Expectations of death

Death is inevitable and people's knowledge of dying can differ. Being with someone you love at the point of passing is indeed a profound experience that requires courage and strength to endure the situation. People will have different views on how much they want to know. Some want to know what to expect and others prefer otherwise.

Talking about death can be a difficult task as well as emotionally and mentally exhausting. For some the idea of life coming to an end can provoke unwanted feelings of selfishness and guilt, and it's important to understand how one responds to the stresses of the situation differs, and every emotion felt is normal.

Death presents itself in different ways and can be an intensely spiritual experience - other times it may feel rather prosaic. The essence of a loved one passing may stir up many emotions and there isn't a right or wrong way to deal with dying or death. A person's beliefs, values, culture, experiences and circumstances will inevitably shape their own views.

Final Days

The final days or weeks in someone's life can be full of physical and emotional changes. As a carer, it helps to understand what to expect. Roles will change as the person becomes less able to do things for themselves.  As people approach the end of their life, new issues can arise. A new symptom may become apparent or an existing one may get worse. It's important to keep in touch with the palliative care team and other possible health professionals to talk about what is happening. This can help to feel less alone.

Small gestures can also help prepare someone in their final days. Sitting with the dying person in a comfortably lit room and reassuring them that you are there can create a peaceful, soothing atmosphere. Hearing is said to be the last sense to go in the dying process, so never assume the person is unable to hear you. Talk as if they can hear you, even if they appear to be unconscious or restless.

Often there are signs death is imminent and family and friends can be acknowledged at this stage. Sometimes a person will pass quickly without warning signs and it is important to try and not feel guilt for something you have no control over.

Stages of Grief

In most cases the bereaved will experience five stages of grief, firstly they will be in denial of death. Denial gives a person more time to gradually absorb the news and begin processing it. This is a common defense mechanism and helps numb the bereaved to the intensity of the situation. Other emotions will gradually surface, sorrow being more than likely.

At this initial stage, it is important to spend time alone with the deceased and embrace all the emotions being felt in that moment. Being left alone can be both reassuring and sometimes unexpectedly peaceful.

Anger may follow shortly after and while denial may be considered a coping mechanism, anger is a masking effect. Anger is hiding many of the emotions and pain that one may carry. This anger may be redirected at other people and possibly inanimate objects.

From the anger stage, one may start to feel vulnerable and helpless.  They may start bargaining with themselves at this stage and create doubts. In those moments of intense emotions, it's not uncommon to look for ways to regain control or want to feel like you can affect the outcome of an event.

It's not unusual after someone has died; especially when you were present at the time, to feel disconnected from people, places or things. This can be especially difficult when you are thrown into the intensity of making funeral arrangements. This is where depression creeps in, the most crucial stage of them all. Whereas anger and bargaining can feel very "active," depression may feel like a "quiet" stage of grief. One may choose to isolate themselves from others in order to fully cope with the loss. This is a vital stage for families to be around and find comfort within one another.

The final stage of grief is acceptance. Acceptance is not necessarily a happy or uplifting stage of grief. It doesn't mean a person has moved past the grief or loss. It does, however, mean that they have accepted it and have come to understand what it means in their life.

Final Goodbye

One of the hardest decisions is when to call in people to say good-bye allowing them to make their own memories for the future. Let family members and close friends know as soon as it's obvious that death is near. The care team can help prepare for what's coming, and support everyone's physical and emotional reactions. Most importantly, being together allows family and friends to support each other.

By Aminah Tejan

Sources:

• https://www.dyingmatters.org/page/being-someone-when-they-die
• https://www.healthline.com/health/stages-of-grief#acceptance
• https://www.webmd.com/palliative-care/journeys-end-active-dying
• https://www.betterhealth.vic.gov.au/health/servicesandsupport/At-the-end-dying-explained