Preparing for the Last 24 Hours Before Death

Published February 28, 2020
Senior man in hospital

It can feel incredibly overwhelming to be in the presence of a loved one during the last 24 hours of their life. It can feel a bit helpful to be as prepared as you possibly can for this type of situation.

What to Expect in the Last 24 Hours of Someone's Life

In the final hours of someone's life, there can be some predictable changes that you can expect to see. While you may not see every sign, chances are you will see quite a few before an individual passes away.

Physical Changes

There are some physical changes that you may notice when you are with your loved one. Your loved one may also have death visions, or hallucinations. This is completely normal and can often bring them comfort. Some shifts may include:

  • Increased skin mottling
  • Difficulty swallowing
  • Body temperature drops
  • Blood pressure drops
  • Teary eyes
  • Weak pulse
  • Lack of movement
  • Lack of appetite

Death Rattle and Breathing Shifts

As the end of life nears, breathing will become more irregular and there may be periods of no breathing. The death rattle is loud, gurgly breathing followed by secretions from the mouth. The death rattle typically occurs in the final hours, but can go on for two days before someone passes on. Although this can be challenging to witness, the death rattle is not known for being a painful experience and there are medications that can be administered that can help with the secretions.

Death Rally

For some people, in the last few days up until 24 hours before death, they can experience a rush of energy. Although there is not a ton of research regarding this rally, so far case studies have noted that even people who have been diagnosed with dementia, schizophrenia, and brain tumors are able to experience this amazing mental clarity. This incredible lucidity can often give family members false hope that their loved one is pulling through. Many will pass within a few days and some will pass the same day.


Your loved one may be unresponsive for a period, or continue to be unresponsive before passing away. Unresponsiveness may be followed by a death rally, but not in all cases. They may go into a coma before passing away as well.

Emotionally Preparing for the Death of a Loved One

You can never really be fully prepared for the passing of a loved one. The dying process can feel overwhelming, disturbing, and upsetting to witness. You may feel flooded with emotions, or experience numbness during this time. Know that this is completely normal. Durig this time, be sure to prioritize your self-care and reach out to loved ones for support. You can also reach out to a counselor or therapist who can help you emotionally process these circumstances as well. You can also:

  • Take breaks as needed when visiting your loved one
  • Practice breathing exercises before bed or as needed when you want to re-ground yourself
  • Join a support group
  • Journal
  • Go for a walk- being outside can help keep your circadian rhythm on track so you have a better chance of getting some sleep

Keep in mind that your presence is probably quite comforting to your loved one. Speak to them in a soothing, gentle tone, and let them know how much you care about them. Even those who appear unconscious may still be able to hear you.

The Last 24 Hours Before Death

Recognizing the signs of the last 24 hours before death can help you feel a bit more prepared in that particular situation. Be sure to take care of yourself during this time as it can feel very overwhelming to process the passing of a loved one.

Preparing for the Last 24 Hours Before Death