Dying: A Guide to Crossing Death's Doorstep
89How to Know Your Loved One is Dying
This hub offers a breath-by-breath-to-last-breath guide to help you recognize and participate in each stage of your loved one's last weeks, days, hours and minutes of life.
Like fingerprints, each person's exit from this earth is unique and highly individual. However, there are certain universal harbingers that signal the Grim Reaper's entrance. As one might hover over a loved one's sickbed watching for signs of recovery, those of us in hospice wait and watch for behavorial death omens (bdo's for short).
Death be not proud (Holy Sonnet 10)
Death, be not proud (Holy Sonnet 10) by John Donne
Death, be not proud, though some have called thee Mighty and dreadful, for thou are not so; For those whom thou think'st thou dost overthrow Die not, poor Death, nor yet canst thou kill me. From rest and sleep, which but thy pictures be, Much pleasure; then from thee much more must flow, And soonest our best men with thee do go, Rest of their bones, and soul's delivery. Thou'art slave to fate, chance, kings, and desperate men, And dost with poison, war, and sickness dwell, And poppy'or charms can make us sleep as well And better than thy stroke; why swell'st thou then? One short sleep past, we wake eternally, And death shall be no more; Death, thou shalt die .
I am not a ghoulish girl, honestly
If you've read some of my hubs you might get the impression I've got some kind of death wish. Actually, nothing could be further from the truth. It's just that my life has been filled with death over the past few months. As a result, it has risen to the top of my topics list.
I'm reminded of the line in "Silence of the Lambs" when Dr. Hannibal Lecter says to FBI Agent Clarice Starling (in reference to serial killer Buffalo Bill): "What is it he does, Clarice?" She says something to the effect, "He hunts women." "No. He COVETS." He then asks her, "And what is it we covet?" The answer: "We covet what we see." Lightbulb-over-head moment for Clarice: "He knew her!"
So have I come to see and know death -- in a much more intimate way than I ever expected to. Death has become an integral part of my life, whether I want it to be or not. As such, it has risen to the top of my list of hub topics. We write what we know.
My dear father died November 24, 2008. This morning, a mere 3 months and 2 days later, my beloved father-in-law joined him in heaven.
MM's Dad and Father-in-Law
The Dying Experience
The hospice social worker gave us a booklet titled "Gone From My Sight, the dying experience" (by Barbara Karnes). The information in this booklet is incredibly useful for famiies of terminally ill patients. Even if your loved one is not terminally ill it can be equally useful. It can help you interpret behaviors that otherwise make no sense. Basically, what you're seeing means your loved one is preparing for death.
1-3 Months Prior to Death
Withdrawal -- Beginning of separation from the world. Decreased interest in newspapers, TV, then from people (refuses visitors) and finally from children, grandchildren and even spouse.
Sleeping More -- During this phase the person is going inside self, sorting things out and evaluating one's self and life. This is typically done with the eyes closed. More and longer periods of sleep occur.
Communication -- Words lose importance. Touch and wordless communication become more prominent.
Food -- When the body is preparing to die it's natural that eating decreases or stops. Meats go first, followed by vegetables and other hard-to-digest foods. Eventually only liquids are taken. The body no longer needs fuel. From this point forward, spiritual energy, not physical energy, will be needed.
1-2 Weeks Prior to Death
Disorientation -- Person is sleeping mos tof the time now. S/he often becomes confused, talking to people and about places and events that make sense only in their head. Conversing with loved ones who are already dead is common.
Agitation -- Picking at the bedclothes and agitated arm movements, restlessness occur.
Physical changes -- several changes signal that the body is losing its ability to maintain itself.
* Blood pressure may lower
*Pulse beat may increase to upwards of 150 or decreasing down as low as 0.
*Body temperature fluctuates between fever and cold. There is increased perspiration and clamminess.
*Skin color changes. It's flushed with fever, then bluish with cold. A pale yellowish palor washes over the complexion.
*Nailbeds, hands and feet are often pale and bluish because the heart can no longer circulate blod throughout the body.
