Palliative care often involves significant changes. You may notice increased sleeping, reduced appetite and thirst, confusion, and restlessness. Breathing patterns and heartbeats may become irregular, and there might be a loss of bowel or bladder control or constipation. Other common changes include chest congestion, variations in skin colour and temperature, muscle twitching, dry eyes, and difficulty focusing. An elevated temperature and pain, often indicated by agitation or a furrowed brow, may also require symptom management. These changes are part of the natural progression at this stage.