When thinking about how to define the stages of death, I was surprised to discover that one of the major search words on Google for end of life issues is “stages of death”. Surprised because dead is dead. Well, you can get into brain dead and clinically dead but I don’t think that is what people are searching for. I think they want answers to the stages of dying, the signs of approaching death. They just don’t know the verbiage to use to find the answers they are searching for. Elizabeth Kubler-Ross coined the term “stages of grief” and that kind of morphed into “stages of death”.
What are the “stages of dying” or better described as signs of approaching death? First, there are only two ways to die–fast or gradual. Fast dying is getting hit by a car, a heart attack, even suicide. A person is alive one minute and dead the next.
We can die gradually two ways. We just get old and our body wears out or we get a life threatening illness, disease, and die gradually that way.
Gradual death has a process to it with signs that indicate death is approaching. These signs begin two to four months before death actually happens.
It doesn’t really matter what the disease is or how long a person has had a disease. When the disease reaches a place where it is stronger than the physical body, when the illness is interfering with the normal functioning of the body, the body will start shutting down, preparing itself to die.
There are three key areas to watch for the signs of approaching death: Eating, sleeping and withdrawing. These signals begin months before death from disease arrives and years before death in someone who is old with no disease. Gradually a person eats less and less, begins sleeping more and more and slowly withdraws physically and emotionally from the activities that make up a life.
As death continues to approach a person reaches a place where they are eating almost nothing, sleeping most of the time and have withdrawn into themselves. They may become confused as they sleep more, confusing reality with dreams.
Weeks before death a person’s breathing changes, blood pressure lowers, coloring becomes bluish. They sleep with their eyes partially open and are often restless, picking at their clothes and bed linens.
Most people are what we call non responsive in the hours to minutes before death. We generally sleep through our final experience.
This blog post has been very brief as to the signs of approaching death, a brief description of what a person dying normally will experience. My booklet “Gone From My Sight” (“The Little Blue Book”) and the DVD kit “New Rules For End of Life Care” offer more detailed information on what to expect.
Remember, humans and animals have died normally forever. The process has never changed. It is what our bodies do. There has always been the normal, natural way that death approaches. How we attend to the dying is what has changed — over and over again.