*Breathing changes. Respiration may increase from a normal 16-20 to 40-50 breaths per minue. Or it may decrease to 9 or even 6 breaths per minute. You may notics a puffing or blowing of the lips upon exhaling. Rhythmic breathing may stop then restart.
*Congestion causes a rattly sound in the lungs and upper throat. Non-productive coughing may occur. The breathing and congestion symptoms come and go.
1-2 Days or Hours Before Death
*Energy Surge. It's common to experience a final surge of energy. Person may be alert and talking instead of disoriented. S/he may request a favorite meal. Visitors may be asked for (or at least tolerated). The person may move about wanting to move furniture or other activities requiring energy.
This means that the spiritual energy for the transition from this world into the next has arrived. It is used for a brief time in physical expressions.
*The 1-2 week signs (above) become more intense as death approaches.
*Restlessness may increase due to lack of oxygen in the blood.
*Breathing patterns become more irregular and slower. Breathing may stop for 10, 15, up to 30 seconds before resuming.
*Congestion may become very loud, still intermittent.
*The eyes have a glassy look, often tearing. They may be open or semi-open but not seeing.
*Hands and feet become purplish. Knees, ankles and elbows, underside of arms, legs, back and buttockscan be blotchy.
*Person becomes generally non-responsive.
Final Minutes of Life
*Cannot be wakened
*Gasping for air/fish-out-of-water breathing
*Final separation occurs when breathing stops. What appears to be last breath is often followed by 1-2 long-spaced breaths.
*Mouth remains open, unable to close.
*The physical body is now empty. Its owner has moved into the spiritual realm.
Death: Are you experienced?
Have you ever watched someone die?
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When my father died whom I wrote about , I felt his last breath against my cheek and it brought back a flood of memories and made me cry. I deal with death it seems on a daily basis, but what hurts the most is when it is someone you love. I know you are not wish death upon you as you are grieving for the loss of two wonderful people, God will make you stronger and now he has given you the gift of seeing the signs before they are gone, which many have not expereinced.My heart goes out to you and yours.
I voted.
goldentoad: What did you vote for???:::::)
Yeah, the vote thingy wasn't there when I first posted.
Mighty Mom's poll.
I find the death process very interesting, especially the passing over. It can be a beautiful experience especially during the after life wanderings. I helped my father who also died last year.
Wow and Hospice told us something that was a bit hard to hear...sometime when a person takes their last breath and you know they have passed it appears their heart still beats...that is with someone who has a heart pacer...the pacer has a battery and it helps the heart beat but when the heart stops it still tries... till the battery run out...
This was a great hub sweetie and I am also living with this happening soon with my mom...all the symptoms are present...just not fully yet...the body shuts down at it's own rate...I pray for hers to be peaceful and for me to be with her...Will be my first actual being there experience...God Bless you for your understanding ways...G-Ma :O) Hugs & Peace
Mighty Mom , please accept from me a huge Hubhug and condolences for the loss of your father in law. I'm sure he and your father are both enjoying a great laugh at we mere mortals trying to cope with all of our worldly problems that we think are so important, but in the big scheme of things don't really matter all that much!
May God bless you!
Pest, It wasn't there for me either or maybe I just overlooked it, I voted and I am certain that you know what my answer was :)
Wow, this is a really unique and interesting hub. I never would have known that such clues exist to a person's final exit from our world. Thanks for the enlightening read.
mighty mom, It is never easy to lose loved ones. I got cancer myself and almost died (actually did die technically for a while) then lost my marriage, my mom and dad, my home and my income within a year of each other a while back. All I can offer is the empathy gained through those experiences. I wish you love and strenght to carry on for those who love you and for yourself.
I think I have observed some of the signs but in retrospect not during the moment. Thanks for sharing MM.
G'day MM , On my puter the top ad is covering up your Sonnet by John Donne , just thought you might like to know? Please Delete this comment .
Wow I got the shivers reading the 1-3 month, 1-2 weeks and final hours phases -- that is exactly how I remember it for dad. The only "phase" that wasn't there for dad was the sudden surge of energy... Personally, I think it's "good" to know what to expect, either for loved ones or for oneself. Great hub, Mighty Mom!
Recieve my compassion and condolence, please. Loosing our dearest ones is never easy. It is easier for people who leave this world.
