First described more than 30 years ago, Kennedy terminal ulcers (KTUs) are associated with the dying process. Although the exact etiology is not known, they are thought to occur as a result of shunting of the blood away from the skin as it dies (skin failure). This process is similar to other types of organ failures that occur during the dying process. KTUs appear as a sudden discoloration of the skin usually on the sacral area in a butterfly or pear shape and are usually purple or black. Properly diagnosing KTUs affords the clinician an opportunity to help family members with providing terminal care. A 91-year-old Hispanic woman was referred for wound care services with a stage III sacral pressure ulcer. Two weeks into care, she developed a KTU, following which she was referred to hospice. The patient died 6 days later.


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