What to Expect Near the End of Life

(General patterns, not predictions)

Weeks to Months: Increased fatigue and sleeping, Less interest in food and activity, More inward focus, Periods of confusion or forgetfulness.

Days to Weeks: Minimal appetite or thirst, Long stretches of sleep, Changes in breathing, Less verbal interaction.

Hours to Days: Irregular breathing or long pauses, Cool hands and feet, Changes in skin color, Minimal responsiveness, Hearing may still be present.

Preparing for Death as It Approaches

Medical & Practical Preparation: Confirm health-care proxy and advance directives are in place; Keep hospice or medical contact information accessible; Discuss wishes for after death (burial, cremation, green options); Identify a funeral home as far in advance as possible.

Emotional & Relational Preparation: Say what feels unfinished or meaningful; Offer forgiveness, gratitude, reassurance; Allow silence when words are no longer needed

Environmental Preparation: Gather meaningful music, objects, or photos; Reduce noise and unnecessary stimulation; Create a calm, familiar space.

What to Do Immediately After a Death (New York State)

If Hospice Is Involved: Call hospice upon natural death; Hospice will pronounce death and guide next steps. Hospice may coordinate with the funeral home if arrangements are in place. If Hospice Is Not Involved call the primary care provider or on-call physician. If no provider is available, call 911 and state the death was expected or natural. Contact the chosen funeral home or prior arrangements.

Body Disposition Options & Planning (New York State)

Families may choose: Traditional burial, Cremation, Green burial at designated cemeteries, Alkaline hydrolysis (where available). Families may also spend time with the body before transport, or hold vigils or rituals, where permitted and desired.

Local and Regional Resources (Albany, Troy, and Capital Region, New York):

a list of local resources for the following will be shared by email for all clients:

Hospice & Palliative Care

Bereavement & Grief Support

Funeral Homes & Cremation Services

Burial & Cemetery Options

Natural & Green Burial Preserves

**Many traditional funeral homes can help coordinate eco-friendly burial options even if they don’t hold green burial sections themselves. Aquamation (water cremation / alkaline hydrolysis) is not currently regulated for human remains in New York State; families interested in truly alternative disposition may need to inquire about out-of-state coordination or human composting services through local funeral directors.