End of Life Service
We’re here to help.
Last updated: September 2021
Next review: September 2023
When someone is dying
Information for relatives and carers
What is this leaflet about?
This leaflet explains the physical and emotional changes that may happen in the last few days of a person’s life. Each person’s experience will be different. It is difficult to say exactly how quickly changes will take place or what will happen.
It is important that the person who is ill and their partner, family and friends know what to expect when someone comes to the end of their life. Having information can help you to cope during this emotional and difficult time.
This leaflet aims to provide some key information to answers any questions you may have.
Less Need for Food & Drink
The effort to eat and drink is likely to be too much for someone who is dying. Therefore, help with feeding may be useful. At some point they will not want or need the food and drink even when helped. When someone stops eating and drinking it can be hard to accept, even when we know they are dying.
Caring can be continued in other important ways such as through providing mouth care (if you feel able to) or simply spending time together and sharing memories.
Pain is not always present but people in the last days of life may not be able to tell you if they are in pain. Common signs to look out for are expressions on their face (for example, screwing up their face), moving as if they are troubled. If any of these signs happen or you are worried that your relative, partner or friend may be in pain, please inform the staff caring for them or call SPA on 0300 125 6789 as they may need pain relief.
The person may slowly become more sleepy and may be drowsy when awake. They may become withdrawn and take less interest in what is going on around them. This is part of the natural process. Sooner or later the person may become unconscious. For some, this period will be short but for others it may last a few days. Even though they are not awake they may still be able to hear your voice and feel your touch.
Restlessness, Twitching or Jerking
Sometimes people become restless in the last days and hours of their life. These symptoms are mostly caused by chemical changes in the body which affect the brain. It could also happen because of pain and/or infection. Medications may be useful in managing this. If you are concerned that someone is restless or agitated, please inform the team caring for your loved one or call SPA.
Sometimes restlessness is due to emotional troubles. It may be helpful to talk to a health care professional you know, a close friend or spiritual and religious leader.
As someone gets closer to death they may lose control of their bladder and bowel. The nurses may use pads or other aids to make sure the person remains dry and comfortable. Sometimes a catheter (a tube that goes into the bladder) may be used to collect urine.
When people are close to death the way they breathe may change. Sometimes there are long gaps between breaths or breathing may become fast and shallow. Occasionally breathing may become noisy due to fluid collecting in the back of the throat. This can be worrying but normally it does not cause the individual discomfort. Often a change of position can help. Medication may also be used.
If the person is breathing through their mouth, their lips and mouth can become dry. The nurses can provide advice on how to moisten the person’s mouth to maintain comfort.
Skin and Sensation Changes
In the last days-hours the skin, hands and feet may feel cold and may appear moist and blotchy. The person’s body temperature may rise and fall however in most cases, this does not cause the person any discomfort.
Changes to bed coverings can help keep them at a comfortable temperature.
The Final Moments
For most people the final moments are peaceful. Breathing may become slower with long gaps in between breaths. Finally they will stop breathing altogether. This may take a long time for some people, but for others it may only take a few minutes. Often the person’s body will relax completely and they may look very peaceful.
After the death of a loved one you may feel very shocked even if you were prepared for the death. In most cases there is no need to do anything straight away.
A nurse or GP can confirm the death.
The care of you, your relative, partner or friend is very important at this difficult time, we will provide support to make sure they and you’re privacy and dignity is maintained.
Who to contact after the person has died
- Your community nursing team via SPA on 0300 125 6789 (24 hours)
- Anyone who may want to spend time with the person
- Funeral Director – but this does not need to be done immediately
To arrange for collection of equipment such as hospital bed or commode please phone Medequip on: 0117 957 9140
Collection of equipment can sometimes take up to a week to happen.
The nurse may ask you to return unused medications to the pharmacy and to sign a document to reflect this.
Any care plans and documentation from the home and any small pieces of equipment such as a syringe pump box will also be removed by the nurse.
The GP will need to complete a death certificate and this can take 2-3 days. You will need to arrange collection of this with the GP surgery.
Registering the Death
You will need to contact (usually by telephone) your local register office to arrange how to register the death. Due to Covid-19, some register offices require this to be completed online. This needs to be done within 5 days and includes weekends and bank holidays. You can find your local register office using this website: www.gov.uk/register-offices
When registering the death, consider how many death certificates you may need as the cost is £11 (May 2021).
You will be given a ‘certificate for a burial’ to give to the funeral director, or an ‘application for cremation’ which
The Bristol Registry Office
The Old Council House,
Bristol, BS1 IJG
0117 922 2800
North Somerset Registry Office
01823 282 251
South Gloucestershire Registry Office
Kingswood Civic Centre,
Yate One Stop Shop
Age UK Bristol
38 Victoria Street,
Bristol, BS1 6BY
0117 922 5353
Age UK South Gloucestershire
67 High Street,
Age UK North Somerset
4 Waterloo Street,
Bereavement Advice Bureau
0800 634 9494
Citizens Advice Bureau Bristol
48 Fairfax Street,
Bristol, BS1 3BL
03444 111 444
Citizens Advice Bureau South Gloucestershire
Yate Shopping Centre,
0344 411 1444
Citizens Advice Bureau North Somerset
25 Old Street Town Centre,
0808 278 7973
Cruse Bereavement Care
9a St James Barton
Bristol, BS1 3LT
0117 926 4045
0808 808 1677
CRUSE Bereavement provides care and support for bereaved people of all ages in South Gloucestershire, Bristol and North Somerset.
You may be able to get a funeral payment from the social fund if you are on a low income and meet the criteria.
To find our more, contact the Department of Work and Pensions Bereavement Service on: 0345 606 0265
If you need any more information on what happens when someone is dying, please ask a member of the team to explain it to you.
Single Point of Access (SPA) 24 Hours: 0300 125 6789
GP Out of Hours: 111
Remembering a loved one: Sirona Foundation
Supporting a local initiative can be a special way to remember someone you have loved.
The Sirona Foundation is a charitable company established to support the health and wellbeing of communities, especially in areas served by Sirona. Its purpose is to fund equipment or projects that enhance health and social care services so that local people using these services can maintain their independence, continue their daily lives and achieve the best possible health and wellbeing.
The Sirona Foundation is a legally constituted body with charitable status that has its own Directors who are also the charity’s trustees.
How to make a donation
By credit or debit card on the Sirona Foundation Just Giving page: www.justgiving.com/sironach
By cheque, payable to The Sirona Foundation and post it to:
Linda Frankland, The Sirona Foundation, Kingswood Civic Centre, High Street, Kingswood, Bristol, BS15 9TR