I recently received a question from “What would you like me to write about?”. The question was: For 20 years I have been asking for a slightly more technical explanation of dying to help social workers and chaplains who are often asked by families. I would like it to be more than just organ and system shutdown. More detailed, but without getting bogged down in micro-information like the cellular level.
My answer is: From a ‘why the body is shutting down’ standpoint I will say it depends upon the particular disease that is invading the body and preventing it from functioning normally. There is no generalized one answer fits all answer to the physiology of approaching death.
For social workers and chaplains the question I think more important is what does approaching death look like? When social workers and chaplains know the signs of approaching death that occur months before death from disease and years before death from old age they can better guide and support the patient and family during this process.
The three areas to assess and evaluate for approaching death are food and fluid intake, the amount and progression of sleep and interest in environment and sociability.
The Final Act of Living provides detailed explanations of the signs of approaching death. It is used by agencies through out the country as a textbook, without medicalese, for the staff that are dealing with end of life care. The booklet Gone From My Sight, guidance for family and significant others, is written in a short, simple, direct yet gentle manner.