I’m sharing a little here about the active dying process, especially some of the physical signs that can be alarming, even though they are often common and a natural part of the sometimes laborious act of leaving the physical body.
My hope is to bring awareness to what this stage can look like, so people tending to loved ones have a clearer sense of what’s happening and feel less alone or afraid.
When you’re caring for someone you love, changes in breathing, appetite, or responsiveness can be unsettling. This is rarely talked about, yet deeply important to understand.
For some, the process is long and drawn out. For others, it unfolds quickly. Each journey is individual, and it’s often said that we die as we have lived.
Above all, it’s important to remember that death is not a medical emergency.
As Ram Dass said, “Death is absolutely safe. It’s like taking off a tight shoe.”
One to three months prior to death
Withdrawal
During this time, a person may begin to withdraw from the world around them. There is often a growing awareness the end is near, and with that comes the beginning of separation from this world and the journey back into oneself.
Interest lessen in things that once mattered deeply —and sometimes even in the people they love most. What we mistakenly experience as rejection is often a deep withdrawal—a necessary turning inward as an important inner journey begins.
Much of this period is spent in deep inner sorting and reflection, as a person reviews and evaluates their life. This is work that often can only be done alone.
It may look like increased sleep: extra naps, more time asleep than awake. This “sleep state” is often a space of very deep inner work.
It’s important to allow and support this rest. The work happening beneath the surface is meaningful and necessary — part of the process of closing the circle of a life.
Decreased interest in Food
A decrease in food intake. Liquids are preferred to solids foods. Or not eating at all.
Hypersensitivity
As the veil begins to thin, a persons sensitivity can significantly increase. In particular sounds, smell and physical touch. What was once comforting and welcome can become completely overwhelming. Loud sounds, unnecessary conversations in the persons presence, fragrances (even essential oils) and physical touch can become unbearable.
Bed sores
Also known as pressure ulcers or pressure injuries are wounds caused by prolonged pressure on fragile skin that cuts off blood flow. As the healing mechanisms shut down bedsores can occur within a few days. Common on the tailbone, Hips, Heels, Ankles, Elbows, Shoulder blades. Bedsores can occur despite proper turning ( regularly shifting the body’s position), padding, and nursing care. Their appearance is not automatically neglect. Professional wound cleaning to avoid infection, pain medication and gentle repositioning are recommended.
End-of-life skin breakdown can be a very difficult for families to witness. This is a natural occurrence and not a reflection of poor care or neglect.
1 - 2 weeks before death
Disorientation
During this time, a person may be disoriented and sleep most of the day. There is often a sense of having one foot in this world and one elsewhere, which can come with a sense of confusion and disorientation. A gradual loosening of their grounding in the physical world
They may speak of seeing or talking with loved ones who have already died.
There can also be increased restlessness or agitation.
Physical changes
Blood pressure often lowers, and the pulse may become significantly faster or slower than usual. Body temperature can fluctuate between feeling warm or feverish and feeling cold. Increased perspiration or feeling clammy is common.
Skin color may change, appearing flushed or bluish. The hands, feet, and nail beds often become pale or bluish as the heart is no longer circulating blood as effectively.
Breathing changes
Normal breathing is about 16 to 20 breaths per min. As death approaches, breathing may become much faster or much slower — sometimes increasing to 40–50 breaths per min, or slowing to as few as 6 breaths per min. Often shifting between rapid breaths and long pauses.
Fluid can collect in the lungs and throat, creating a rattling sound when the person breathes. This can sound very alarming to those nearby. Coughing but be unable to clear the fluid. These sounds can be distressing, but they don’t usually mean the person is suffering.
One to two days to hours prior to death
Energy surge
There can be a surge of energy. A person may suddenly seem more alert, speak clearly, or appear more engaged after a period of disorientation. They seem as though they are improving. This is when the spiritual energy strengthens for them to make the transition from this world to the next. And it often occurs very close to before they pass.
Other occurrences
- Further restlessness and discomfort due to lack of oxygen in the blood.
- Congestion can become very loud.
- Eyes may be semi-open but not seeing and appear glassy or tearing.
- The hands and feet become purple. The knees, ankles, and elbows appear blotchy.
- The person may become non-responsive. The person may become non-responsive.
- What seems like the final breath is often followed by one or two more long, spaced-out breaths before the body fully lets go.
It’s also common for people to die when they are alone, after others have left the room. Final letting go and full surrender that can often only be done in the privacy of their own heart.
I hope that this information is supportive. If you have any questions, please feel free to reach out to me directly.