We are born, we experience, and then we die. That is how the “game” of life works. If it is a guarantee of life that living will at some point end, why do we have such a challenge coming to terms with a terminal diagnosis?
Yes, medical advances have been amazing in curing and healing, BUT death will still come at some point.
There are two ways to die. Fast is one way, where you have a heart attack or a stroke or you're hit by a truck. The body is alive one minute and dead the next. There is no process here. It is immediate. There are no signs, no warnings. A person is literally alive one minute and dead (for whatever reason) the next.
When death is not immediate, it will arrive gradually; and this is the other way we die. There will be signs, movements, bodily functions and changes that signal death is approaching. The unfolding of this process can give us a timeline— not a specific timeline, but a generalized one.
The timeline measures the months, weeks, days, and hours until death. When we know what to look for, we can “guesstimate” when death will occur.
“Guesstimate” is the important word here. There are factors that affect how this pattern unfolds. We die according to our individual personality. How we have dealt with living our life is how we will deal with the challenge of dying. We also have limited control over the time that we die. Not complete or indefinite control, but some.
Why did I write this? I think if we remember that all life ends at some point we can make better decisions about the timeliness of stopping treatment. And hopefully we will appreciate each day a little bit more.
Something More about… Why Knowing the Dying Process Can Change How We Live
Don’t wait until you’re overwhelmed. Get the Approaching Death Support Kit—Barbara’s comprehensive set of end-of-life resources for families. It includes practical guides, clear explanations of the signs of dying, and compassionate support for families and caregivers. If someone you love is nearing the end of life, this kit gives you the knowledge and confidence to navigate the final months, weeks, and days with peace, presence, and understanding.
5 comments
Jennifer
These stories are familiar to me – I am a surgeon of 30yrs now moving into Palliative Medicine. I have seen the lack of forthright discussions which leads to extended suffering. Hope is always important but I think some doctors use it to escape the hard conversations. We need more honesty in medicine. I actually think Palliative Medicine has been and should always be part of our ‘care’ of patients. Somehow it dropped off the radar for a lot of doctors. My hunch is that it takes a lot of time to have heartfelt conversations and a lot of doctors do not have that kind of time in a day. We can correct this. Doctors and patients need to have more complex conversations. Doctors not being afraid to discuss the difficult…patients not being afraid to ask the difficult questions.
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BK Books replied:
Oh Jennifer, yes, yes yes. I am with you 100%. Blessings to you in the work you are doing.Barbara
These stories are familiar to me – I am a surgeon of 30yrs now moving into Palliative Medicine. I have seen the lack of forthright discussions which leads to extended suffering. Hope is always important but I think some doctors use it to escape the hard conversations. We need more honesty in medicine. I actually think Palliative Medicine has been and should always be part of our ‘care’ of patients. Somehow it dropped off the radar for a lot of doctors. My hunch is that it takes a lot of time to have heartfelt conversations and a lot of doctors do not have that kind of time in a day. We can correct this. Doctors and patients need to have more complex conversations. Doctors not being afraid to discuss the difficult…patients not being afraid to ask the difficult questions.
———
BK Books replied:
Oh Jennifer, yes, yes yes. I am with you 100%. Blessings to you in the work you are doing.Barbara
Kim
Hi Barbara,
I have followed your writings for several years and have learned so much from you. I sent you a message after your husband passed and you responded.
Even though I have read numerous blogs about dieing, I don’t recall if anyone has asked this question…
My mom is 84 and our family has noticed a decline with her memory over the past year. It’s been a slow process, but over Thanksgiving, it was apparent something had changed. I’ve had the conversation with my father about my mom. They have been married for 63 years. My father just turned 89 and he’s having mobility issues. I have stepped in and have discussed with my father that I will have the “conversation” with my mom regarding her memory and that we are going to begin the process of tests to find out if she has dementia or alzheimer’s. We think it may dementia because no one in our family has ever had alzheimer’s. My question is this…my mom does not think she’s having any memory issues and says “she’s fine”. How do I begin the conversation to let her know we are concerned and want to begin taking steps to see if it’s possible the slow the progression with medication. I am close to my mom and it’s going to be difficult to talk to her about this. Do you have any suggestions? Thank you. Kim kcpa106@yahoo.com
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BK Books replied:
Hi Kim, I’d say to your mom what you’ve just said to me. “We’re concerned about you and want to have some tests done. If there is a problem we can begin to address it. If the test shows no problem, look how reassuring that will be. We lose nothing by having tests done and gain a lot if they show a problem”. You can’t force her to do anything and if her reasoning is becoming affected you can always speak to her physician to recommend testing. Blessings to you and your family during this challenging time. Barbara
Hi Barbara,
I have followed your writings for several years and have learned so much from you. I sent you a message after your husband passed and you responded.
