Dying Awareness

Question: How much is comprehended by the patient as they approach end of life? Do they know who is present, if someone is absent? How does the patient feel knowing that the loved one's spirit is present?

In the hours to minutes before death most people are non-responsive. They do not respond to touch or being talked to. They may be moving about in their bed but they are unaware of what is occurring around them. I do believe, as do many others, that the person can hear. I also believe the person can perceive, on an inner level, what is happening.

I’m going out on a limb here but consider this: we are more than our physical bodies. There is a “driver” to this earthly vehicle we call a body. The driver is not bound to the physical so the driver can perceive what is happening when the body does not. The driver knows who is in the room, who is not. The driver hears all that is being said. The driver understands more of the dynamics of relationships and physical living than the personality that has operated the body.

Now let’s add that the person dying knows that they are dying. For months they have been processing their life, On many levels they have been processing what their life has meant and trying to make sense of it. Now they know there is a very short time left.

Over months they have withdrawn from earthly, every day interests. They have gone inward, disconnected from everyday concerns. Now in the hours before death they are like the little chicken working to get out of it’s shell.

Because this is the time of inwardly processing relationships I suggest that family and significant others present at the bedside spend some alone time with the patient. Even though it appears the patient cannot hear or is unaware, talk to them. Tell them what is in your heart. Talk about the good times and also talk about the challenging times. Remember they are processing their life (who did they touch, what did they do). You can help them put the pieces of their life together.

I’m not sure what the last question, “How does the patient feel knowing that the loved one's spirit is present?” means. I am interpreting it to ask how does the dying person feel seeing loved ones who have already died there with them? First, I have no doubt that those who have died before us come to help us get from this world to the next (another blog article). From the experiences of patient’s telling me about seeing the departed I have gathered that seeing them is a pleasant experience. They are pleased and happy to see them.

I had a person once say to me “You make dying sound so easy and pleasant but I have been on the battlefield. It was not easy or pleasant.”

I can’t imagine a place more frightening than the battlefield, fear must abound everywhere. It is fear that blocks serenity. Imagine the sun as being the peace that comes with finally being free of a cumbersome physical body, of realizing you are more than physical, that you continue in a different way. But there are clouds between you and the sun. Clouds totally blocking out the warmth of the sun. Clouds are the fear we bring to our dying experience. The amount of clouds, of fear, determines how gentle our letting go will be. We die according to our personality. Some of us will go gently, others will fight to the last breath.

Something more about Dying Awareness...

Look at the trailer for my DVD Kit, NEW RULES FOR END OF LIFE CARE, and see if it is something you, your family, your fellow nurses... could use. I talk more fully about how the moments before death will look. Sometimes reading is difficult when a loved one is dying and learning is easier in a film format.


Debra Palmquist

Your blog posts are always so helpful. I first learned of you and your blog after reading your book, “Gone from my Sight” when my Father was dying from Melanoma three years ago. Now my Mother is ill with pancreatic cancer and we are on a new journey with her. Very different experiences. I love what you say about each person brings a life experience/personality to death in a different way. I will hold your words and those of others close as we are walking with Mom.

Claudia Hauri

Again Barbara, thank you for your wise words from your experience as a hospice nurse.

Cate C.

Thank you for the wonderful information you provide. I lost my husband last October to Pancreatic Cancer, and I am the caregiver for my father who has Dementia. I am very interested in learning everything I can about end of life situations.

Cate C.

I am the caregiver

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