People often ask how they will know that someone is in the last few days of their life. People with pancreatic cancer can become ill very quickly over a few days, and you may not get much warning that the end is near.
Ask the doctor or nurse what signs to look out for when your family member is close to the end of their life. They can answer any questions you have. We have listed some signs that the end of life may be near.
In the final few weeks, you may notice your family member starts to gradually withdraw from the world. They may speak less than usual, be more tired and sleep more. In the final few days, they may stop speaking, although this doesn’t mean they won’t speak again. You can keep talking to your loved one. It can be reassuring for you both.
Another sign that someone is in the last few days of life is sleepiness. They may spend lots of time sleeping or they may slip in and out of consciousness. Even if they are unconscious, they may still be able to hear you speaking to them. It can be comforting to both of you to keep talking to them or to hold their hand.
“We played music for my dad at the end. He loved music, even wrote a few songs himself when he was younger. So we played him these, and a couple of Beatles songs he told me a week prior would be his picks for Desert Island Discs. He couldn’t talk or open his eyes, but I remember how he murmured and tried to sway his head when we played them. He died an hour later, but he died in full song, just as he lived.”
It is natural for people to stop eating and drinking in the last days of life. You can help your family member stay comfortable by giving them sips of water, ice lollies or small pieces of ice to suck, to keep their mouth moist.
Ask the doctor or nurse if you can have a mouth hydrator. This small plastic tube releases tiny drops of water or other drink. It helps moisten their mouth.
If they are not awake, the GP or nurse may give you a small, soft brush to keep their mouth and lips clean and comfortable. Lip balm or moisturisers can help stop their lips and mouth getting dry.
Your family member’s breathing may become slower or less regular in the last few days. Fluid in the throat or chest may make their breathing noisy, or there may be a rattling sound. This is sometimes called a death rattle. This isn’t usually uncomfortable, and they may not be aware of it, but it can be upsetting for family or friends.
If it is distressing your loved one, the doctor or nurse may try moving them into a different position. They can also use medicines to help reduce it.
Sometimes a person may become confused, restless or agitated. This is sometimes known as terminal agitation. They may not know where they are or who is with them. They may make strange or disturbing noises. Or they may fidget or want to move about even if they’re not able to.
You can reassure them by reminding them of who you are and what is going on around them.
They may describe speaking to someone who has died, or they may see things that aren’t there. If they are not upset, it’s fine to talk to them about what they can see or hear. Some people may be frightened. Staying near them, gently touching them or holding their hand and reassuring them may help. A calm room with quiet music and familiar items like photos nearby can also help.
It can be upsetting if your loved one is confused or agitated. There could be different reasons for why it is happening, so speak to the doctor or nurse. They will look for anything that is causing it, like pain, problems with their bladder or bowels, or issues with their medicines.
They may recommend medicine to relax them. Or they may suggest putting in a catheter (a tube into the bladder to drain urine). This will stop the bladder getting full and causing discomfort. If you are worried that your family member may be in pain, speak to the doctor or nurse.
“My partner became very confused towards the end of his life. For me that was possibly one of the most upsetting things, seeing someone who had been so strong and capable being so vulnerable. The healthcare team were great though. The doctors, nurse and the paramedics were kind and patient with him.”
Towards the end, your family member’s skin may become blue, grey or pale. They may feel cold. Layers of clothes or bedding can help keep them comfortable.
There is a small risk of bleeding towards the end of life. This is not common but it can be upsetting and frightening. There may be bleeding internally from the stomach or around the pancreas. This can sometimes cause people to vomit blood or have blood in their poo. If there’s blood in their poo it may look very dark or black.
If bleeding happens at home, contact the GP, nurse or hospice team or call the out of hours number. Stay with your family member and try to reassure them. Using dark towels and sheets may help to make it look less frightening.
In the last few days, the doctor may talk to you about stopping medicines that are no longer needed or that aren’t helping to control symptoms. They may also suggest giving medicines in a different way – for example, by injection or a syringe driver if your family member can no longer swallow medicines.
Join this online session on Tuesday 8th September to hear from Simon and Jeni, our specialist nurses, as they talk about what you can expect from palliative care, who is involved in delivering it and signs that the end of life may be near. They’ll talk about where you can find further support and take time to answer your questions.
To read more about end of life care, download our booklet, Pancreatic cancer and end of life care: information for people in the last months, weeks and days of life.
You can also order a physical copy.
If you have questions about what to expect, ask the doctors and nurses.
You can also speak to our specialist nurses on our free Support Line.
We have listed some of the references to the sources used to write this information. If you would like the full list of references, email us at publications@pancreaticcancer.org.uk
Published August 2024
Review date August 2027
