What does ‘actively dying’ mean?

If you’ve heard a doctor or nurse say that someone is actively dying, you might feel unsure what that means – or even frightened by the words. It’s not a phrase most of us use in everyday life, but understanding it can help you make sense of what’s happening and feel more prepared.

At the Anne Robson Trust, we work alongside nurses and palliative care teams to support people who are dying. In this context, actively dying is the term we use to describe the very last stage of someone’s life.

The final stage of life

Actively dying is the body’s natural way of slowing down and preparing for death. It usually happens in the last few days of someone’s life, and follows a longer period called the pre-active stage, which can last for several weeks.

During this time, the person is very close to death, and you may notice physical and emotional changes as their body gradually shuts down. Every person’s experience is unique, and not everyone will show all the signs.

Signs that someone may be actively dying

These changes are a normal part of the body letting go. Some of the things you might notice include:

• Breathing changes – long pauses between breaths, or breathing that seems irregular

• Deep sleep or unresponsiveness – you may not be able to wake the person up

• Changes in bladder and bowel habits – they may lose control or pass very little urine, which might look darker than usual

• Drop in blood pressure – often a sign the body is slowing down

• Skin changes – hands, feet and limbs may become cold or change colour (sometimes called mottling)

• Gurgling sounds – caused by a build-up of fluid in the lungs, often referred to as the ‘death rattle’

Not all of these signs will happen, and some may only appear in the final hours. You can read more about what to expect in the final weeks, days and hours of someone’s life.

Can we know when death will happen?

Even when we recognise these signs, it’s still hard to predict exactly when someone will die. Some people show many signs, others only a few. Occasionally, a person may even tell you they feel that they are dying.

Supporting someone through this stage

If someone you love is thought to be actively dying, try to talk openly to the nurses and doctors caring for them. They can explain what’s happening, answer your questions, and guide you on how to bring comfort, whether that’s playing gentle music, holding their hand, or simply sitting with them.

How can I support someone who is actively dying?

Being with someone you love as they die can feel overwhelming. You may be worried about saying or doing the right thing and afraid of getting it wrong. The truth is, there’s no perfect way. But there are gentle, simple things you can do that can bring comfort, both for them, and for you.

Being there matters

The most important thing you can offer is simply being there. You don’t have to fill the silence or find the perfect words. Just sitting nearby, holding their hand, or quietly being in the room can be deeply reassuring to the person who’s dying.

• Sit where they can see you. When someone is dying, vision can narrow. Sitting at the foot or in front of the bed can help them focus on you.

• Let them know when you come in or leave the room. This helps them feel more secure and less startled.

• If others are visiting, gently say who is there. Familiar names and voices can bring comfort.

Even if they don’t seem to respond, many people believe hearing is the last sense to fade. Talk to them as if they can hear you. Tell them you’re there, you could share your favourite memories or read to them.

Create a calm environment

Small details in the room can make a difference.

• Keep the lighting soft. Harsh light can be uncomfortable for tired eyes.

• Play gentle sounds. Their favourite music, birdsong, or something peaceful.

• If possible, position the bed so they can see out of a window or towards the door. Familiar sights can bring reassurance.

Offer physical comfort

There are simple, practical ways to ease discomfort:

• If their mouth is dry, you could gently moisten their lips with a damp sponge or apply lip balm.

• Adjust their pillows or blankets to help them feel more comfortable.

• Avoid strong perfumes or chemical scents. If you add fragrance, keep it familiar and gentle, like a favourite perfume or a light natural smell.

• If they want a taste of food or drink, offer tiny sips or touches to the lips, but don’t force it. It’s natural for appetite and thirst to fade.

It can be worrying to see someone stop eating or drinking, but it’s a natural part of dying. You can learn more about why this happens.

Offer emotional comfort

Sometimes words are hard to find. What matters most is your presence.

• Tell them who you are when you approach, especially before touching them: “Hi Mum, it’s Sarah, I’m just sitting with you now.”

• Share love, gratitude, or reassurance. A simple “You’re not alone” can mean so much.

• If they speak of seeing people who have already died, go along with it if it brings them peace.

This can be surprising to witness, but it’s actually quite common and often comforting for the person dying. We explain why this can happen and what it means in our commonly asked questions as someone is dying guide. 

Silence can be powerful too. Just sitting quietly, holding their hand, or placing your hand gently on their arm can bring calm and connection.

Look after yourself as well

Watching someone die is exhausting, emotionally and physically. It’s natural to feel helpless, guilty, or anxious. Remember:

• Take short breaks, eat, and rest where you can. You will cope better if you look after yourself too.

• Accept help from friends or family if they offer. Even small things like meals or errands can make a difference.

There is no right way

You might worry you’re not doing enough, or not doing it “properly.” But what matters most is that you are there. Your presence, your love, and your willingness to simply be there are what truly support someone who is dying.