Becoming an End-of-Life Companion, Part 9: The Process of Dying

Our next training session covered the biological process of dying, a topic that terrifies a lot of people, which is why I was surprised to leave feeling so calm. Learning how dying actually works turned out to be strangely reassuring.

Here's what I took away.

❧ Our bodies know how to die
Dying is a biological process that doesn't need any guidance. Our bodies know how to do it, the same way a woman's body knows how to give birth. And like birth, once dying has begun, it can't be stopped.

❧ Don't disturb the process
Because there's an inherent logic to dying, it's important not to interfere with it, and to trust it instead. At some point, a dying person will stop eating or drinking, for example, and that's simply part of the process. As the body dries out, the brain releases morphine-like substances that help relieve pain. That natural response won't kick in if the body is kept hydrated through IV fluids, but the person will still die, just with more pain.

❧ We die in small steps
Our bodies don't die all at once, but gradually, piece by piece. The process usually starts with the heart, then the brain, then the other organs follow, one by one. A man's sperm, for instance, remains alive for up to three days after his heart has stopped beating.

❧ Who is really uncomfortable here?
During the dying process, a person might show symptoms that look like distress, the so-called "death rattle," restless movements, or vocalizing. But these symptoms aren't necessarily uncomfortable for the person experiencing them, and may even be part of their own process of letting go. It's important that families understand this, so they don't push the medical team for interventions simply because they, the family, find the sounds of a natural dying process hard to witness.

❧ Most people don't need special care
I was surprised to hear that, in our trainer's experience, around 90 percent of people don't need any special medical intervention while dying. Most people have a fairly gentle death.

❧ Can you miss your own death?
It seems like you can. Studies on brain activity in dying people suggest that those who die in their sleep may not actually be aware that they're dying. Which raises an interesting question: would you rather witness your own death, or die without ever knowing it happened?

I always assumed dying in my sleep was the best way to go. Now I'm starting to wonder if that might mean missing out on something extraordinary. If I ever get to choose, I think I'd want to be fully present when death arrives.

What about you? Would you rather be conscious while you're dying, or slip away in your sleep?