The Passing: What to Expect When Witnessing a Loved One's Death

Relatives describe the death experience

Nothing prepares you for being present at the death of a loved one. The emotional enormity of the experience and its relative rarity give survivors little frame of reference to draw from.

"The time of life we call dying is an extremely difficult part of the life cycle, but a normal part," says palliative-care physician Ira Byock, author of Dying Well. "The nature of it isn't medical, it's experiential."

The death experience unfolds differently in each situation. But those who have witnessed "the passing" observe the following:

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The dying person may talk to people not in the room, or may see other places.

"A few hours before she died, my mother suddenly said, 'No, I'm not Sarah [her mother's name],' but she didn't say it to any of us in the room. Then she was telling Dad she loved him. It was like she was having two conversations at once. One of the last coherent things that she said was, 'Are you the gentleman who's come to meet me?'" -- Michele, a North Carolina mother of four

Dying people often seem to be in two worlds at once: here and not here. They may talk to or gesture toward people who aren't visible to others in the room. Or they may describe things or places they see, such as a garden, a favorite location, or lights.

These "deathbed visions," as British neuropsychiatrist Peter Fenwick, a specialist in near-death experiences, calls them, almost always take place when the person is clearly conscious -- even though witnesses sometimes mistake the visions and speech for signs of delirium. Some dying people switch easily between conversations with those at the bedside and with someone unseen. The people and places are usually connected with feelings of peace and security. In the U.S. and the U.K., nearly three-fourths of visions are of friends and relatives who aren't living, says Fenwick, author of The Art of Dying. About 13 percent of people seen are religious figures, compared to 50 percent of people in India who see Hindu figures. Seeing strangers is relatively rare.

More things you may witness at a loved one's death

Dying can seem to involve great physical effort.

"My mom had a dry mouth and scary raspy breath that worsened over a few days. But she didn't die until the day we gave her morphine. I felt responsible, wondering if we had rushed things." -- Emma, a 45-year-old artist in San Francisco.

"Some go gently -- you look up and their chest is no longer moving," palliative-care physician Byock says. "But for others it's hard to die. It's like an animal shedding its skin, a physical struggle to wriggle out of this life."

Younger people and those who are healthy aside from a single fatal illness often have the most difficult time. But dying can be effortful for anyone. Palliative care -- comfort care including pain relief -- improves quality of life to life's end. Unfortunately, say hospice workers, families are often reluctant to use painkillers out of a misguided fear that they curb awareness or hasten the death process.

Morphine dosages given in hospice are only enough to ease pain, Byock says. Even with good comfort care, certain reflexive symptoms of the dying process, such as labored breathing, can still appear as distress. Mental confusion is another common effect of the organs -- in this case, the brain -- shutting down (see 10 Signs Death is Near).

The personality of the dying person usually stays consistent to the end.

"My mother never lost her sense of humor. I was complaining about my brother not coming to my daughter's birthday party. 'So shoot him!' she said in her typically droll way. My mother's last words to me were instructions to kill my brother!" -- Dawn Barclay, a New York manager in her 40s, who saw her mom through 18 months of complications of heart surgery and stroke

People tend to die as they lived, says Maggie Callanan, a hospice nurse who's the author of Final Gifts, who has witnessed more than 2,000 deaths. "Nice people get even nicer, manipulators manipulate, funny people die funny," she explains. "We all have ways of navigating through life, and when dying those tendencies are intensified by ten."

More things you may witness at a loved one's death

The dying person may speak in metaphors.

"On the day she died, my mom kept talking about traveling, like, 'Let's go, what are we waiting for . . . oh, there's a plane ahead of us . . . no, that's not the right plane.' She also told my dad that he should take a later flight. She was definitely going someplace." -- Patricia Anderson, 45-year-old Ohio insurance account executive

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"The dying often use symbolic language, especially to indicate an imminent change or a need to go forth -- to die," says hospice nurse Callanan. Travel is one of the more common themes, such as talking about modes of transportation or about going somewhere (making a flight, a golfer talking about going golfing).

The person may also allude to "making ready" (packing, making checklists, issuing directions). Some observers think that this talk of journey-making is a subconscious way dying people let family members know they know they're passing away. It's a signal for families to offer reassurance -- that they, too, understand what's happening and to convey that although they're grieving, they'll look after one another and be all right.

"The family's reassurances that they'll be all right often bring the peace a dying person needs," Callanan says.

More things you may witness at a loved one's death

The dying person may seem to choose the final moment.

