The phrase is not always literal, can imply someone is extremely weak or exhausted. After running the marathon, he felt like he was at death's door.
Pro Tip 2/3
Emotional Weight
The phrase carries heavy emotional connotations, use with sensitivity to others' feelings. I avoided saying she was at death's door to not upset her family.
Pro Tip 3/3
Dramatic Flair
It can be used dramatically to emphasize dire situations, not just concerning health. After the company's huge loss, it was at death's door financially.