I was talking with Richard and Bill on their The Healing Power of Grief Radio Show yesterday about how and when to talk about dying and death. We Americans don’t talk about dying and approaching death when we NEED to talk about it (doctors hesitate to tell patients they can’t be fixed, families hesitate to talk with a loved one about the possibility of dying and approaching death). 

If we can’t talk about dying when it is paramount to do so how can we expect people to talk about dying and death, to make plans for their own death, BEFORE they need to? We are such a death denying society. We believe other people die, but not me or anyone close to me.

YET, and I purposely put yet in capitals, we are all going to die someday. Our bodies are programmed to die. It is how we are made. We are born, we experience, and then we die. Nothing lives forever. From the time we came into being the physical body was made to die. There is a process to the body dying, that has not changed EVER. How we as individuals and societies deal with the body dying has changed over the eons and will continue to change.

Basic dying 101: there are only two ways to die, gradual or fast. Fast is a heart attack, accident, suicide. A person is alive one minute and dead the next (or within days and hours. Covid seems to be fitting into that category).

Gradual death has a process to it. It doesn’t just happen. The process is the same for both old age and disease, but with old age the timeline is different. In this article I'm going to talk about the dying process and timeline from the disease perspective, from when the disease begins robbing the body of its ability to function and eventually the body dies. 

The dying process basically has stages to it that begin months before actual death occurs. We can address the stages as months, weeks, and days/hours. 

Looking at a few guidelines you can determine if a person has entered the dying process. Important to note: just because a person has a life threatening illness does not mean they have entered the dying process.

Months before death changes begin in eating, sleeping and social interactions. Weeks before death changes occur to alertness, ability to interact, breathing, and eyes are generally partially open while sleeping. Days to hours further changes in breathing, body coloring, and blood pressure occur. The person is now non responsive. (All of this is more detailed in my booklet, Gone From My Sight.)

In the days to hours before death, even an unplanned-for death, the signs of the process for days and hours kicks in and you see the process unfolding.

Now, back to why I started this blog: if we would educate ourselves before we need the information, before someone we care about is dying, before we are faced with a life threatening illness, or before someone we care about dies a fast death we will have “tools” to guide and support us through one of the most challenging experiences of our lives ——the dying and eventual death of someone we care about and even our own dying.

Knowledge reduces fear. Knowledge allows us to approach an experience with information. Knowledge supports us, keeps us from, or at least reduces, our floundering.  

Contrary to superstitions many of us carry, knowledge does not make something happen sooner and lack of knowledge does not keep something from happening. However, knowledge does make an experience just a tad gentler to live through.

Something More... about We Are Born, We Experience, and Then We Die

In my book, The Final Act of Living, Reflections of A Hospice Nurse, you will not only read about experiences I have had in my 40 plus years caring for the dying. There is a chapter that goes over advance directives.