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The Dying Process

This page explains what commonly happens during the natural dying process for an expected death (a person with a life limiting illness). Understanding the physical changes that may take place can reduce fear and uncertainty, helping you respond with calm, comfort, and confidence.

The Dying Process: Pre-Active and Active Phases

​In the final days and hours of life, the body follows a natural process as it begins to shut down. While every person’s experience is unique, healthcare professionals often describe two general stages: the pre-active phase and the active phase of dying. Understanding these stages can help loved ones feel more prepared and less alarmed by the changes they may notice.

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Pre-Active Phase of Dying (often days to weeks before death)

 

During this phase, changes are gradual and may come and go. A person may:

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  • Sleep much more and have less energy

  • Eat and drink less, with little or no appetite

  • Withdraw from conversation and social interaction

  • Show periods of confusion or restlessness

  • Have changes in breathing patterns at times

  • Experience increasing weakness and need more assistance

  • Become less interested in their surroundings

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These changes are a natural part of the body conserving energy as it begins to slow down.

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Active Phase of Dying (usually hours to days before death)

 

This phase signals that the body is nearing the end of life. Changes become more noticeable and consistent. A person may:

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  • Be mostly or completely unresponsive

  • Have irregular breathing, with pauses between breaths

  • Develop noisy breathing due to relaxed throat muscles (sometimes called a “death rattle”)

  • Have cool hands and feet, and changes in skin colour

  • Stop eating and drinking entirely

  • Lose control of bladder and bowels

  • Have glassy or half-open eyes, with little awareness of surroundings

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Although these signs can be distressing to witness, they are a normal part of the body’s natural process and are not usually uncomfortable for the person.

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Providing calm presence, reassurance, and comfort during these stages can be deeply meaningful for both the person who is dying and those around them. Remember that although the person may be unconscious for long periods it is thought that they can often still hear what is going on in the room and may still be able to feel your touch.

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After Death

When a person dies, the body begins a natural process of change. These changes are a normal part of what happens once the heart has stopped beating and breathing has ceased. Spending time with your loved one after death, if you wish to, can be a gentle and meaningful part of saying goodbye.

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There are practical steps that will need to be followed afterwards, which may vary slightly depending on whether the death occurs at home, in a hospital, or in a hospice. However, there is no immediate rush, and it is important that you are given the time and space you need.

What Happens to the Body After Death

​​Immediately After Death

 

At the moment of death:

  • Breathing stops completely

  • The heart stops beating

  • The muscles relax fully

  • The bladder and bowels may empty as muscles release

  • The eyes may remain open or half open (the eye lids can be gently closed with the side of your palm)

  • The mouth may fall slightly open (can roll up a towel and place underneath the jaw to keep the mouth closed)

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There is often a sense of stillness in the room. It is common and completely okay for loved ones to sit quietly with the person during this time. You may want to hold their hand, or kiss or hug them and this can bring significant comfort.

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Within the First Hour

 

As circulation has stopped:

  • Depending on the colour of the persons skin, it may appear more pale or grey/purple in colour

  • The body begins to cool to room temperature

  • Blood settles in the lower parts of the body due to gravity (this is called livor mortis), which can cause a purplish colouring on the back or underside

  • The body remains soft and flexible

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A Few Hours After Death

 

Over the next few hours:

  • The body continues to cool

  • Muscles begin to stiffen gradually (this is called rigor mortis), usually starting in the jaw and neck before moving down the body

  • The skin may show more noticeable colour changes where blood has settled

  • The body may appear slightly different in shape as muscles firm

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