According to hospice, what is actively dying?

When my dad was in hospice care (16 months), he didn't enter the actively dying stage until his last 48 hours. He had been mostly awake but unresponsive for a couple of days, but on the third day, one of his nurses told us that he was actively dying and that he was at an irreversible point. The next day, another of his nurses pulled me aside and showed me the signs that they can see, like fixed pupils, shallow, uneven breathing, graying skin, folding earlobes (this one shocked me) and rattling in his chest. It was unnerving. He died the next day.

A shout out to any hospice workers here - y'all are a blessing. Dad's hospice nurses were such a comfort to all of us, but most of all to Dad. Thank you for what you do.

For both parents, they were actively dying when their breathing changed to the gurgled Cheyenne-stokes sounds. That's when death is immininent. Both of them took to their beds quite a while before they were actively dying. Mom was semi conscious for a week beforehand, no eating/drinking/dark urine, etc. She started the labored breathing about 30 hours before she passed.

Dad was in bed for about 2 weeks, same as mom. He began the labored breathing about 8 hrs before he passed. His hands, lips and feet were particularly blue so we knew he was actively dying.

Best of luck with a difficult situation.

It's been my experience when hospice says someone is actively dying that they are showing the signs of the body and organs shutting down. It could be not eating or drinking, skin mottling, pee turning very dark, becoming unconscious and more.
Hospice should have given you a booklet explaining what to expect at end of life and if they haven't please ask them for it.
Also please ask your hospice nurse any questions you may have as that is what they are there for.

Hi George. As you will know, people enter hospice when their doctors decide that there is likely to be fewer than six months to live, and when the family and the patient wish to decline further treatment and to accept that death is coming, to opt for comfort rather than attempting life saving treatments that will have no good result, and may indeed cause more pain.
When most people enter hospice they are perhaps diagnosed with fewer than six months to live, but are not actively dying. But as the disease process continues their organs begin to fail and to slowly or more rapidly shut down. There are then signs that death is dear. More shallow breathing, more congestions in airways, slower or more rapid heartbeats, failure of the kidneys with concentrated urine, cooling of the extremities, a total loss of appetite or the inability to swallow and process food. This indicates that death is near.
Hospice patients often don't die in the 6 month time frame. A fellow member has had a parent on hospice for 1 and 1/2 years and has been removed because it seems any assessment in 6 months is not happening. So they are hospice patients, but not actively dying. Someone in the final passage, usually less than two weeks in duration, can be considered to be actively dying. Some Hospice personnel use the newer term "transitioning" , but because this term in dictionary definition means changing sex, some dislike the term.
Basically we are talking semantics here, so if hospice tells you something, and it's a term you don't understand just ask them what they mean by that term. They will explain.

George, welcome. I hope this helps:

https://www.crossroadshospice.com/hospice-resources/end-of-life-signs/what-is-active-dying/

Also, call Hospice and ask them. There is no shame in not knowing their lingo. They should have explained what they meant.