Every journey is different
The changes described here are common, but they are not a schedule. Your loved one will move through this time in their own way, and that's exactly as it should be.
End of Life Journey
Understanding the time ahead
When someone you love is nearing the end of life, it helps to know what is coming — gently, and only as much as you're ready for. This page walks through the changes you may see, what you can do, and who is beside you. Every journey is different, and you never have to face a moment of it alone: our team answers 24/7 at 772-403-4500.
Finding your way through this page
This is a long read, and you don't have to take it all in at once — start wherever you need to be right now.
A gentle place to start
Every journey is different — and no one walks it alone
No two people come to the end of life the same way. Some of what's described on this page may happen for your loved one; some of it may not, or may come in a different order. That's normal. The body knows how to do this, and it tends to do it gently, in its own time.
You don't need to know what to do. That is our work — keeping your loved one comfortable, and keeping you steady — so that yours can simply be to love them. If anything on this page raises a question, or if it's 3 a.m. and something feels wrong, call us. A real person answers, any hour, any question.
Comfort is always the goal
Whatever changes come, there is always something we can do to ease them. Your loved one does not have to be in pain, and neither do you have to watch helplessly.
We answer around the clock
Day or night, weekday or holiday, a real person picks up at 772-403-4500. If something worries you, that is reason enough to call.
View & print guidePrintable guide
Keep The Journey guide close
This illustrated guide offers a gentle reference for the physical, emotional, and spiritual changes that can happen near the end of life. View it online, print a copy, or share it with someone helping you care.
What you may see
The natural changes of the final months, days, and hours
The changes below are common parts of the body's natural process of slowing down. They usually call for comfort-enhancing care rather than invasive intervention. They may not happen in this order, and some may not happen at all. Read only as far as you're ready to; this page will be here when you need the rest.
In the final months and weeksMonths to weeks
What you may notice
- Your loved one sleeps more — hours that once held visits and conversation are given over to rest.
- Appetite and thirst fade. The body no longer needs food to feel comfortable; this is not starving, and refusing meals does not cause suffering.
- Urine may become darker and less frequent, and bowel movements may also decrease as the body takes in less fluid and conserves energy.
- Bladder or bowel control may be lost as muscles relax. This can be upsetting, but it is a physical change rather than something your loved one can control.
What you can do
- Don't force food or drink — pressing them to eat can cause distress rather than comfort.
- Offer small sips, ice chips, or a favorite taste when they want it, and let that be enough.
- Let them sleep. Sit nearby; your quiet company matters even when they're resting.
- Keep your loved one clean, dry, comfortable, and covered for privacy. Your nurse can provide protective supplies and advise whether a catheter may help.
- Ask your hospice nurse before changing medications, fluids, or feeding. Call any hour if swallowing, comfort, or bodily changes worry you.
As circulation and alertness changeOften days
What you may notice
- Body temperature may shift between hot and sweaty, cool and dry, or hot and dry as body chemistry changes.
- Hands, arms, legs, and feet may feel cool and look mottled — blotchy, darker, or purplish — as circulation is reserved for vital organs.
- Your loved one may be confused about the time, place, or people in the room as metabolism and oxygen levels change.
- They may sleep much of the time and become difficult to wake, while still being able to hear familiar voices.
What you can do
- Use a light blanket for coolness, but do not use an electric blanket or heating pad.
- If your loved one seems uncomfortably warm, call the hospice nurse for guidance before giving medication or changing coverings.
- Identify yourself, speak softly and truthfully, and explain care before you provide it. Do not quiz or argue with someone who is confused.
- Make the most of awake moments and rest when your loved one rests. Continue speaking naturally even when they cannot respond.
Emotional and spiritual changesMay happen at any point
What you may notice
- Your loved one may withdraw or want only one or two people nearby. This is often a turning inward and preparation for release, not a rejection of anyone they love.
- They may see or speak with people who have died, describe a beloved place, or talk about taking a trip, packing a bag, or going home.
- Restlessness can look like pulling at sheets, repeating movements, trying to get up, or seeming unable to settle.
- Some people appear to hold on until they feel that loved ones will be all right or until unfinished relationships or practical matters feel settled.
What you can do
- Let your loved one choose who is close, and offer quiet presence without taking withdrawal personally.
