My mother-in-law had been hospitalized for the last 4 months of her life due to a diagnosis of terminal stomach and bowel cancer.  She chose to die in a hospital to spare her elderly husband the burden of her care. On her last day, the family was gathered around her bed and were quite upset as she was quite agitated yet unresponsive to determine if she was in pain. An observant person in the room noticed that her very swollen hand was pinched between the mattress and railing- when her hand was re-positioned, she became calmer and died peacefully surrounded by family. Little things matter!