What to expect when someone is approaching death
As illness progresses, people become weaker and need more support from those caring for them. Understanding what happens when they are approaching death will help to anticipate the care they need. Some of the things that happen at this time may seem strange or frightening, especially if they are not expected. People are individual, so it is not easy to say exactly what will happen and in what order changes might occur, but this sheet seeks to explain what may happen in the last few days and hours of life.
Eating and drinking
As people become weaker, they may need help with eating and drinking. They may feel sick or find it difficult to swallow: if this happens, it is important to tell their nurses or doctors. As people get nearer the end of their life they often don’t want to eat or drink: this is normal and rarely causes them distress, though those caring for them are often worried about this. Again, it is important to let the doctors and nurses know about any concerns you may have.
Medication
As people become weaker they may find it difficult to swallow medication. Their doctor will often decide that some medications can be stopped as they are no longer needed in the final days of life. Other medications, for example pain relief, can be given in different ways.
Sleeping
As a person’s illness progresses, they are likely to get weaker each day and will spend more time sleeping and become more drowsy. They will become less able to talk or join in things that are happening around them. Even if they are drowsy or asleep, they may still hear what’s going on and can take comfort from hearing the usual sounds of life or hearing someone talking to them, even when they are unconscious. Towards the end, some people may lapse into unconsciousness and cannot be roused at all for a period before they die. Some people never lose consciousness and die in their sleep.
Breathing
People may experience changes to their breathing in the last days of their life. People who have had difficulty breathing may find it easier to breathe, as the body needs less oxygen because it is less active. Breathing may be made worse if they are anxious. People who are very drowsy or unconscious may have noisy breathing because of a build-up of fluid in the back of the throat, which they are no longer able to cough up. Such noisy breathing does not distress the patient, though it may be distressing for those around them: it may be eased by moving the patient into a different position and by medication.
When death is near
When death is only hours away, breathing may change again, becoming shallow and irregular. Sometimes there are pauses between breaths that become longer until the last breath is taken. They may produce less urine and it will become darker in colour as they drink less. They may lose control over their bladder: if this happens the nurses will give advice. Some people may become restless, agitated or confused: if this happens, the nurse or doctor can consider giving medication. Arms and legs may become cool to the touch and blue in colour as a result of blood circulation slowing down. The skin may become dry or moist and clammy.
Support in the home
Doctors and nurses should be visiting to check on people close to the end of life: they will be happy to answer any of your questions. They are available 24 hours a day every day of the week, though they are often particularly busy during the night.
It is normal for people to feel frightened and out of their depth when their loved one is close to death. It is OK to ask for help or just to talk to someone about your concerns and fears. In working hours call your GP practice: at nights and weekends call 111 (rather than 999) who will be able to get hold of a doctor or nurse for you.
When someone dies
Most people stop breathing and die peacefully after a period of unconsciousness. If you think this has happened, phone your GP practice in hours, or 111 out of hours, and explain that you think they have died and that this was expected. They will arrange for someone to visit to confirm that they have died and explain what happens next and what you need to do and what support is available.
Non-urgent advice: Support
If you feel you need support or advice, it may be helpful to first talk to your GP. They may be able to signpost you to support services. Your place of work or school may also be able to help. Faith communities can also be a source of support for many people.
If you feel that you or a loved one are at immediate risk to themselves or others, please contact your GP, A&E department or call NHS 111. If you are experiencing a mental health crisis, call 111 and select option 2 when prompted for the mental health service. You can also access 111 online via www.111.nhs.uk . You can also contact the Samaritans by calling 116 123.
Hospital Bereavement Care Services
If a person died in hospital, support for the bereaved is offered by the hospital bereavement care services and the chaplaincy teams.
Please note that chaplaincy services in all the hospitals are for people of all faiths, or none.
