The Silent Scream, Grimaces, and Scary Faces As We Die... Why?

Dear Barbara, I can’t get mom’s last minutes out of my head. Just before she died it was like nothing of this earth. It was like she was possessed, a silent scream, totally distorted facially. Have you seen this horror before?

What you described had to be scary for you. Yes, I have seen facial expression changes in the moments before death. Scary faces, grimaces, silent screams. What do I think it is? Here are my thoughts:

There is a labor to dying. It is hard work for us to get out of our body (some harder than others). Think of the little chick that works, struggles to get out of its shell. As we, humans, are dying we are working, struggling also to get out of our bodies. We, the watchers, see the hard work and don't know how to interpret it. As someone who has seen a lot of dying moments I see that struggle as often intense and unexplainable.

I don't think anything bad is happening. Those facial expressions and movements can be ugly and disconcerting but you were witnessing the final release, the final attachment to the physical being let go.

I don't want you to carry that image as something bad. I want you to understand it was optics we can't explain, distortions of the body as it was releasing its hold on this earth.

I can only say from having been at the bedside of hundreds of people that your mother's facial expression was not unusual. I describe it in my booklet Gone From My Sight or my book The Final Act of Living as a grimace or a frown. More detailed descriptions of faces I've seen could be a silent scream, or facial distortions that a Hollywood producer could use in a horror film.

The other side is I have seen smiles, beautiful, peaceful faces. What I learned from seeing all the various moments of death is it doesn't matter what they look like or why. What we are watching is a struggle to end this life connection, to get out of our physical shell. It's like childbirth in reverse. For some the baby just pops out, for other's, mom has to scream and push for hours.

I do not believe your mother would want you to be concentrating on her last moments and forgetting the good moments of her life. Here is an exercise for you: every day write down one good, beautiful, meaningful memory you have from the many years with your mom.

I don’t want that memory of your mom to overshadow all the good.

I assure you nothing bad or evil or even unusual was happening.

Something More... about The Silent Scream, Grimaces, and Scary Faces As We Die... Why?

I wish that more families were educated on what the dying process looks like and what to expect. More patients and families would experience a sacred death. Their grieving would be normal and not complicated. If you are not offered end of life education, ask for it.

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Bridget McGowan

My husband passed away April 3, 2022
Eight days ago. He suffered for 3 years after diagnosis. Congestive Heart Failure, Pulmonary Fibrosis. I was his caregiver. He had been on hospice 6 days. Was in and out of the hospital Feb. and March. Came home March 28 to be put on hospice. Our adult daughter came to help me Wednesday before he passed. That morning his breathing was different. He was on high flow oxygen 24/7. But that morning it was different. I told him I was going to check his blood sugar, which I did and he did not need a shot. I told him no shot honey. He wasn’t very responsive. He did say he needed to pee with urgency in his voice. I put the urinal there but he couldn’t I asked his daughter to help me, she couldn’t get him to go either. I called the nurse and told of his urgency and the breathing when I hear our daughter yell for me. I ran into the room seeing him raising his head with that grimace face that you speak of. Then all of a sudden a calmness came over his face he laid it back on the pillow. I whispered in his ear, my darling it’s ok you can go, go with it. I put my head to his chest to hear heart beat I heard one beat then silence. It all stopped. Everything stopped.
I take comfort in your words up there and I thank you. 💔

BK Books replied:
Hi Bridget, thank you for sharing your husband’s experience with us. Once we know that a facial expression of some sort is what most people do just before they take their last breath, then we can let go of the idea that something pathological happened. Blessings! Barbara

Penny Hope

Hello Barbara – thank you for this space. I have been looking through the internet for answers and finally found you. Thank goodness for you sharing this information. My dad just died last night after a long struggle with Alzheimer’s disease. My mom and I were there when he finally, finally was able to go. He had a very bizarre, lower jaw snap up into a strange grinning grimace, took another breath, had another grimace and was gone. He had a slow, very long journey and for him to have died was a relief for him I am sure. Thank you for sharing that this is all about the struggle to leave the body/shell behind. Thank you so very much.
BK Books replied:
Penny, thank you for sharing your father’s last moments with me. It sounds
like he did just what he needed to do to get out of his body. You might
write him a letter and put everything your heart and tears want to tell
him, burn the letter and scatter the ashes to the wind. Blessings to you
and your family. Barbara


