Guide to Mottling and Circulatory Changes During the Dying Process in Hospice

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The patient’s hands and arms, feet and legs may be increasingly cool to the touch. At the same time, the color of the skin may change. The underside of the body, or the body parts lying against the bed, may become darkened. Nail beds and lips may take on a bluish appearance, and extremities become mottled (patches of bluish discolorations). This is a normal indication that the circulation of blood is decreasing to the body’s extremities and being used by the most vital organs. This is also an almost universal indication that the patient is very close to death.


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