Though everyone's experience is different, there are some typical stage 4 lung cancer symptoms that may indicate a person is near to dying, including:

People's needs may also vary. Some need oxygen, for instance, while others don't.

It can be hard to think about what to expect at the end of life with lung cancer. But knowing the signs can help you prepare yourself or a loved one for the final stages of this challenging disease.

This article will examine the different factors that affect people in the end stages of lung cancer and consider physical, emotional, and spiritual changes that may affect them.

There's no single roadmap, but many families can tell when things "start to change." Some of these physical and emotional changes are nearly universal, no matter what condition a person dies from.

With lung cancer, there are signs along the road that point to its end. Some of these conditions include pleural effusions requiring a hollow tube called a shunt and repeated fluids draining. A person may find it hard to be awake because of pain. They may become extremely weak or don't want to eat.

Here's a look at some of the specific changes you may see.

Some people want to fight their cancer to the end, but others seem ready to accept death. Your loved one may start to withdraw in those last few months. They may seem less open to visiting with family and friends. Activities that once excited them now no longer capture much interest.

For caregivers, taking care of yourself is very important at this stage. A support system helps you maintain your well-being so you can support your loved one with cancer as well as possible.

In late-stage lung cancer, it's not unusual for people to seem lost in thought, begin to sleep a lot, or “have one foot in the next world.” They also may be frustrated, and irritable over fatigue and other limitations that mean they need more help.

One thing that happens often, and that may seem troubling, is for people to talk about seeing heaven or loved ones who have died before. That's common whether the dying person was religious in life or not.

Sometimes, a family may think these visions are delirium or terminal restlessness, an end-of-life agitation that can be frustrating to experience. They may occur when a dying person seems to have an awareness that death is near.

It's important to speak gently instead of "correcting" these comments from a dying person. Offer comfort and let them know they are not alone in the life they still live here. After all, we don't know what a dying person may or may not see and know.

If loved ones do try to correct a dying person or tell them they are just "seeing things," they often become quite distraught. It's best to simply listen and allow your loved one to share comments like this, even if they may be upsetting to you.

The physical changes during the final stages of lung cancer are because of the lung tumor, the cancer's spread to other parts of the body, or the end stages of cancer in general.

By definition, the final stage of lung cancer means there are no more treatment options, and a cure is not possible. However, palliative treatments, used to ease symptoms or improve comfort, may still be used. If you are enrolled in hospice, you may be given a hospice comfort kit with supplies that can help. Some common physical changes include:

Verywell / Brianna Gilmartin

End-of-life care focuses on quality and comfort when treatment is no longer an option. Because pain, shortness of breath, and other symptoms are common in late-stage lung cancer, there are helpful drugs and other techniques to help you or your loved one make a better transition.

Many researchers now believe that dying is an active process the body is designed to go through. During the final days, your loved one may begin a phase known as "active dying."

Your loved one's skin may become cool as body temperature lowers, and you may notice mottling (bluish, blotchy patches) on the skin. The dying person often sweats, and even though the skin is cool, it may feel wet and clammy. They usually stop eating and drinking, and this is normal. They will not feel thirsty or hungry.

As death approaches, the person's breathing may change. Rapid, deep breaths may alternate with periods of very shallow breathing (Cheyne-Stokes respirations). Fluids building up in the back of the throat may cause a gurgling sound (the death rattle). This may distress family members but apparently is not upsetting to the dying person.

Confusion is common. Your loved one may be restless, picking at the sheets or clothing. There may be a surge of energy or even the appetite for a full meal after eating little for days. This can be heart-wrenching if family members misinterpret this as a sign that their loved one is getting better.

Most likely, it is the body's way of giving them a last chance to say goodbye. They will stop communicating and enter a deep sleep as the dying progresses. Continue to express your love, which the person likely still hears even if they cannot respond.

It's not necessary to know what actually causes death to give your loved one the best care possible. Not everyone wants to know, but some people do.

As dying continues, all breathing stops, and the heart stops beating. Some say they know the exact moment or "feel" when a loved one has left them. Others find comfort in staying near their loved one's body as it becomes cooler and find it easier to let go after that.

If your loved one is dying at home, check with your hospice nurse or doctor ahead of time to know what next steps to take after the death.

In most cases, family members are allowed to spend time mourning and saying goodbye to their loved one before the funeral home is called.

Caring for a dying loved one can, at the same time, be the most challenging and even most rewarding thing you have ever done. But take care of yourself during this time, even if it feels selfish. Keep in mind that grieving often begins before a loved one dies—called anticipatory grief. It can be lonely as others around you may not recognize it. 

When your loved one passes, you may find yourself in a state of shock. What comes next? If you are connected with hospice, your hospice team can help you with the next steps for survivors after death.

Dying is a natural process, but it's also a profound mystery in the human experience, and no two deaths are ever truly the same. It helps to know that there are some common steps as you navigate the physical, emotional, and spiritual changes that come when lung cancer patients die. A dying person usually wants support, but be sure that caregivers have a support system, too.