My 34 year old son passed in his sleep alone from effects of hemochromatosis. His heart was extremely enlarged. It haunts me that I was not by his side. He kept the extent of his illness from us. We were on vacation and his friends were going to visit for several days while we were gone. They were unable to come. Had I known, I would have come home because I knew he had an injured leg. He had lost weight but would always say he was watching his diet. He had been overweight and I didn’t want to discourage him if he wished to lose weight. But, we believe the facts are he knew what was happening. He knew his time was short. He did not tell anyone- not a friend, family. No one. He suffered in silence for over 2 years. This is all causing a lot of problems for me. I live with extreme guilt. What is passing like when it happens during sleep. I am so afraid that he was frightened or felt abandoned. The pain of grief is debilitating. I miss my son so much.
BK Books replied:
Dale, I am so sorry for the anguish you are experiencing. Here are my thoughts: I really don’t know what happens when you die in your sleep. My guess is you are having a dream, your heart stops and you are dead. I know that most people will tell you they would like to just go to sleep and not wake up (it skips the hard part of the labor to get out of the body). People die according to their personality. By not sharing his illness with you your son was protecting you and his family from his challenges. Was that part of his personality pattern? You might write your son a letter. Put all of your thoughts, concerns, regrets, “I wish I had”, tears, on paper. Everything you would say if you could then burn the letter and scatter the ashes to the wind . Let go of the weight of guilt that you are carrying and let how well you live your live now be your gift to your son. If you would like to correspond with me further use my personal email barbara@bkbooks. com. Blessings! Barbara


Hi. My Dad passed two days ago after a vicious battle with cancer. He was 59. He passed surrounded by his parents, his wife, his daughters, his beloved dog, and his brothers. I came to the internet looking for answers and I’m thankful to have found you. We held vigil for days.. knowing it was coming, but I was unprepared for what happened. After being unresponsive for several hours, he shot up in bed screaming. Blood curdling screams. He was pushing at the air around him and kept repeating “I can’t go. I can’t go” followed by more screaming. This lasted for about a minute before he fell back, took a final breath, and passed away. I’ve never witnessed death, and I dont know if that was normal. I hate that its the last memory I have of him.
BK Books replied:
Hi Alyssa, The last minutes before death give so many of us memories that last forever, memories of behaviour we don’t understand. We want explanations of what did the behavior mean, what was happening, did it hurt, why, why, why. Here are some things to think about, not answers but just food for thought:  for some of us it is hard work to get out of our body; for all of us what we are experiencing is like a dream, distorted, unclear; for most of us there is a struggle to free ourselves from the shell of a body  (think little chick, think labor); we die according to our personality and have limited control over the time that we die; generally what is spoken as we leave our bodies does not make sense to us the listeners; we, the watchers, will never get answers to the questions we ask as to the why’s of someone we watched die, why they did the things they did.  What we can do is write them a letter, write all our concerns and love down on paper, then  burn it and scatter the ashes to the wind. Release the no finding answers to questions and let the life you live going forward be a testament of the love you have for the person that is gone. Blessings! Barbara


Hi Barbara, I to cannot get the vision of my husband’s last breath from my mind, he let out a loud scream & passed away seconds later, he wasn’t ill, it was just a normal morning & he had a heart attack so suddenly & out the blue … I still ask why & how this could be, maybe reading your book will give me the answer I need.
BK Books replied:
Hi Susan, those last moments when a person is freed from our physical connection are shocking, disturbing and frightening for us the watchers. It’s that final push to break free that seems to leave the lasting memory. You might write your husband a letter. Put all the words and thoughts that you would have said if you had known you didn’t have time to say them on paper. Burn the letter and scatter the ashes to the wind. Release what you have been holding inside. My blessings and thoughts are with you. Barbara

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