Addenbrooke’s Hospital
Chaplaincy Team
Email: [email protected]
Tel: 01223 217 769
Website: Chaplaincy | CUH
Bereavement Care Services
Email: [email protected]
Tel: 01223 217 537 (extension 217537)
Website: Bereavement Care Service | CUH
Hinchingbrooke Hospital
Chaplaincy
Email: [email protected]
Tel: 01480 847 474
Website: Chaplaincy – North West Anglia NHS Foundation Trust (nwangliaft.nhs.uk)
Bereavement Care Services
Tel: 01480 847 494
Website: Bereavement – North West Anglia NHS Foundation Trust (nwangliaft.nhs.uk)
Peterborough City Hospital
Chaplaincy
Email: [email protected]
Tel: 01733 673 115
Website: Chaplaincy – North West Anglia NHS Foundation Trust (nwangliaft.nhs.uk)
Bereavement Centre
Tel: 01733 673 543
Website: Bereavement – North West Anglia NHS Foundation Trust (nwangliaft.nhs.uk)
Queen Elizabeth Hospital, Kings Lynn
Chaplaincy Team
Email: [email protected]
Tel: 01553 613 441
Website: The Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust: Chaplaincy (qehkl.nhs.uk)
Bereavement Care Services
Tel: 01553 613 878
Website: The Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust: Bereaved (qehkl.nhs.uk)
Royal Papworth Hospital
Chaplaincy
Email: [email protected]
Tel: 01223 639 121
Website: Chaplaincy Service at Royal Papworth Hospital
Bereavement Care Services
Email: [email protected]
Tel: 01223 217 537 (extension 217537)
Hospice Bereavement Support Services
Alan Hudson Day Treatment centre, Wisbech
part of Arthur Rank Hospice Services
Offers bereavement support to the families of patients who have received care from the service.
Email: [email protected]
Tel: 01945 669 620
Arthur Rank Hospice, Cambridge
Offers bereavement support, including a monthly wellbeing and relaxation support group, to the families of patients who have received care from Arthur Rank House Hospice services.
Email: [email protected]
Tel: 01223 675 770
Website: Bereavement – Arthur Rank Hospice Charity (arhc.org.uk)
Sue Ryder St John’s Hospice, Moggerhanger, Bedford
Offers bereavement support to families and friends of those patients for whom this Hospice service has cared.
Email: [email protected]
Tel: 01767 642 446
Sue Ryder Thorpe Hall Hospice, Peterborough
Family support team
Specially trained staff and volunteers offer family support to patients, and pre- and post-bereavement support to their loved ones on a one-to-one and group basis, including Wayfinders, a bereavement support walking group. Specialist support is also available for children and young people.
Email: [email protected]
Tel: 01733 225 921
Website: Online Bereavement Support | Sue Ryder
The Norfolk Hospice
Tapping House
Offers support in bereavement to family members of patients who have received care from the service. This includes counselling, individual support and bereavement support groups.
Tel: 01485 601 700
Monday to Friday, 09:00 to 17:00
Website: The Norfolk Hospice
Support after the loss of a child, including during pregnancy and birth.
PETALS
Provides specialised counselling for parents suffering trauma or loss during pregnancy or birth.
Email: [email protected]
Tel: 0300 688 0068
Website: Petals Charity | The Baby Loss Counselling Charity
SANDS: Stillbirth and Neonatal Deaths Charity
Emotional support for anyone affected by the death of a baby before, during or shortly after birth.
Email: [email protected]
Tel: 0808 1643 332 (Freephone)
Website: Sands | Saving babies’ lives. Supporting bereaved families
Saying Goodbye
Provides comprehensive information, advice, support to anyone who has suffered the loss of a baby, at any stage of pregnancy, at birth or infancy.
Email: [email protected]
Tel: 0300 323 1350
Website: Saying Goodbye – support for miscarriage and baby and infant loss
The Compassionate Friends
A charitable organisation of bereaved parents, siblings and grandparents who support other bereaved parents, siblings, and grandparents who have suffered the death of a child.
Email: [email protected]
Tel: 0345 123 2304
Open every day 10:00 to 16:00 and 19:00 to 22:00
Website: The Compassionate Friends (tcf.org.uk)
Bereavement support for children
Centre 33
Provides free counselling to young people aged 13 to 25 years in
Cambridgeshire and Peterborough. There is also support for young carers aged 8-18.
