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Final 8 - 48 hours
- Very difficult to rouse from sleep or elicit a response from
- May have no response or only nonverbal communication (eg, winks, waves, or nods)
- May seem relaxed and comfortable
- Usually very minimal or no urine output
- Reaches a point of unresponsive sleep (coma), which can last from 1 hour to most of the day
- No longer any involuntary movement during sleep (no fidgets or eye movements)
- Mouth may slacken and eyes may remain partially open during sleep, as voluntary muscle control is lost
- Vital signs may be OK until just hours before death
- Blood pressure may drop significantly
- Heart rate may be twice-normal (120-180 beats per minute)