"The hospice people had told me that sometimes people won't die when their loved ones are in the room, especially if the person has played a protective role in their lives. Or that they hang on if they feel you can't let them go. So before I stepped out to get something to eat, I told my Dad that if he had to go it was OK, that he had done everything he could to raise us and we could raise ourselves now. Not seven minutes later, a nurse met me in the hall and said he was gone. I guess I felt a bit cheated because I wanted to witness this crossing over." -- Lise Funderburg, Philadelphia writer

Many people report feeling "cheated" or as if they "let down" a loved one by not being there at the moment of death. Others blame themselves as "failures" for inadvertently allowing the person they love to die alone. In many cases the survivor had stayed glued to the bedside for hours, determined to be there, turning away or stepping out for only an instant.

But those who work in hospice think it's the other way around: Passing away often happens minutes after loved ones leave the bedside, as if the dying person is choosing to spare them the final moment. This is especially true, they say, with individuals toward whom the dying person feels protective.

Also common: The dying person seems to hang on to wait for someone to visit or something to be said. One South Carolina woman's mother lingered in hospice for months until she received the news that her also-ill, adored younger sister had died. She died herself the next morning. "It was as if she wanted to spare her sister her own news," her daughter said.

More things you may witness at a loved one's death

The dying person often seems peaceful at the end.

"She opened her eyes, and the house grew quiet. Her face softened and all the wrinkles and tension went away. Later the hospice nurse recommended that I not watch them take the body out because it had stiffened, and I appreciated that because now I can remember the relaxed mother I saw last." -- Aoife, a northern California designer

Especially when the route has been long and marked by physical struggle, many people observe that the moments around death itself are calm. "So many people I talk to about dying tell me they wish they could die in their sleep. I'd estimate 95 percent of people dying naturally from illness go into brief coma -- like a profound sleep state -- before they die," hospice nurse Callanan says. "So the good news is that most of us do die in our sleep."

Jo Reichel, a teacher in Michigan, sat watching the Olympics with her father the morning he died after a summer full of repeat hospitalizations. "I was sitting on the floor next to his chair and kept looking between the TV and him. At 6:30 he was alive, and by 6:32, he'd simply stopped breathing. At first I wasn't even sure I should wake my sisters to tell them, because he looked so relaxed."

For Frances, an Ohio accountant, the moments after death were unreal but not frightening. "I'd never been in the room with a dead person before. But I had a strong sense that body wasn't my father any more. It felt like he had up and left the room; it was terribly sad but also strangely peaceful."

More things you may witness at a loved one's death

Witnessing a death is often transformative and brings survivors close.

"Seeing a person you love dying taps into the best parts of your nature." -- Lise Funderburg

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Before experiencing the death of a loved one, many people view the prospect with dread. Afterward, they often look back on their death-witnessing experience as having been a horrible, grief-stricken time that nevertheless brought certain gifts. Among these: new insights into their own capacity for selfless love and caring, renewed or intensified bonds with other family members, a new respect for siblings or medical staffers, a healing of old wounds.

"The situation asked for grace, patience, and charity, so something I actually benefited from was to see I had a fairly deep capacity for those things that hadn't been called on in the same way before," says Funderberg, who wrote about her father's long final illness in Pig Candy: Taking My Father South, Taking My Father Home. "Someone dying is a great prioritizer. What does something like the resentment you were holding onto matter now?"

To be sure, the passing away of a loved one can be almost unendurable. That in the end it is endurable seems to be both its blessing and its curse.


4 days ago, said...

My mother died in Nov. 2014 of complications due to ovarian cancer. Ater moving from the hospital to a nursing home (less than 5 min. from my home), she first was optomistic about receiving PT, in order to move home with me, to live out her last few months. After about 6 weeks she began to seriously decline. It started with her receiving Ativan (I think), which she was offered to reduce her stress about seeing a new doctor, who was going to assess her ability to come home. After taking the pill around 2pm, at 2am I received a call from the nurse. My mom was insisting to talk with me and when I got on the phone with her she was not herself - not at all. She sounded completely panicked and like a totally different person. She was insistant that I come get her, sayint that the nursing home was a death factory and that she was fine, but needed to be taken home immediately. I rushed to her side, but she continued to be unsoothable and frenetic. I did not want to give her more drugs, but she was in danger of harming herself, so I agreed, sobbing, and walking away, to try to figue out what to do. I stayed with her all night and although she continued to be agitated, she eventually slept a bit. Two days later, she was extremely uncomfortable and unsoothable - and agitated. I knew she was near death, but really wanted to find a way to bring her home. I called Hospice, since the nursing home was unable to help me in any way. The hospice worker suggested putting her on a fentynal patch, since she was throwing up and unable to keep the (huge liquid doses of blue morphine) down. [I later found that she could have received less liquid, more intense morphine]. The Hospice worker suggested 10mg. per hour of morphine while the fentynal patch took over. I had been with her for 36 hours and decided to leave because NO ONE told me that she was at the end. Absolutely no one suggested that she was near death. At 7:30am the next morning I received a call that she was experiencing shortness of breath and that I should come to the nursing home. When I arrived, the nurse asst. said that they were cleaning her up. He had no idea hat I was expecting her to be alive and was SHOCKED that she had died. Not only did I NOT get a call to let me know that she was close to death, but they only gave me an hour or so with her before they required her body to be removed. I will never forgive myself for not knowing more about how this process works. My mom is still the most important person to me in the entire world. This process, and not being told how / why things were happening, and ultimately, not being with my mom when she died, will cause me grief until I also die alone -- unless something changes.