I believe that life never stops, it is just yourney of the soul, when time comes, we must leave our bodies, But love, which is connection between people stays forever, we will all meet again...many times. You will see your dearest ones again.
It is good to have such informations.
Great Hub, thank you.
Great effort!!!
I'm so sorry for your loss. Thank you for writing this hub. This is an amazing and brave hub, and it is exactly right. We NEVER talk about this stuff! It is so refreshing to see it openly laid out this way.
My father died of lung cancer in his late 40s. Everything you list here I can relate to. He died alone in the hospital, but at the moment of his death I was awakened from a sound sleep by that death rattle sound. I was in my apartment. I kept hearing it even after I was awake. I was terrified and ended up driving to my mother's house and staying until the funeral was over. For three days after his death I heard or felt him off and on, and then it stopped.
I know he is not gone, he's just not here in the way he was before.
MM, thank you for being the brave person you are and writing this hub. I've witnessed all but the moment, and you've described this so well. Some of the signs are ones I didn't even realize were signs.
I remember my grandmother, a few weeks before her death, asking for her stuffed rabbit which was something she had as a kid, and she'd get very irritated at not having it.
Thumbs up and great job. :)
I am so sorry for you loss. I too feel I have come to know "Death" more than I would have liked to. My fiance of 2 years was murdered in 2002, My step-father died of Non-Hodgkins Lymphoma two weeks after my Fiance( literally rooms apart in the ICU unit at the hospital). My Uncles died a few days apart in 1998. And my Grandfather passed on 12/12/08. I have dealt also with several of my dearest friends passing as well.
I have learned that death is certain and life is not. I know they are safe now in GODS care and I do not have to see any of them suffer as they did in their state prior to their sad ending. Again, I am truly sorry for your loss.
I was with my dad last year when he passed, and he was peaceful. I can only hope my own time is peaceful and surrounded by loved ones.
Cheers! - Chef Jeff
I lost my parents within 14 months of each other when my children were very small. Even now when I think of them it brings a tear to my eye. You have my sympathy MIghty Mom. A big cyber hug to you.
Great Hub!! None us are getting out of here alive. This shell that we inhabit is not forever. We have to come to grips with that. Thanks for sharing this important information!!
MM: I'm so sorry for your losses. When it rains, it pours. It is always difficult, and it never gets any easier, and I guess it shouldn't. How are you holding up? My moms behavior was very odd. She asked me to come over and pick up her plants to put them in my sunroom for the winter. When I got there, she kissed me for the first time since I got to that age where you say, "Oooo, Mom! I'm too old for that." A similar experience happened with my brother. Then she waited for my sister to get home from school and a couple of minutes later, slumped over in the chair with an aneurism. It was very strange.
Thanks for sharing your story and your observations.
I'm sorry for your loss Mighty Mom,
I would like to share another view on this subject. What you have described is certainly the case the majority of the time, but there are rare occasions where this is not the case. I bring this up because of two experiences I am aware of.
The first was my Mothers Mom. In 1988, on a Saturday night, I received a phone call from my Grand Mother. She was confused because one of my Uncles was pushing the teachings of a book "88 Reasons Why Christ Will Come In 88." She asked me about the second coming of Christ, after sharing all the verses with her, I replied, one thing for sure Grandma, if you go to be with the Lord before the Rapture takes place, then it will not matter to you when the Lord returns. Up to this point Grandma had showed no signs what-so-ever of nearing death. The next morning she went to Sunday Service. My sister was beside her as they all prayed. My sister noticed that Grandma wasn't praying. Grandma had stepped out and was gone.
The second instance is of my Grandma on my Dads side. She too had showed no signs of nearing the end. She was constantly traveling and visiting her Christian friends around the Country. After her last trip she had been home for about three weeks. Everything was fine. Her routine was to awaken and and spend time in prayer, and then have her morning coffee. My Uncle had noticed that my Grandma had not had her morning coffee, so he went to her room. When he entered the room, he found Grandma on her knees at the bed side, she was gone.
Most others that I know, have gone the way you have described. But I thought I would also share that a rare few, do not go the way most of us do.
