Can a Dying Person Choose When to Die? What Caregivers Should Know

Can a Dying Person Choose When to Die? What Caregivers Should Know

In the final days and hours, a person may “wait” for someone to arrive—or let go when everyone is out of the room. Hospice nurse Barbara Karnes, RN, explains the limited control we have over the timing of when we die.

Why Knowing the Dying Process Can Change How We Live Reading Can a Dying Person Choose When to Die? What Caregivers Should Know 2 minutes Next Blessings to all, especially the grievers

I have said, many times, “There are two ways to die — fast or gradual.” Today I am going to address the control we have over our dying. Yes, we have limited control over the time that we die. The operative word here is “limited.”

I don’t know as much about fast deaths, alive one minute and dead the next. My experience is with gradual death.

I have been at the bedside so often watching this dynamic unfold that I truly believe we have “limited” control.

We can stay here a bit longer to wait for someone to arrive. We can die when someone has been at the bedside and leaves the room. 

We can decide life is not worth living anymore and set in motion or speed up dying. We can stay here a bit longer to wait for someone to arrive and be with us when we take our last breath or we can wait until a person leaves our bedside to let go, which is often a gift of protection.

Because of this limited control I encourage those present to talk to the person in the days to hours before their death and tell them everything that is occurring. They will probably be non-responsive, but who is to say they cannot hear. Opportunities are lost if they can hear us and we stay silent.

If you are with someone when they die you are with them because they want you there. If you are not with someone when they die, even though you wanted and tried to be, that was their gift of protection to you.

Yes, we have that much control.

Something more...

When someone you love is dying, questions come quickly. Here's what you need- Gone From My Sight helps you recognize the signs of approaching death, The Eleventh Hour offers calm guidance for the final hours to minutes and after the death. Both are in the End of Life Guideline Series. These booklets were created to gently guide you through the final days and hours of life. Share this with someone caring for a person at end of life.

10 comments

Cody Tani

My friend passed away this morning. I visited her at lunch yesterday and stayed for a couple of hours. She was awake, tried to eat and said a few things. I was wondering if she held on until this last visit before she let go. I had to tend to some things and didn’t visit her for six days. I could tell that she was dying but I didn’t her to pass in less than 24 hours! Cody
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BK Books replied:
Hi Cody, yes, we have limited control over the time that we die. Your friend could have very well waited to say good bye to you. Blessings to you. Barbara

My friend passed away this morning. I visited her at lunch yesterday and stayed for a couple of hours. She was awake, tried to eat and said a few things. I was wondering if she held on until this last visit before she let go. I had to tend to some things and didn’t visit her for six days. I could tell that she was dying but I didn’t her to pass in less than 24 hours! Cody
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BK Books replied:
Hi Cody, yes, we have limited control over the time that we die. Your friend could have very well waited to say good bye to you. Blessings to you. Barbara

Michelle Crosby

My dad and I never left my mom, while she was in hospice care at the hospital, during her final days of dying with lung cancer. I said I would be right back, that I was going outside to get some air and I’d be right back. I was only gone eight minutes. When I was outside, I said to my partner that I was positive she wouldn’t die with me in the room. He told me I was probably right. When we walked back to her room the nurse supervisor told me she was gone, that there was no heartbeat. I’m totally convinced she was protecting me. She knew my Dad could handle it, but her 51 yr. old baby girl didn’t need to always remember that image of her Momma taking her last breath. ❤️
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BK Books replied:
Hi Michelle, I agree your mom protected you from seeing her last moments. She knew you well and gave you her gift. Blessing! Barbara

My dad and I never left my mom, while she was in hospice care at the hospital, during her final days of dying with lung cancer. I said I would be right back, that I was going outside to get some air and I’d be right back. I was only gone eight minutes. When I was outside, I said to my partner that I was positive she wouldn’t die with me in the room. He told me I was probably right. When we walked back to her room the nurse supervisor told me she was gone, that there was no heartbeat. I’m totally convinced she was protecting me. She knew my Dad could handle it, but her 51 yr. old baby girl didn’t need to always remember that image of her Momma taking her last breath. ❤️
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BK Books replied:
Hi Michelle, I agree your mom protected you from seeing her last moments. She knew you well and gave you her gift. Blessing! Barbara

Alyssa Hellmann

I’ve seen this for myself. My stepmom died in 2022 when COVID restrictions meant only 2 people at a time could be in her ICU room. My dad and little sister (her bio daughter) were with her for a long time and stepped away to get food, then my other sister and her bf took some time. Next my bf and I went in, I held her hand and talked to her and essentially said goodbye. And then I said it’s ok to rest, we don’t want to let you go but it’s ok.

