Shogo Caparros

The last days or hours of a person's life are sometimes called the terminal phase. This is when someone is "actively dying".

Everyone's experience of dying is different, and some people will die suddenly or unexpectedly. But there are often signs that can help you to recognise when someone is entering the terminal phase. These include:

It can be difficult to know whether someone is entering the last days of their life. If you're unsure, ask a more experienced colleague for advice.

If a patient shows signs that they're entering the terminal phase, speak to the district nurse, GP or palliative care team. They will speak to colleagues, the patient and the people around them to decide whether the patient is entering the last days of life and what care they need.

Read more about caring for patients in the last days and hours of life.

Some conditions can cause the signs and symptoms of dying but can be treated. Be aware of reversible causes of decline, which may include:

If you think the patient may have any of these conditions, tell their GP or specialist nurse, who will arrange assessment and treatment.

Keep monitoring the person regularly (at least every 24 hours) to make sure they're settled. Talk to the GP or district nurse if there are any changes in their symptoms.

Even when someone has been living with a terminal illness for a while, it can be a shock for the patient and the people around them when they reach the last days of their life. It's important to be honest and reassuring when you're speaking to the patient and those important to them.

The best person to speak to the patient and the people close to them is a health and social care professional who is confident and experienced. It can help if they have had time to build a relationship with the patient. If you do not feel comfortable doing this, ask a colleague to help. You can learn the communication skills needed to speak to patients at the end of life through training, experience and feedback from colleagues.

Check whether the patient has recorded their wishes in a care plan or other document. If they haven't discussed their wishes with anyone, offer them the chance to do this as soon as possible.

Read more about advance care planning.

Some family members and friends may experience grief before the patient dies. This is called anticipatory grief.

Find out how you can help support family and friends.

You may find our guides on specific conditions, which include targeted information about signs of dying, useful:

Here are some useful resources from other organisations:

National Institute of Health and Social Care Excellence Guideline: Caring for dying adults in the last days of life

National Institute of Health and Social Care Excellence Clinical Knowledge Summary: Palliative care-general issue: The terminal phase

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Historically, it comes from the teaching system in which an apprentice lived with his teacher to know everything related to his art or trade, and in return the disciple served his teacher in everything he might need. In an effort common economic, there was no charge for coexistence, but the disciple contributed what he could. It used to only refer to students who lived with their teacher, but now it can also mean "full-time student".

Disciple status is obtained when a teacher allows more than one student to be uchi deShi. The teacher puts in a special trust for his student, which he can use to dedicate a particular time to train those he has chosen, or he can make all their time available, even if they consider this election an honor.

Sometimes the students live in the same house as the sensei, but most of the time they live in the dojo. It is a way to receive intensive training, learn more and better techniques, and learn about the philosophy and life criteria of your sensei that can reveal deeper aspects of his teachings.

There are different ways to practice. Some schools have a dedicated program for Uchi-deShi so that you can get more contact with instructors than with your teacher, receiving only technical training.

In other cases, the contact is so direct that you end up with secretary duties, or even private purchases from your teacher, if that's the case.

The rest of the day is dedicated to dojo tasks such as clean and order, and physical training, such as jogging, push-ups, resistance exercises, and so on. There is very little time for personal time.

It consists of paid programs, a special amount or a monthly fee paid, applicants are admitted periodically, they impose some conditions, and contact with the teacher is more measured.

The teachings of the founder of O-sensei, Morihei Ueshiba, were subject to multiple interpretations due to his particular transmission style. Many of O-sensei's earliest students decided to create their own styles after taking issue with the official style.