.

Finding Spirituality

Many people seek comfort in their faith or religion as they approach death. They may request a visit from someone they trust in their religious community. These people will often provide answers to questions and offer a sense of peace as your loved one seeks comfort in the unknown. Praying or reading religious texts may offer a great deal of comfort as well.

Observing your loved one move through the stages of death can be a very difficult experience. It’s natural for you to desire to relieve their pain and discomfort in any way possible. Knowing the stages of death and how to respond to them can be the best way of offering support.

Did you find this information helpful as you offer support and encouragement to your loved one? We’d love to hear any feedback on what you found to be helpful during your experience.

Photo of author

Stevie Compango, CNSC, CPT

Stevie is Certified Nutrition Specialist and Certified Personal Trainer for the past 10 years. He specializes in mobility and chronic pain management. His methods have helped thousands of clients improve the quality of their life through movement.

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