The last weeks of life: a guide for families caring at home

Common signs of end of life in the elderly include sleeping more, eating and drinking less, growing weaker, and changes in breathing, temperature and alertness. These changes are a natural part of the body slowing down, and they vary from person to person. Knowing what to expect, and who to call, can help you keep your relative comfortable and feel less alone.

At a glance

• In the last weeks, people often eat less, sleep more and become weaker (Marie Curie).
• In the last days, breathing may change and hands and feet may feel cold (NHS.uk).
• The GP, district nurses and local hospice team should be your first contacts. Out of hours, call NHS 111.
• After an expected death at home, you do not need to call 999. Contact the GP or NHS 111 so a professional can confirm the death.
• Marie Curie Support Line: 0800 090 2309, free.

What changes happen in the last weeks of life?

Every person is different, and not everyone shows every sign. Marie Curie describes these common changes in the last weeks:

• Eating less. The body needs less energy, so appetite falls. This is natural.
• Weakness and weight loss. Your relative may need more help to move and more rest.
• More sleep. They may spend much of the day dozing.
• Feeling cold. The body finds it harder to control temperature.
• Breathlessness, which can feel worse with anxiety.
• Confusion or restlessness, sometimes caused by infection, medicines or dehydration, which can often be treated.
• Incontinence or constipation.
• Vivid dreams or visions, sometimes of people who have died.

Pain, sickness and breathlessness can usually be eased. Tell the GP, district nurse or hospice team about any new or worsening symptom.

What happens in the last days and hours?

NHS.uk describes changes that are common as death approaches:

• being drowsy and hard to wake, with less energy;
• not wanting to eat or drink;
• changes in breathing, including pauses and alternating shallow and deep breaths (called Cheyne-Stokes breathing);
• noisy breathing, caused by a build-up of mucus. Tell the nurse or doctor if it worries you;
• confusion, hallucinations or restlessness;
• cold hands and feet, because circulation changes.

The medical team can often treat distressing symptoms, including by giving medicines another way if swallowing becomes difficult.

How can you keep someone comfortable at home?

Small things matter a great deal. Marie Curie and NHS.uk suggest:

• Food and drink: offer small portions of favourite soft foods, but don’t press. You do not need to make them eat.
• Mouth care: keep lips and mouth moist if they can no longer drink much. Ask the nurse how.
• Warmth: use light blankets rather than heavy layers.
• Position: help them change position gently, following the nurse’s advice on protecting skin.
• Calm: keep lights soft, play familiar music, and talk to them gently, even if they seem not to respond.
• Company: sit with them and hold their hand. You don’t need to fill the silence.

Ask the district nurse about equipment such as a hospital bed, pressure-relieving mattress and commode. Many families also bring in paid carers or waking nights so they can rest. Our guide to palliative care at home explains costs and NHS funding, including Fast Track Continuing Healthcare. If your relative needs social care as well, ask your council’s adult social care team for an assessment.

Who should you call?

Keep these numbers by the phone and share them with everyone helping:

If your relative has a do not attempt CPR decision or an advance care plan, keep a copy somewhere visible so visiting professionals can see it. Talk to the GP about this in advance.

What to do when someone dies at home

When a death is expected, there is no need to rush. A Royal Free London leaflet advises:

1. During GP surgery hours, call the surgery and ask for a visit to confirm the death.
2. Outside surgery hours, call NHS 111 and ask for a healthcare professional to confirm the death.
3. A doctor, district nurse or palliative nurse completes a verification of death form. You can then call a funeral director.
4. The GP arranges the medical certificate of cause of death.

GOV.UK says you must register the death within 5 days of getting confirmation from the medical examiner’s office, including weekends and bank holidays. You can then use the Tell Us Once service to inform government departments.

Looking after yourself

Caring for someone at the end of life is exhausting. Accept help, take short breaks, and speak to someone. Your local hospice may offer family and bereavement support, and Marie Curie offers emotional support by phone. See our palliative care hub for more help, or read about hospice at home and private end-of-life care.

Frequently asked questions

What are the first signs that an elderly person is nearing the end of life?

Common early signs include eating and drinking less, sleeping more, losing weight and becoming weaker, according to Marie Curie. People may withdraw, feel cold or become confused. These changes can have other causes that can be treated, so tell the GP or district nurse about any change.

How long do the last stages of dying last?

There is no fixed timetable. Some people decline over weeks, others over days. In the last days, breathing changes, drowsiness and cold hands and feet are common (NHS.uk). The GP, district nurse or hospice team can talk you through what they are seeing.

Should I make my relative eat or drink?

No. Marie Curie says wanting to eat less is natural in the last weeks, as the body uses less energy. Offer small amounts of favourite foods and sips if they want them. Keep their mouth moist and comfortable. Ask the nurse if you are worried about hunger or thirst.

Do I call 999 when someone dies at home?

Not if the death was expected. Call the GP surgery during opening hours, or NHS 111 out of hours, and ask for someone to confirm the death. If the death was sudden or unexpected, call 999.

What should I do about noisy breathing?

NHS.uk explains that noisy breathing near the end of life is caused by a build-up of mucus. It can be upsetting to hear. Tell the district nurse, hospice team or doctor, who can check whether your relative is comfortable and whether anything would help. Out of hours, call NHS 111.

Sources

• Marie Curie: What to expect in the last weeks of life
• NHS.uk: Changes in the last hours and days
• Marie Curie: Support Line
• Royal Free London NHS Foundation Trust: What to do following an expected death of a patient at home
• GOV.UK: What to do after someone dies

This guide is general information, not financial, legal or medical advice. Last reviewed September 2026.

Reviewed by The Care Panel team on 15 October 2026. This guide is general information about care in England, not legal, medical or financial advice. Rules and rates change; check with your council or an adviser before making decisions.