My condolences Mighty Mom.
You have inspired me. I am at this moment writing a new essay. You have evoked memories that speak to me now more clearly than a moment ago.
If it becomes a hub, it will be dedicated to you.
Mighty Mom,
Thank you. I love hospice. They were there for my son, mother and Barbie’s father. They walked us through much of what you have written here and it was very helpful. To me it is good to know that there is a natural process and signs for the family. We can’t avoid death, but we can prepare.
Thank you. ~ eddie
So sorry to hear of your most recent loss MM. Your summary of how it happens was very accurate from my own recollections of watching my first Husband die of Cancer on his final day, What I do know is that apparrently there are 7 stages of final breathing, and each is so unique that Nurses will recognise it. I was woken by Dave's family once he got to the 7th stage, and he died within half an hour afterwards. As you said, a day or so before he was really coherant and chatty, but that was straight after they released him from the hospital, (which is also quite normal apparently).
They also say the soul knows it is going to pass before the physical body/conscious mind does, and that signs are often noticed by famly that preclude death, but make more sense when you consider this fact afterwards. This was certainly true of my Husband.
Very interesting. I didn't know there was a pattern towards death. Sad to hear you have had some experience recently. I have to keep an eye out for the signs when my elders begin to become terminally ill.
A person at the twilight will return to a specific event over and over during their early years or at least my grandfather did.
Glad you wrote this MM. I teach a lot of literary stories surrounding death and dying and it is my wish to assuage the angst surrounding the event. We have life celebrations for the dead, not funerals....they are beautiful!
Great hub.
Pattern towards Death. interesting indeed!!
My thoughts are with you today ~ this Fathers Day ~ we lost a precious son/grandson/great grandson/nephew eleven years ago today. Although it was an accidental death, our family was all present when he was taken off life support. The other side of this life is always just a heartbeat away.
MM,
I am not sure what happened to me physically when
i dued but-I know what happened to "my head"- "In my head".see my 3 part series on this...*shameless self promotion I admit it"
good hub...TH
I watched four people die after I took them off life support and it took each one of them 30 minutes to finally die. The last thing that was to stop was their heart-beat I thank God they did not have to suffer because they did not know what was going on around them.
God Bless,
Karissa
Thank you. Good hub and helpful hub. Do you think death comes in 3s? I wonder why that is?
Hi MM, it's been a while. Doing a little research on HP about end of life and Hospice and came across this hub. Sorry for your losses. I am struggling thru a very hard situation with my mom at the moement. Cancer and complications brought her home from the hospital on Thursday last week with the help of Hospice. They said 2 to 7 days. I am already seeing a lot of the signs you wrote of. My heart is broken but I am so thankful for this time with her. It is very special, precious to me indeed. Thanks for the hub.
MM) I am so sorry for the loss of your dad and father-in-law. It's so very very hard to lose people we love. The hardest thing in the world,I'd say.
This is a very useful guide to help loved ones know what to expect in the dying process. I wish I had known these things when my parents were sick - in fact if I could go back and do it all again I would have called Hospice in. I just did not want to let go - and feel selfish for that.
I was with both of my parents when they died. With my dad it was very peaceful and I "saw" his cross-over. My mom, on the other hand, struggled for breath and it was hard to watch that. I miss them so much, always will - they were my best friends. Getting teary-eyed thinking about it.
God bless you my friend.
Mighty Mom
Thanks for your hub.A variation of those symptons did appear when my husband died but I didn't want to see them and tried to will him back to me.But failed. He died in my arms last week and I will write about it when I awake from this fog.He was my all and I need to find another direction but for now I just exist.
Thanks for sharing.
My husband died 2010 of cancer. Watching him laying there in his last moments was the hardest thing I ever had to do. I loved him dearly. The sadest part is that I didn't see all the death signs were there. I didn't even know them until a hospice nurse handed me a booklet that explained all of them after his death. I learned more about death in that time then I ever wanted to know.
I hear you about the signs.I went through it with my darling husband this summer. I worried about the signs and while I saw them,all of them.I still thought he was going to get better.I guess I didn't recognize them for what they were. I just walked with him and thought I'd eventually take him home. Heartbreakingly I didn't.