about 1 month ago, said...

My mother died in Feb. 2013.. She was 85. I was her caregiver with the help of Hospice. She announced that her death was near and talked to all of her loved ones and friends over the phone. She told us that she was going to a better place . Hospice helped me to care for her at home. She was conscious right up until about ten hours before she died. I saw all of the outward signs that were mentioned in the article and it made me determined that she was not going to die without me at her bedside. I played her favorite hymns throughout the night and held her hand. When her breathing got more labored and shallow, I told her that it was ok for her to release herself from her body. About thirty minutes later, she suddenly sat straight up in bed and stared intently toward the corner of the room. She appeared to be looking at something for about a minute, then she laid her head back upon her pillow and I could see a peaceful look on her face. I am so thankful that I was able to take care of her during her final days. I would encourage those who are facing the death of a loved one to consider Hospice care. I was blessed to be able to care for Mom at home, but for those who can' t do so, Hospice centers are available and help the patient as well as the family during their loved one.s final journey. A grateful son.


about 1 month ago, said...

10 signs death is near is right! Mommie and I were with lots when they died from age or illness or tragedy. She often said she wanted to be with this person or that when they past, even though the friend or family member had no reasonable control over who was them, my mommie got her wish. She past at home, putting her head down on her chest, returning her orange juice to the jewelry closet. Her daughter, my only sibling was there. We called rescue, they came to the house and took her to the baptist doctors hospital in coral gables, fl. The night before, we saw president Clinton drive by the three of us. He would turn the lights on in his limo so we could see him wave. She was v. V. Thankful to see the president ( former ). That calendar date was Sat. 16 Sivan . And because of tornado warnings all night on noaa weather radio, we all slept on beds chairs sofas and floors in our safe room. Her passing was sudden at 7:28 am. But when we got back from the hospital we knew mommie was a real presence with us. The grief is overpowering daily and years on without warning. To be clear, several campaign fund raisers live in the area as do Bush and Rodham Clinton Brother. So we were used to the drill. What has been awesome is the clear awareness of mommie...the presence of love. We did have to move from the house but chose to me be to Alabama, the county where we had never lived but from whence all our family derived. That part has been hard. But the home we grew up in was memorable to the point it saddened our souls. Still working out the grief. It's not easy or pretty.


about 1 month ago, said...

My grandmother who I loved very dearly. She was there for me at a low point in my life. My grandmother was there for me like a mother. If it wasn't for her I wouldn't be who I am today. It was March 23, 2016, my aunts birthday (grandmother's daughter). My grnadmother was put on hospice. We got the call saying your granny is not doing so well. She's been sleeping for 2 days now and hasn't woken up. I quickly came to be by her side. I went over at 2pm that day not wanting to leave her side. Our family from out of town were rushing to come be by her side. Minister came and said a prayer over her bedside. Sun was going down everyone still by herside. It was 11:30 pm. My daughter and I were in the room with my grandmother. I was able to hold her hand and hum to her like she use to. I was thinking of all the times she was on the go. So I softly spoke to her, let's go let's go wishing she would get up and go. 2min. Later my aunt came back in and that was the moment my grandmother took her last breath. I have never experienced death. Being with my grandmother was a special gift to be by her side. I thank God everyday for letting me be there to hold her hand. It has been 3 weeks since her passing. The first week was very hard I cried everytime I thought about her. The 2nd week was getting better. Now the 3rd week so many emotions are going through my head. I'm thinking about my grandmother more. The what ifs come to play. I replay that night in my head thinking would it be easier if I wasn't there to see her pass. Because all I think about is every second of that night like it happened just yesturday. How long will this feeling last? I just know that I really miss her and wish she was still here. She lived a wonderful 89 years. I know she is lookin down on me trying to comfort me and continue to guide me and my children.


about 1 month ago, said...

