1. Irregular Breathing
Breathing may become uneven, with alternating rapid breaths and long pauses. A rattling sound can sometimes be heard due to fluid buildup in the throat and chest.

2. Changes in Skin and Circulation
Hands, feet, and sometimes the face may feel cool. Skin can appear pale, bluish, or blotchy as blood flow slows and the body focuses on vital organs.

3. Reduced Awareness and Increased Sleep
The person may be difficult to wake, speak very little, or not respond at all. They often lose interest in food, drink, and surroundings, resting quietly for most of the time.