Even though I have read numerous blogs about dieing, I don’t recall if anyone has asked this question…
My mom is 84 and our family has noticed a decline with her memory over the past year. It’s been a slow process, but over Thanksgiving, it was apparent something had changed. I’ve had the conversation with my father about my mom. They have been married for 63 years. My father just turned 89 and he’s having mobility issues. I have stepped in and have discussed with my father that I will have the “conversation” with my mom regarding her memory and that we are going to begin the process of tests to find out if she has dementia or alzheimer’s. We think it may dementia because no one in our family has ever had alzheimer’s. My question is this…my mom does not think she’s having any memory issues and says “she’s fine”. How do I begin the conversation to let her know we are concerned and want to begin taking steps to see if it’s possible the slow the progression with medication. I am close to my mom and it’s going to be difficult to talk to her about this. Do you have any suggestions? Thank you. Kim kcpa106@yahoo.com
———
BK Books replied:
Hi Kim, I’d say to your mom what you’ve just said to me. “We’re concerned about you and want to have some tests done. If there is a problem we can begin to address it. If the test shows no problem, look how reassuring that will be. We lose nothing by having tests done and gain a lot if they show a problem”. You can’t force her to do anything and if her reasoning is becoming affected you can always speak to her physician to recommend testing. Blessings to you and your family during this challenging time. Barbara
Robert Meadows
My wife’s journey really began with a broken hip. After surgery and rehab, memory and mobility issues were more frequent. More falls and 911 calls to get her to her feet and trips to the er because he had hit her head. On the last trip to the er she was admitted for a scan of her brain and a vicious uti. On a Saturday she told me, I don’t want any more blood sticks, no more iv’s and I want to go home. And by home I knew she meant heaven. It was a little scary but we had an honest conversation and I knew exactly what she wanted. My wife was a nurse and we had experience with hospice in our home taking care of her son some years before. On Sunday morning i asked her about her decision to go on hospice service and she was firmly committed. Thus began our odyssey with copd and dimentia. I was holding her hand as she took her last breath and it was truly a sacred moment. Our hospice service had prepared us for the last days. I am so grateful. The Little Blue Book prepared me for her death. Thank you.
Take advantage of your clergy, they were a part of our journey and understand the situation.
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BK Books replied:
Hi Robert, thank you for sharing your wife’s final time with me. How blessed you were to have the support and guidance Hospice brought you. Blessings! Barbara
My wife’s journey really began with a broken hip. After surgery and rehab, memory and mobility issues were more frequent. More falls and 911 calls to get her to her feet and trips to the er because he had hit her head. On the last trip to the er she was admitted for a scan of her brain and a vicious uti. On a Saturday she told me, I don’t want any more blood sticks, no more iv’s and I want to go home. And by home I knew she meant heaven. It was a little scary but we had an honest conversation and I knew exactly what she wanted. My wife was a nurse and we had experience with hospice in our home taking care of her son some years before. On Sunday morning i asked her about her decision to go on hospice service and she was firmly committed. Thus began our odyssey with copd and dimentia. I was holding her hand as she took her last breath and it was truly a sacred moment. Our hospice service had prepared us for the last days. I am so grateful. The Little Blue Book prepared me for her death. Thank you.
Take advantage of your clergy, they were a part of our journey and understand the situation.
———
BK Books replied:
Hi Robert, thank you for sharing your wife’s final time with me. How blessed you were to have the support and guidance Hospice brought you. Blessings! Barbara
Maryannchappelle
In 1979, my husband was at a company dinner when he was an innocent victim of a crime. He became a quadriplegic that night. I took care of him for 34 years before he died. I know exactly what this lady is talking about. All the inept staff, lack of support, trips to the ER. Bless you and thank you for sharing your journey.
experience.
