Death, a universal certainty, is perceived differently across cultures. While some view it as a celebratory return to ancestors, others remain distanced from it, making the recognition of its signs challenging. The process of dying is unique for each individual, with diverse symptoms and trajectories, even among those suffering from the same illness. Recognizing these signs can help loved ones prepare and provide necessary support during this critical stage.
Common indicators of impending death include increased weakness, reduced mobility, and fluctuating consciousness. Despite the variability in symptoms, one consistent observation is that hearing often remains the last sense to fade. However, societal tendencies to medicalize death can lead to neglecting its social and spiritual dimensions. In recent years, Australia has seen an increase in death literacy, influenced by the COVID-19 pandemic and voluntary assisted dying laws. This shift has prompted more individuals to engage in conversations about death.
“Death literacy is our ‘knowhow’ around death, dying, loss and grief, and how that helps us to plan better and to be prepared for end-of-life and death experiences,” – Noonan
The reluctance to discuss death can result in missed opportunities to provide support and comfort to those nearing the end of life. Families and health professionals often feel pressured to prolong life, which can overshadow the need for quality end-of-life care. Understanding the signs of impending death allows loved ones to better prepare and support the dying person emotionally and spiritually.
“For all of us, information helps reduce the fear of the unknown.” – Noonan
In some cases, individuals experience a final surge of mental clarity or energy before passing. This can be both comforting and confusing for loved ones witnessing these changes. Changes in breathing patterns, such as Cheyne-Stokes breathing, are also common indicators. Despite this knowledge, many people have not encountered these signs before and rely on healthcare professionals for guidance.
“So, when those signs come, we often haven’t seen them before and are relying on health professionals to point them out,” – Noonan
The medicalization of death often leads to viewing it as a failure rather than a natural part of life. This perspective can hinder the proper acknowledgment of death's social and cultural aspects. In some cultures, avoiding discussions about death affects access to palliative care and disrupts planning for post-death rituals.
“If it’s taboo this impacts access to palliative care and planning ahead for sorry business and sad news … as well as the cultural protocols after someone has passed,” – Munro
Family members supporting a dying loved one often face immense emotional challenges. The unpredictability of death necessitates gentle self-care for those providing support. It is crucial to remember that being present in the final days is one of the most difficult yet significant acts of love.
“When someone has been spending hours on end by someone’s bedside wanting to be there the moment they die, then the moment they walk away to go to the toilet, that person dies … it’s not helpful to beat ourselves up and say, ‘I should have done this or that,’” – Hillman
Proper planning for end-of-life wishes can alleviate stress during an already overwhelming time. Knowing a person's desires regarding their death can ease the grieving process and prevent financial burdens on families left behind. Awareness and acceptance of these realities are essential in managing the complexities surrounding death.
“Uncertainty tends to cause stress and anxiety … so whether you read some information, or have a conversation with a friend – if you can find a way to alleviate that uncertainty, your anxiety and stress, on one level, can come down,” – Noonan