As people get close to death, there comes a time when they feel very weak and are not able to get out of bed at all. From needing to sleep and rest a lot, people move into a phase where their sleep becomes deeper and they spend time drifting in and out of consciousness.

At times they may become confused, and not recognise you or their family or friends. This can be upsetting if you are not expecting it. They may also hear or see things which are not there (hallucinations). The drowsiness and confusion can be due to the chemical changes that are happening in their body and a build up of waste chemicals (toxins). The changes may sometimes be partly due to the medicines that they need to keep them comfortable.

The person’s feet and hands may feel cold, or their skin may feel very sensitive to any touch. People looking after them may need to be very gentle when moving or touching them.

The drowsiness and sleepiness usually gradually develops into a phase where the person becomes unconscious and can’t respond at all to anything around them. They may seem to be peacefully asleep or may move, twitch or grimace occasionally as though they are dreaming. Although they will not be able to respond to people around them at this time it is likely that they will be aware that you are there and be able to hear you if you talk to them. This phase may last only a few hours or can continue for a few days.

At this stage, food and drink are not necessary as their body is no longer able to absorb or use them. Moistening their lips or mouth is all that is needed. Once a person stops drinking they usually only live for a few days.

If a person is not moving around, the fluid normally produced by their lungs is not able to drain away and may collect in the air passages, so that when they breathe they make a slight groaning (rattling) noise. This can be upsetting for you, but does not seem to be uncomfortable for the dying person themselves. Their breathing may also become irregular, with long gaps between the breaths.

The final moments of life are very peaceful for most people, as their breathing gradually slows and becomes irregular before it stops. With some people this seems to take a long time, while for others it happens over a few minutes.

It can be difficult to pinpoint the exact moment of death. Often the person’s body will relax completely and their face will look very peaceful. People around often say that they can sense when the person’s consciousness has gone from the body.

In some cultures and religions, it is believed that the person’s mind (consciousness) remains around the body for some time after death. In other cultures and religions it is thought that the consciousness moves on to another place quickly. Some people believe that once the person has died there is nothing left of their mind (consciousness).

When the person you are caring for has died, you may feel very shocked, however well you have prepared yourself. You may feel confused and bewildered. Do not feel that you have to do anything. You can just stay with your friend or relative’s body for a while. You may have many different emotions.

The death of someone close to you is a very significant event in a person’s life. Most cultures and religions have developed rituals or processes to mark this event and to help the people left behind to adjust to the change.

During the first few hours, the loss of your loved one may seem very unreal, and there are some actions which you need to take. However, it is important that you do not feel rushed to 'get on with things'. If you want, you can just spend some quiet time with the person who has died. Many people like to sit and talk or hold hands, and see their loved one at peace, especially if the last few hours or days were a strain. In many religions this is a time when there is much that the people who have been left behind need to do to help their relative or friend to pass onwards. It is important to follow your instincts, and do what you feel is appropriate.