When a person is in their final days or hours, their body begins to change in ways that can be startling for those around them. One of the clearest signs experts point to is in the hands.

According to Marie Curie, the UK’s leading end-of-life charity, the hands, feet, arms, and legs often become cold to the touch as circulation slows down and the body focuses its energy on protecting vital organs.

This reduced blood flow can also cause the skin to develop a mottled appearance – blotches or patches that may look blue or red on lighter skin tones, or purple or brown on darker tones.

These symptoms typically emerge in the final stages of life, sometimes hours or days before death. “These changes are a normal and natural part of dying,” exprts at Marie Curie explain. “They do not usually cause the person pain or distress.”

Hands aren’t the only place to notice changes. Marie Curie adds that breathing often becomes slower, irregular, or more shallow, with some people experiencing a build-up of saliva or mucus that creates a rattling sound in the throat or chest.

Many people also spend more time asleep or may become completely unconscious in their final hours – though experts believe they may still be able to hear voices and feel touch.

Another physical sign often observed in those final moments is a waxy, pale look to the skin, particularly on the face, as well as the muscles of the face relaxing suddenly.

In addition to these physical changes, some end-of-life nurses have observed a haunting but fascinating phenomenon often referred to as the “death reach”.

Katie Duncan, a nurse practitioner and end-of-life coach who has worked in intensive care and hospice settings, explained in a viral TikTok video that many people nearing death will suddenly raise their hands or arms, as if reaching out to something above them.

“This is one of those unexplainable phenomena,” she said. “In my personal experience working with people who are dying, this reach towards someone or something above them is really common.”

Often, this movement is linked to what professionals call end-of-life visions. Some patients have been heard describing seeing a bright light, an angel, or even a beloved family member or pet who has passed away. Other times, they simply reach silently, without explanation.

For relatives, this can be a surprising and emotional thing to witness, but Duncan reassures families it doesn’t indicate distress. “It’s really common, and in my experience, it doesn’t cause the person to suffer,” she said.

Marie Curie advises loved ones to stay close, speak softly, hold hands, or gently stroke the person’s skin, even if they appear unconscious. Small, comforting actions can still provide reassurance.