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uk Death, bereavement & serious family crises relative in hospice • hospice end of life • death seems near • last days of life • last hours of life • what to do when dying • expected death at home • hospice nurse on call • unsure what to do • breathing changes dying • noisy breathing dying • no eating or drinking • restlessness at end of life • family at bedside • imminent death signs • what happens after death • verification of death • dnacpr form • palliative care at home

What to do if…
a relative is in hospice and you are unsure what to do when death seems near

Short answer

Call the hospice/palliative care team (or their out-of-hours number) and say you think your relative may be in the last hours or may have just died — they will guide you and can arrange a professional to come and verify the death.

Do not do these things

  • Do not automatically dial 999 for an expected hospice death (unless you think the death is unexpected, there’s a safety issue, or you’re told to).
  • Do not force food, drink, or tablets if they are drowsy, struggling to swallow, or turning away.
  • Do not change doses of “just in case” medicines on your own — ask the hospice nurse/doctor what to give and when.
  • Do not assume noisy/irregular breathing means you must “fix it” yourself — if you’re worried or it seems uncomfortable, call the hospice team for symptom advice.
  • Do not rush to move the person, wash them, or remove equipment immediately after death unless you need to for safety/comfort.

What to do now

  1. Work out where they are, then make the right call.
    • If they are in a hospice (inpatient) building or ward: tell staff immediately (use the call bell/reception/ward phone). They will attend and guide you.
    • If they are at home or in a care home under hospice/community palliative care: call the hospice 24/7 line, community palliative care number, district nurses, or GP out-of-hours contact you were given.
  2. On the call, say the key phrase and ask for a visit if needed.
    Say: “They’re on hospice/palliative care and I think death may be very near / I think they may have died.” Ask: “Can someone come to assess and (if needed) verify the death?”
  3. Ask three specific questions (and write the answers down).
    • “What should I do right now to keep them comfortable (pain, agitation, breathlessness, secretions)?”
    • “What should I give (or not give) from the medicines we have at home?”
    • “Who do I call next if things change before you arrive?”
  4. Make the space calmer and reduce distress triggers for the next hour.
    • Lower noise/light, keep the room comfortably cool, and limit visitors if it’s overwhelming.
    • If breathing is noisy/rattly, ask the nurse if you should gently change their position (for example, onto their side) and whether a small fan/open window might help.
    • Speak simply and calmly; it can be comforting even if they don’t respond.
  5. If they seem distressed, treat it as a care issue you escalate — not something you must manage alone.
    • Call back and describe what you see (grimacing, agitation, gasping, long pauses, rattly breathing).
    • If you have “just in case” medicines, follow the hospice/clinical instructions exactly and ask what to do if it doesn’t help.
  6. If you think death has happened, do the minimum first.
    • Check for breathing/responsiveness briefly, but don’t start CPR if there is a DNACPR in place or you’ve been told not to.
    • If there is no DNACPR and you think the death may be unexpected, call 999 and follow the call handler’s instructions.
    • For an expected death under hospice care, call the hospice/community nurse/GP service to arrange verification of death.
  7. While waiting, gather what the visiting professional may ask for.
    • Your relative’s details (name, date of birth, NHS number if known).
    • Care paperwork nearby (DNACPR form, anticipatory medication chart, hospice plan/contact sheet).
    • A short note of when you noticed the change (e.g., “breathing changed around 8pm; unresponsive since 9pm”).

What can wait

  • You do not need to decide about funerals, registration, or notifying everyone immediately.
  • You do not need to tidy the home, return equipment, or deal with paperwork tonight unless someone advises it.
  • You do not need to be “certain” about what you’re seeing before calling — the hospice team can talk you through it.

Important reassurance

Being unsure and frightened in these moments is normal — even when death is expected. Hospice teams are used to these calls and can guide you step by step. You are not “bothering” anyone by calling.

Scope note

This is first-steps guidance for the hours when death seems close (or has just occurred). After that, there are formal steps (verification/certification, registering the death, and practical notifications) that your hospice/GP service can explain in order.

Important note

This is general information, not medical or legal advice. If you think the situation is unsafe, the death is unexpected, or you are unsure what you’re seeing, seek urgent help via the hospice team, NHS services, or emergency services as appropriate.

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