Email: [email protected]
Tel: 0333 414 1809
Website: Free Help & Counselling for Young People ¦ Cambridgeshire, Peterborough (centre33.org.uk)
Child Bereavement UK
Supports families and educates professionals when a baby or child of any age dies or is dying, or when a child is facing bereavement.
Email: [email protected]
National support & information line: 0800 028 8840
Website: Child Bereavement UK
CHUMS
Mental Health & Emotional Wellbeing Service for Children and Young People provide bereavement support.
Email: [email protected]
Tel: 01525 863 924
Open every day 9:00 to 17:00
Website: CHUMS – Mental Health and Emotional Wellbeing Service for Children and Young People
Cogwheel Trust for Children
Provides subsidised counselling in Cambridgeshire to couples, families and individuals of all ages.
Email: [email protected]
Tel: 01223 464 385
Open Monday to Friday 10:00 to 14:00
Website: Cogwheel Counselling – Affordable help when life slips out of gear
CRUSE Bereavement Care
This voluntary organisation has a specialist team providing support to children and young people.
CRUSE National helpline: 0808 808 1677
Open Mon and Fri 09:30 to 17:00, Tuesday to Thursday 9:30 to 20:00, weekends 10:00 to 14:00
Website: Home – Cruse Bereavement Support
Little Miracles
Provides bereavement support and counselling to families that have a child under 25 with an additional need, disability or life limiting condition.
Email: [email protected]
Tel: 01733 262226
Website: Little Miracles – About Us (littlemiraclescharity.org.uk)
Scotty’s Little Soldiers
Provides support to young people, up to and including the age of 18 years who have suffered the loss of a parent serving with the British Armed Forces.
Email: [email protected]
Tel: 0800 092 8571
Website: The Charity for Bereaved Military Children | Scotty’s Little Soldiers (scottyslittlesoldiers.co.uk)
Ormiston Families Stars
Provides specialist counselling for bereaved children and young people aged 0-25, living in Cambridgeshire. Also provides support for families and professionals. (Service not provided to those living in Peterborough).
Email: [email protected]
Tel: 01223 292 276
Website: Ormiston Families Stars – Ormiston Families
The Young People’s Counselling Service, Peterborough
Provides free and confidential counselling for young people aged 11-16 years old who are dealing with emotional distress – such as bereavement, loss, loneliness and anxiety, low self-esteem, bullying, self-harm, abuse, addiction or depression.
Email: [email protected]
Tel: 01733 903288 (Peterborough), 01945 479956 (Wisbech)
Website: The Young People’s Counselling Service – Supporting Young People (ypcs.uk)
Winston’s Wish
Supporting bereaved children, their families, and the professionals who support them.
Email: [email protected]
National helpline: 0808 802 0021 (Freephone)
Open Monday to Friday 08:00 to 20:00
Website: Winston’s Wish – giving hope to grieving children (winstonswish.org)
Bereavement support and counselling services
Bereavement UK
Provides bereavement support and information, including podcasts, articles and free e-books.
Email: [email protected]
Website: Bereavement UK
BIG-C in Kings Lynn
Offers support for people affected by cancer including bereavement.
Email: [email protected]
Tel: 0800 092 7640
Open Monday to Friday 09:00 to 17:00
Website: Home – Big C Online Support Centre (big-c.co.uk)
Caring Together
At Caring Together we provide information and advice, run services in our local communities and campaign for carers’ rights, so that carers have choices. Our support for carers can continue after their caring role has come to an end.
Email: [email protected]
Tel: 0345 241 0954
Open Monday to Thursday 09:00 to 17:00, Friday 09:00 to 16:30
Website: Caring Together | Carers Support | Homecare | Cambs, P’boro and Norfolk
CRUSE Bereavement Care
CRUSE bereavement care promotes the wellbeing of anyone bereaved by death to enable people to understand their grief and cope with their loss.
CRUSE National helpline: 0808 808 1677
Open Mon and Fri 09:30 to 17:00, Tuesday to Thursday 9:30 to 20:00, weekends 10:00 to 14:00
CRUSE National website: Home – Cruse Bereavement Support
CRUSE Local Contacts
Cambridge with Fenland and Uttlesford – 01223 633536
Huntingdonshire – 01707 278389
Peterborough – 01733 348439
Macmillan Cancer Support
Offers support for people affected by cancer including bereavement.