My dad is in hospice surrounded by his children and grand children. It is hard to watch him dying and after reading this article, it has brought some more peace of mind towards the way I feel. The part in the article where it mentions that if the dying person was nice during life, then the niceness increases 10x more. This has been the case with my dad. Before the morphine he told my sister to sit down and that she didnt have to stand. My father is one of the most nicest and generous person one could ever get to meet. He raised his 9 children to be the same way. I know one day I will see him again. It will be a joyous day for all of us to be reunited in the love God wanted us to be, as humans in a beautiful place where there will be no more sickness, sorrow, pain or death. But all those being replaced by peace, happiness and love. Rev.21:3-5. God will sustain us through this difficult time and we will continue to have the hope of seeing our dad again soon. Php 4:6,7.


about 1 month ago, said...

I saw most of all of these signs while helping my mom and siblings with dads hospice in home care. It was heartbreaking. On the morning of February 14, 2016, dad woke from his coma sleep, turned to look at mom and old her "Hi." Afterward he went back to sleep. Dad has an identical twin brother. Always very close, my uncle told my aunt that he needed to see his brother. When he arrived, he went to dads bedside and leaning over whispeted to dad "I will be fine. You can go now." Dad died that night.


about 1 month ago, said...

I believe my dad is passing away soon, so hard to watch. Feel helpless and just not ready to say goodbye.


about 1 month ago, said...

I'm sitting her with my husband of almost 40 years. He is on hospice, he was getting really confused and now he does not wake up, been asleep now for almost 24 hours, his breathing is getting shallow and at times I can hear the rattle in his throat. Every once in a while he cries out in pain, he has been getting terrible leg cramps but he can't tell us, this is probably one of the hardest things I am going through. 3 months ago I sat at my mothers bedside and watcher her die, and a month ago my brother in law. This has been a bad year. I am going to be so lost without my best friend.


about 1 month ago, said...

My dad passed away almost a week ago from prostate cancer that gave him many other complications. My family and I camped at his bedside for the final 3 weeks after he started to go down hill, I promised him I wouldn't leave him. One night he randomly said the name of the minister that he had met once thought hospice. 3 days before his passing dad started becoming less responsive and my teenage son stayed with me too. We stayed up watching him, holding his hand and telling him how much we loved him, but it was ok to go. He just seamed to hang in there. I decided to get hold of the minister to visit dad who came and prayed for him. Later that night my son offered to say so I could sleep at home, but even at home, I couldn't sleep, I worried. At 4 am my son rang me to say granddad had waited till he's had fallen asleep to peacefully pass away.


about 1 month ago, said...

Mack622t....... my dad passed last may from complications from surgery. He had copd. The dizziness and loss of awareness, or odd behavior is due to the CO2...... when the body isn't getting enough O2 and isn't releasing the CO2, it starts acting all funky and shutting down. Prayers for u and yours.


about 1 month ago, said...

My name is Melinda and I cared for my brother Russ for 2 years after his bone marrow transplant. The transplant caused Russ to have dementia. That was when we really lost him. Even tho I was his primary caregiver for 2 years he would get mixed up and think I was his wife. He got so mad when I'd tell him I'm your sister. He wanted us to share a bed and I'd tell him over and over again, Russ I'm your sister not your wife. I know it bothered Russ that he couldn't do anything for himself and that he had to humiliate himself every time he had a bowel movement or pissed the bed. I think he suffered so much and knew I was suffering as well that on a 5 day respite with hospice he made it up in his mind he was going to go to sleep and not wake up. And that's exactly what happened. Course they gave him morphine too which slowed down his heart rate to nothing. I think he died away from me and our mom to spare us. He didn't want us to hurt anymore so he checked out while we we're gone.


about 1 month ago, said...

I was very interested in the comments about how the dying personal seems to choose their moment to die. My mother, who I was very close to, died on March 2. I had been sitting with her all that day, holding her hand, watching her. Two of my children were also there. Around 6:00, my daughter had to leave. My son was standing behind me, and started crying, as he loved his grandmother very much. I stood up and turned around to hug my son and comfort him. As soon as I turned around and was no longer sitting with her, holding her hand, within about a minute the nurse said "I need my stethoscope". I turned around, and said, "she's gone, isn't she." And the nurse said yes. She waited until I stood up and turned away from her before she took her last breath. I truly believe she was trying to spare me from actually witnessing that.