Maryann Chappelle
PS. I would love to connect with the author of the above. I’ve found talking with others helps me more than anything. Can you share her email?
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BK Books replied:
Hi Maryann, thank you for your comment. You can contact me via email at barbara@bkbooks.com. Blessings! Barbara
In 1979, my husband was at a company dinner when he was an innocent victim of a crime. He became a quadriplegic that night. I took care of him for 34 years before he died. I know exactly what this lady is talking about. All the inept staff, lack of support, trips to the ER. Bless you and thank you for sharing your journey.
experience.
Maryann Chappelle
PS. I would love to connect with the author of the above. I’ve found talking with others helps me more than anything. Can you share her email?
———
BK Books replied:
Hi Maryann, thank you for your comment. You can contact me via email at barbara@bkbooks.com. Blessings! Barbara
Amy
Wish I had known about dying. After 20 years of Caregiving for my husband with Multiple Myeloma, his last 6 months was the worst. In and out of the ER almost every month. His health seemed to be declining yet he was still getting chemotherapy for both MM and a new diagnosis of Lymphoma. His Palliative Care person could only meet every 3 months and was always on her way on vacation and never said, Gary, you are dying or Amy, you need to begin hospice. His Onc wouldn’t do a televised visit as Gary was having trouble walking and never said he was dying. He just stopped seeing us. The last visit to the ER he was diagnosed with cellulitis and they told him he would be admitted and after lying in the ER for 13 hours on fluids and a dose of vancomycin, Oncology sent down a Resident to tell me he had to go home they weren’t going too admit him. Never said he was dying. He had huge canker sores in his mouth and was weak. Said the Doc wasn’t going to visit and I had no choice but to bring him home. It was when I took him to is PCP the next day, she was upset seeing the condition he was in and I asked her if he was dying and she told me to take him home and call hospice and have them come right away. He is dying she said. No one told you? Nope. Out of all the 20 years of care, chemotherapy, emergency surgery for infected ports, a SDH, and 2 transplants, this was the most horrific trauma I suffered. After being in Hospice for 3 days he looked at me and asked me if he was dying. I was the one who had to tell him. And the following week he died. A very peaceful death and seeing the peace on his face after all those years of pain and struggle was a blessing.
———
BK Books replied:
Oh Amy, I am so sorry for all the lack of direction and honesty you and your husband received during the course of his illness. Your experience is all too frequent. I think it is the result of our medical model treating diseases people have instead of people that have diseases. Quality of life, kindness, honesty often gets lost in the pursuit of treatment. Blessings! Barbara
Wish I had known about dying. After 20 years of Caregiving for my husband with Multiple Myeloma, his last 6 months was the worst. In and out of the ER almost every month. His health seemed to be declining yet he was still getting chemotherapy for both MM and a new diagnosis of Lymphoma. His Palliative Care person could only meet every 3 months and was always on her way on vacation and never said, Gary, you are dying or Amy, you need to begin hospice. His Onc wouldn’t do a televised visit as Gary was having trouble walking and never said he was dying. He just stopped seeing us. The last visit to the ER he was diagnosed with cellulitis and they told him he would be admitted and after lying in the ER for 13 hours on fluids and a dose of vancomycin, Oncology sent down a Resident to tell me he had to go home they weren’t going too admit him. Never said he was dying. He had huge canker sores in his mouth and was weak. Said the Doc wasn’t going to visit and I had no choice but to bring him home. It was when I took him to is PCP the next day, she was upset seeing the condition he was in and I asked her if he was dying and she told me to take him home and call hospice and have them come right away. He is dying she said. No one told you? Nope. Out of all the 20 years of care, chemotherapy, emergency surgery for infected ports, a SDH, and 2 transplants, this was the most horrific trauma I suffered. After being in Hospice for 3 days he looked at me and asked me if he was dying. I was the one who had to tell him. And the following week he died. A very peaceful death and seeing the peace on his face after all those years of pain and struggle was a blessing.
———
BK Books replied:
Oh Amy, I am so sorry for all the lack of direction and honesty you and your husband received during the course of his illness. Your experience is all too frequent. I think it is the result of our medical model treating diseases people have instead of people that have diseases. Quality of life, kindness, honesty often gets lost in the pursuit of treatment. Blessings! Barbara