Within the next ten minutes her numbers suddenly dropped and she passed. I think she waited for me, to spare my dad and little sister, and between my other sister and I, I was more present for her illness. It helps me and honors me greatly to know that she most likely did hear me and held on for a time when she felt safe to let go.
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BK Books replied:
Hi Alyssa, yes, I think your stepmom gave you a beautiful gift of trust and love as she was leaving. Blessings to you and your family. Barbara

I’ve seen this for myself. My stepmom died in 2022 when COVID restrictions meant only 2 people at a time could be in her ICU room. My dad and little sister (her bio daughter) were with her for a long time and stepped away to get food, then my other sister and her bf took some time. Next my bf and I went in, I held her hand and talked to her and essentially said goodbye. And then I said it’s ok to rest, we don’t want to let you go but it’s ok.

Within the next ten minutes her numbers suddenly dropped and she passed. I think she waited for me, to spare my dad and little sister, and between my other sister and I, I was more present for her illness. It helps me and honors me greatly to know that she most likely did hear me and held on for a time when she felt safe to let go.
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BK Books replied:
Hi Alyssa, yes, I think your stepmom gave you a beautiful gift of trust and love as she was leaving. Blessings to you and your family. Barbara

Monica

dad’s friend& wife wouldn’t leave my dad’s side for 4 days.mom finally talked them into going home to shower & check on things.they weren’t gone 15 mins. My dad passed.
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BK Books replied:
Hi Monica, thank you for sharing your experience. It is interesting to me how much control we have in our dying process. Blessings! Barbara
dad’s friend& wife wouldn’t leave my dad’s side for 4 days.mom finally talked them into going home to shower & check on things.they weren’t gone 15 mins. My dad passed.
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BK Books replied:
Hi Monica, thank you for sharing your experience. It is interesting to me how much control we have in our dying process. Blessings! Barbara

Judy Smith

Is the death process very different if a person is killed by I.C.E.? For then it would be sudden and the person would not have the ability to sort through thoughts and see landscapes. Are those who die in battle ever calm in the after life?
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BK Books replied:
Hi Judy, those killed by ICE, or any other way that death is immediate, do not follow any of the “rules” of dying. A person is literally alive one moment and dead the next (normal activity then dead). BUT if a person is dying, even if it is sudden death, and the person is not immediately dead, they will show the signs of approaching death in those minutes between breathing and heart beating and death. Those changes will be in breathing patterns, lack of awareness, and non-responsiveness. About how a person dying a sudden death will be in the afterlife——I don’t know. Thank you for your questions and blessing. Barbara

Is the death process very different if a person is killed by I.C.E.? For then it would be sudden and the person would not have the ability to sort through thoughts and see landscapes. Are those who die in battle ever calm in the after life?
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BK Books replied:
Hi Judy, those killed by ICE, or any other way that death is immediate, do not follow any of the “rules” of dying. A person is literally alive one moment and dead the next (normal activity then dead). BUT if a person is dying, even if it is sudden death, and the person is not immediately dead, they will show the signs of approaching death in those minutes between breathing and heart beating and death. Those changes will be in breathing patterns, lack of awareness, and non-responsiveness. About how a person dying a sudden death will be in the afterlife——I don’t know. Thank you for your questions and blessing. Barbara

Patty Latz

I have seen that a dying person can hear to the end of their life. I was volunteering for the Provincetown AIDS Support Group in the late "80"s sitting with my friend Richard C., who had been in a coma for 2days and seemed so agitated. The medical staff and I were trying to figure out what he was needing to feel more at peace and to be able to let go. We remembered he had been married and had a son that were not in his life for over 12 years. Noone had met them. Looking back on his paperwork we found her name and got a phone number that we had no idea if it was up to date. I called her and she answered and I explained what was going on and asked her if she would be willing to talk with Richard and tell him it was OK to let go or whatever she wanted to say to him. We both took long breaths and she wanted to know a little of Richard’s story. Amazingly, she graciously agreed to talk to him. I told Richard she was on the phone and put the phone to his ear. Almost instantly his body loosened and he smiled and in no more than 3 minutes he died. An amazing, tear filled goodbye for all.
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BK Books replied:
Patty, it is the many experiences like you just described that taught me we have limited control over the time that we die. Thank you for sharing. Barbara