- Do not argue with visions or symbolic language. Listen, affirm the feeling, and tell the hospice team if the experience is frightening.
- Reduce noise, dim the lights, play soothing music, speak calmly, and avoid restraining repeated movements. Call the hospice team so physical or emotional causes can be addressed.
- Say what matters: "I love you," "thank you," "I'm sorry," or "I will be okay." Tears and silence are both natural ways to say goodbye.
In the final hoursHours
What you may notice
- Breathing becomes irregular — long pauses, then a run of quick breaths. Your nurse may call this Cheyne-Stokes breathing. It looks alarming, but it is a natural rhythm at the very end and is not distressing to your loved one.
- You may hear a soft rattling sound as saliva pools in the throat. It is hard to listen to, but it is not choking and it does not cause pain.
- Your loved one will likely be mostly unresponsive. Their eyes may stay slightly open, their jaw may relax, and their skin may become pale or waxy.
- Hearing is believed to be the last sense to fade. Even when they can no longer answer, your voice still reaches them.
What you can do
- Keep speaking softly. Say what matters — they can likely still hear you.
- Hold their hand. Being there is the whole of what's needed now.
- If it feels right, let them know you'll be okay. Many people hold on out of worry for those they love, and hearing that you'll be alright can free them to let go in peace.
- For congestion, raise the head of the bed or gently turn their head to one side, and wipe the mouth with a soft, moist cloth. Your nurse can suggest medication when appropriate.
- Do not suction unless the hospice team recommends it; suction can irritate tissue and increase secretions.
- Call us at any hour. A nurse can come, and you do not have to sit through this night alone.
Every person is different, and no list can tell you exactly what your loved one's journey will look like. Your hospice nurse is your best guide — call us any hour at 772-403-4500.
The team beside you
You are not doing this alone
Around you and your loved one stands a whole team — nurses, aides, social workers, and chaplains, each carrying a different part of this with you. And if your loved one is a veteran, we match them with veteran volunteers who understand what their service meant. Whoever you need, whenever you need them, it starts with one call: 772-403-4500, answered any hour.
Nurses
Your nurse manages pain and symptoms, explains each change as it comes, and is the person who answers when you call in the middle of the night.
Aides
Hospice aides carry the tender, physical work — bathing, grooming, keeping your loved one clean and comfortable — with gentleness and dignity.
Social workers
Social workers help with the practical weight of this time — paperwork, family decisions, what comes next — so it doesn't all rest on you.
Chaplains
Our chaplains offer spiritual care in whatever form fits your family — any faith, or none — and are simply present when words run out.
When the time comes
When death comes at home
If your loved one dies at home on hospice care, the first thing to know is this: there is no emergency, and you do not need to call 911. Nothing has to happen quickly — take all the time you need.
Take your time
Stay at the bedside. Hold their hand, say goodbye, sit in the quiet. There is no rush, and no one will hurry you.
Call us, not 911
When you are ready — and only then — call us at 772-403-4500. A nurse will come to you, whatever the hour.
Let the nurse help
Your nurse will pronounce the death, handle the paperwork, and notify the physician. You don't need to manage any of it.
Reaching the funeral home
When the moment is right, we'll help you make the call to the funeral home and stay with you while arrangements begin.
Grief & bereavement
The journey doesn't end at goodbye
Our care for your family continues for at least thirteen months after your loved one's death — through the first holidays, the first anniversary, and beyond. You are still part of this community, and grief support is here for every member of your family.
13 months of bereavement support
Individual counseling when you need one steady voice, and support groups when it helps to sit with others who understand. For at least thirteen months, at your own pace.
Explore grief supportCamp Good Grief
An overnight weekend camp where grieving kids and teens ages 8–18 play, connect, and meet peers who truly get it — because grief is lighter when you're not the only one carrying it.
Learn about Camp Good GriefChildren's grief support
Children grieve differently than adults — in bursts, through play, with questions that surface weeks later. Our counselors meet them where they are, in ways that make sense at their age.
Support for children
Whatever tonight looks like, we're awake with you
If something on this page raised a question — or if you just need to hear a calm voice — someone at Treasure Coast Hospice is awake and ready to help. Call us, any hour, any question.