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 in their final days and hours. 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 here.

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.

If you’re looking for more guidance, we’ve shared answers to some of the questions people often have at this time.