During the final stage of life, a person may lose control of their bladder and bowels, have difficulty breathing, lose interest in food and drink and have visions or hallucinations. Not everyone exhibits the same signs at the end of life.
People who work in hospice care are often accustomed to these and other signs that signal a person is about to die. Patients often become withdrawn from the outside world and are much less responsive to touch and talk less than usual. People on the verge of death often think they can hear or see loved ones who have previously died, and they also sleep more and tend to try to focus on another world or realm.
Patients, especially those who have battled a long illness, often exhibit the "death rattle." This is a sound a dying person makes when saliva and bronchial secretions get stuck in the throat, and it is often accompanied by difficulty breathing and rapid chest movement. To the untrained person, the death rattle may be mistaken for choking. Hospices use drugs to lessen this phenomenon.
Hospice workers can help families deal with these and other signs of impending death. Loved ones are often traumatized by what these workers consider to be normal.