Is this normal?

Why isn’t Mum eating?

Watching someone eat and drink less can be one of the most distressing parts of the end-of-life journey.

“The body knows how to die,” says Sue.

“As we die, everything slows down naturally and normally. The body needs less food and less fluid.”

For families, this can feel as though their loved one is giving up. In reality, it is often part of the body’s natural process.

Why are Dad’s hands and feet so cold?

“It’s because the circulation is going much, much slower,” says Sue.

As the body slows down, blood is no longer reaching the hands and feet in the same way.

Families often become distressed when they notice cold hands and cold feet, but Sue says this is often a normal part of the dying process.

What is the rattling sound in their throat?

One of the sounds families often find most distressing is what was traditionally known as a “death rattle”.

“The old terminology for it is death rattle,” says Sue.

“It’s often just a small amount of saliva or secretions that the person is no longer able to clear.”

As the body becomes weaker, swallowing becomes more difficult and saliva can collect at the back of the throat.

For families, the sound can be frightening, but Sue says it is usually a normal part of the dying process.

“If we can get this over to people, it’s natural,” she says. “It’s a normal part of dying.”

Is it normal for someone to sleep all the time?

Yes.

People approaching the end of life often spend much more time asleep.

Their bodies are conserving energy as different systems begin to slow down.

My loved one suddenly seems better. Are they recovering?

Sometimes families experience what Sue describes as “the rally”.

A person who has been sleeping for long periods may suddenly wake up, ask for food, or want a conversation.

“It can be very confusing for families as they naturally assume things are improving.

“Nobody’s ever explained that this can happen.”

Not everybody experiences a rally, but it is a recognised part of the dying process.

How long have they got?

According to Sue, this is one of the most common questions families ask.

“They’re frightened to ask how long,” she says.

But as practical decisions need to be made, it becomes an important question.

The reality is that nobody can predict exactly how long someone has left. But for many families, the question is not just about time. It is about understanding what lies ahead and feeling prepared for the changes that may come.

Am I doing this right?

This is perhaps the question Sue hears most often, even when it isn’t spoken out loud.

“I see families feeling helpless all the time,” she says.

“They desperately want to help the person they love.”

Many are caring for someone approaching the end of life for the first time.

“There is no handbook,” says Sue.

“No perfect way to do it.”

Sue believes families need more than practical advice. They need the confidence to ask questions, be given honest answers, and the reassurance that what they are experiencing is normal.

If you could tell every family one thing, what would it be?

“I would want them to feel safe,” says Sue.

“In a space where they could really, really go deep and ask the questions they’d been afraid of asking.”

For Sue, many of the fears families have come from not knowing what to expect or understanding the changes they are seeing in the person they love.

“If we can get people to the point where they feel confident to ask us the questions and hear the answers,” she says, “it can help them feel more prepared for what lies ahead.”

Because sometimes the greatest reassurance is understanding that what is happening is a normal part of the end-of-life journey.