I have seen that a dying person can hear to the end of their life. I was volunteering for the Provincetown AIDS Support Group in the late "80"s sitting with my friend Richard C., who had been in a coma for 2days and seemed so agitated. The medical staff and I were trying to figure out what he was needing to feel more at peace and to be able to let go. We remembered he had been married and had a son that were not in his life for over 12 years. Noone had met them. Looking back on his paperwork we found her name and got a phone number that we had no idea if it was up to date. I called her and she answered and I explained what was going on and asked her if she would be willing to talk with Richard and tell him it was OK to let go or whatever she wanted to say to him. We both took long breaths and she wanted to know a little of Richard’s story. Amazingly, she graciously agreed to talk to him. I told Richard she was on the phone and put the phone to his ear. Almost instantly his body loosened and he smiled and in no more than 3 minutes he died. An amazing, tear filled goodbye for all.
———
BK Books replied:
Patty, it is the many experiences like you just described that taught me we have limited control over the time that we die. Thank you for sharing. Barbara

Traci Eaton

If the person who has been holding court over the death bed is not a person of good will to the patient perhaps the patient is protecting his or her self from any more annoyance. i can think of a few folks who I would like not to have in the room with me for my last moment on earth.
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BK Books replied:
Yes, Traci I think we can die to avoid others presence in the same manner we can die to protect someone. Blessings! Barbara

If the person who has been holding court over the death bed is not a person of good will to the patient perhaps the patient is protecting his or her self from any more annoyance. i can think of a few folks who I would like not to have in the room with me for my last moment on earth.
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BK Books replied:
Yes, Traci I think we can die to avoid others presence in the same manner we can die to protect someone. Blessings! Barbara

Ann Pitman

When doing my required CPE course in seminary, I was with a number of families who said they couldn’t understand why their loved one was still here. I would ask if there was someone they needed to see before they died, or an important birthday or anniversary coming up that they wanted to be here for. Invariably there was.

Another family, 8 members, literally camped out on the floor in the hospital room their loved one was dying in. For 5 days, There was ALWAYS someone in the room with her, until once when they had all stepped out of the room. In the 5 minutes they were out of her room, she died. They were all upset that “she died alone.” I explained that there are some people who prefer to die alone, a concept they had never considered.

My family has experienced several sudden deaths of both elderly and mid life. While it has always come as a shock, family members all agreed we would prefer to go that way than to have a prolonged, painful death.

When doing my required CPE course in seminary, I was with a number of families who said they couldn’t understand why their loved one was still here. I would ask if there was someone they needed to see before they died, or an important birthday or anniversary coming up that they wanted to be here for. Invariably there was.

Another family, 8 members, literally camped out on the floor in the hospital room their loved one was dying in. For 5 days, There was ALWAYS someone in the room with her, until once when they had all stepped out of the room. In the 5 minutes they were out of her room, she died. They were all upset that “she died alone.” I explained that there are some people who prefer to die alone, a concept they had never considered.

My family has experienced several sudden deaths of both elderly and mid life. While it has always come as a shock, family members all agreed we would prefer to go that way than to have a prolonged, painful death.

Steve Reddy

Great article. As a hospice chaplain I have seen people hang on for weddings, births, visits from estranged family members etc. I have also seen patients who seemed to be doing fairly well and they announce to me “ I’ve had enough and I’m ready to go”. We always have a conversation about this as it is truly a pivotal moment in a persons life. I have had them say, oh maybe tonight, maybe next week, etc. Guess what? They are usually right!!

Great article. As a hospice chaplain I have seen people hang on for weddings, births, visits from estranged family members etc. I have also seen patients who seemed to be doing fairly well and they announce to me “ I’ve had enough and I’m ready to go”. We always have a conversation about this as it is truly a pivotal moment in a persons life. I have had them say, oh maybe tonight, maybe next week, etc. Guess what? They are usually right!!

Pam Michael

I can guarantee that people hear right up until the moment they take their last breath. I saw that at bedside with my own mother, long before I was a nurse. My brother and I were sitting next to her bed, holding hands and picking on each other as brothers and sisters do. We looked over and Mom was smiling underneath her oxygen mask. She had not been responsive to anything for at least 12 hours at that point. But she heard us and was probably laughing her butt off internally at how we were still going at it decades later!
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BK Books replied:
Hi Pam, thanks for sharing. I think sometimes it takes a personal experience for us to truly know something. Blessings to you and your brother. Barbara

I can guarantee that people hear right up until the moment they take their last breath. I saw that at bedside with my own mother, long before I was a nurse. My brother and I were sitting next to her bed, holding hands and picking on each other as brothers and sisters do. We looked over and Mom was smiling underneath her oxygen mask. She had not been responsive to anything for at least 12 hours at that point. But she heard us and was probably laughing her butt off internally at how we were still going at it decades later!
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BK Books replied:
Hi Pam, thanks for sharing. I think sometimes it takes a personal experience for us to truly know something. Blessings to you and your brother. Barbara

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