Tel: 0808 808 00 00
Open every day 08:00 to 20:00
Website: Macmillan Cancer Support | The UK’s leading cancer care charity
WAY – Widowed and Young
Provides a social and support network for widows and widowers up to age of 50. Members can meet and chat online through a secure website.
Tel: 0300 201 0051
Open Monday to Friday 09:30 to 17:00
Website: WAY Widowed & Young – Bereavement support UK (widowedandyoung.org.uk)
Bereavement by suicide
Lifecraft Cambridgeshire and Peterborough
A contact point providing support and information on bereavement after a loved one’s suicide.
Email: [email protected]
Tel: 01223 566 957
Website: Welcome – Lifecraft
Compassionate Friends – Local Groups
Local support groups for parents bereaved through suicide within Cambridgeshire and Peterborough.
Please contact National Helpline or [email protected] for further information on local support groups available.
National helpline: 0345 123 2304
Open every day 10:00 to 16:00 and 19:00 to 22:00
Help is at Hand
Provides video advice and a further directory for Bereavement support.
Website: Help is at hand – Support After Suicide
Keep Your Head
Provides video advice and a further directory for Bereavement support.
Website: Cambridgeshire & Peterborough Adults Mental Health Support – October 2017 (keep-your-head.com)
The Heart and Soul Team at Cambridgeshire and Peterborough Foundation Trust
Provides a bereavement support group to give individuals the opportunity to meet others who have been bereaved by suicide and be able to talk in a warm, caring environment supported by experienced bereavement volunteers.
The bereavement support group meets on the 2nd Monday of each month, from 6.00-7.30pm, via Zoom. Meeting ID details will be sent to you on enquiry.
Tel: 07973 883511
Email: [email protected]
Support After Suicide
A network of organisations who support people who are affected by suicide
Website: Support After Suicide
Survivors of Bereavement by Suicide (SOBS)
Support for people aged over 18 who have been bereaved as a result of suicide
Email: [email protected]
Tel: 0300 111 5065
Open Monday and Tuesday 09:00 to 17:00
Website: Survivors of Bereavement by Suicide – Overcoming the isolation of people bereaved by suicide (uksobs.org)
Other information and advice
Age UK
Provides wide-ranging support and information for older people through an advice line‚ publications and volunteer network.
Tel: 0800 055 6112
Open every day 08:00 to 19:00
Website: Age UK | The UK’s leading charity helping every older person who needs us
Evolve Counselling
Provides an individual counselling service with a range of fees according to ability to pay.
Tel: 01223 233 047 (Cambridge)
Tel: 01733 553 166 (Peterborough)
Website: Evolve Counselling – Community Counselling Charity
Cambridge University Counselling Service
This free service is for enrolled students and staff of the University of Cambridge.
Students email: [email protected]
Students Tel: 01223 332 865
Staff email: [email protected]
Staff Tel: 01223 762 160
Website: University Counselling Service | Student Counselling (cam.ac.uk)
Staff Counselling Centre | (cam.ac.uk)
Dying Matters
A coalition of members across England and Wales, which aims to help people talk more openly about dying, death and bereavement, and to make plans for the end of life.
Website: Dying Matters | Hospice UK
Healthwatch
Healthwatch offer a signposting service for health and social care services across the area. If you are unsure who to speak to you can contact them for advice.
Email: [email protected]
Tel: 0330 355 1285
Open Monday to Thursday 09:00 to 16:00, Friday 09:00 to 15:30
Website – Cambridgeshire: Healthwatch Cambridgeshire | Your spotlight on health and social care services
Website – Peterborough: Healthwatch Peterborough | Your spotlight on health and social care services
Lifeline
Mental Health helpline for Cambridgeshire and Peterborough
Tel: 0808 808 2121
Open every day 11:00 to 23:00
Website: Lifeline – Lifecraft
The Samaritans
Provide confidential emotional support at all times of day and night.
Email: [email protected]
Tel: 116 123
Open 24/7
Website: Samaritans | Every life lost to suicide is a tragedy | Here to listen