I'm sad for you and me.
Hi, my mother is fighting cancer. My mother now sees things that are not there. When she talks it doesn't makes many sense to others, and talks about a dead brother of hers. My mother has stage 4 cancer. My mother is dizzy a lot, out of breath like she has been running at times, and has even passed out on my father. could this be a sign that she has only weeks to live?
Dear MM, I'm so sorry for your loss!!! In January of 2006, I lost my mom due to complications from ovarian cancer. At the time all this was going on, I watched my mother slowly pass away right before my eyes. For some reason or another, I sensed that she would be gone sooner than I had expected. My 3 older sisters & I went to mom's house on a Saturday.....to help clean up and fix a potluck dinner of fried catfish, spaghetti and salad. We laughed and talked and shared memories of growing up. Meanwhile, we were constantly checking on mom to see if she was ok. We each took turns being by her side. Later on that day, I stayed with mom during night, but I could not sleep. I went into mom's room, she was ok. But when I looked into her eyes, something inside told me that she would not be around much longer. Sure enough, later on that week, she passed on. I have not been the same. I have moved on, but it still hurts because I miss her so much. What a great hub you have written. Thank you so much.
Hello MM,
Like you, I still find myself in tears when I think of my mom. My mom has been gone for 5 years now, but it still seems as if it happened yesterday.
Again, thank you for such a well written article. May God bless you and your family as well. Have a Happy Thanksgiving!!!!
MM -- I lost my son and only child a year ago yesterday. I've somewhat beaten myself up as I don't feel I've gone forward as far as adjusting to him being gone as I should have -- and I can't change that. If this Hub does nothing else for anyone in the world it has helped me to know there are others who feel as I do and we all grieve differently and in different time frames. Thank you so very much. Best, Sis
My dad passed away last month from emphysema in hospice.
He was in the hospital for 2 months and his condition improved. One day, he stopped eating as much and didn't talk much either (he talked CONSTANTLY before). He didn't care about most of the things he did before..he just wanted to hear things that made him laugh and listen to stories about our beloved cat :)
Eventually, he had respiratory arrest and went into a coma, and instead of ventilating we sent him to hospice. My twin sister and I stayed the night with him there, and it only took about 10 hours for him to pass. We fell asleep for about 30 minutes, then woke up because his bi-pap alarm went off. My sister went over to him and told him she loved him so much and said goodnight, and as soon as she turned around he stopped breathing. We were in such denial..so it was a shock.
The nurse came in and said "His heart stopped, but he can still hear you". So we ran over to him and she took off the bipap. He looked completely different than he did before, and we both got jumpy when he took a few more last few breaths (not expecting them). I feel ashamed and like a failure that instead of comforting him I got scared :((((I think all I said was "it's ok" or something like that) And once he passed we closed his eyes and left the room quickly. It was the worst moment of our lives but I'm glad we were with him.
My husband of almost 30years is terminal with pancreatic
cancer went the whole route of surgery and chemos not effective i watched my father and mother die its so hard to sit here and watch all of the signs again i sure hope that i am strong enough in the end he is at home with me and on hospice care they are an incredible group of people they tell it up front and frank just saw this sight and had to comment thanks
My question is , I recently have had my daughters dad pass away in the home and grandma or his mom did mont of the funeral arrangements. we all had agreed to have him crematted. Now the issue at hand is that His remains would be split into three small urns... His mother did that nor is she speaking to me now an tells me shes putting urn in a cemetary... Does she hav that right to his urn at all to be doing this or legally does my daughter..... ?
My families life long friend is dying of cancer. It is all through her body now. She has had 2 days of energy. Going out to dinner and doing activities she use to enjoy. My sister asked me to search the web for anything I could find about the spurt of energy, what it means and how long do we have left with her. Although it hurts to read the stages, you have done an excellent service for me. I won't be there at the end of her life but I do believe she will be beautiful til the end.
















































Pest 3 years ago
WOW! I held my aunt's hand as she passed away, that is exactly how it happened!