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

Readers share their experiences
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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 neuropsychiatrist and 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.

Dying may 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 and 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 10."

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 designer from Northern California

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.

Paula Spencer Scott

Paula Spencer Scott is the author of Surviving Alzheimer's: Practical Tips and Soul-Saving Wisdom for Caregivers and much of the Alzheimer's and caregiving content on Caring. See full bio

about 2 months, said...

My mom was 90 years old when she passed away 5 months ago, but the start of her passage seemed very distressed. At first she seemed okay & mentioned she was glad to see all of us--as we were to see her (it was a 60 mile drive to the hospital she'd been life flighted to the evening before). We shared smiles & talked a little bit about her cat. Then the nurse brought her applesauce for lunch & mom mentioned she wasn't hungry & became a bit fractious about all the noise & light in the ICU area. It was as if she was suddenly draining out of herself & in an instant "she" was only aware of discomfort while writhing in her hospital bed, and over & over again she kept saying, "I can't do this, I can't do this." These words haunt me to this day--,what couldn't she do? Was there a hidden cue I missed out on? She & I were very close, so much so that she often told me she thought I was her mom, returned to life to take care of her. I miss her fiercely, she was so central to my life & I was fortunate to be able to take an early retirement & spend extra time caring for her & enjoying her company. I'm trying to move forward, but it's hard because I'm very much alone. Is there anyone in this forum who can spare a few words & thoughts of hope that will help me step beyond this grief? Will I ever not be haunted by the image of her obvious pain in leaving & those last words of, "I can't do this."? Please help. I'm a very religious person & sometimes wonder why I can't just skip the rest of my time on earth so I can just get to heaven & join her...because I feel there is nothing left for me here.

2 months, said...

My husband was diagnosed with stage 4 biliary tract cancer with metastasis to the liver. He tried 2 rounds of chemo. I was horrible for him. So he decided not to continue and we called in Vitas Hospice. What an amazing organization. He was diagnosed 1-12-18 and has been given less that 6 months to live. Watching this beautiful man I have been with for 37 years becoming so frail and weak. Today was the first day he ate nothing at all and tonight he is sleeping and talking in his sleep. Call it what you will I know he will not make those 6 months. thank you for your amazing post. ;-(

6 months, said...

At 60 my father found out he had stage 4 liver cancer. He went to Dr because he wasn't feeling well. They gave him one year to live.. things escalated quickly. The next week he was on hospice care.. a few weeks after that we (mymom) 2 sisters and brother decided to leave our families for the night and have a sleepover at mom and dads. My dad knew better that none of us were leaving his side no matter how long he took. So we got settled in and my sister said watch dad is going to go after we all fall asleep. Not 5 min after my mom and sister shut off the light he went. We all felt a numbness over our skin.. we were all with in inches of him. It was so special. It was so unreal. We didn't even have time to process the news and he was gone. First thing he told his Dr when he found out was he can't die yet.. he needs to work 8 more years to get the SSI. Then he couldn't wait to piss his boss of 30 years off by telling him he was toast. The love hate thing was funny. 44 weeks later we did it again for my 92 year old grandp.a myom lost her husband and father 4 weeks apart. Both on hospice in same house. My mother and her 4 adult children all taking shifts helping, it's been 6 months and the fog is just starting to lift. We're left just amazed and confused and in disbelief of what has just happened.

11 months, said...

RIP Ronna Rae Riley Wright - 04/16/38 - 11/11/14

11 months, said...

It's been 2 years, 3 months and 11 days since my mom died, alone in the nursing home, from oral morphine + fentenal patch. It was not a great nursing home, but not horrible. It smelled and she didn't have a private room, but it was not bad, and it was very close to my house. I loved my mom more than words can ever possibly express, we were extremely close - as I was her only child. I did everything within my power to find the best place for her when I was told that she had less than 6 months to live. My plan was for her to get strong enough to move home with me to live out her last days. But things didn't work out as I had hoped. Nothing anyone says, and nothing I say to myself will ever take away the guilt I have for not being able to bring her home to be in comfortable surroundings for her last weeks and days. I was by her side every day, but not, sadly at her final moment. For that I will never forgive myself. I am, however, very grateful that I was able to get enough drugs from hospice and from the nursing home (by being her advocate - running around the nursing home like a crazy person to get the proper morphine dose [not the BLUE huge amount of liquid please, but, per hospice, the stronger, less amount of liquid, easier to digest version -- who knew -- who knows this??? She was throwing up blood all day - and was in so much pain, could not get comfortable. I was working all day every minute to ease her pain - this is nothing you can ever prepare for - it's literally the MOST horrible thing ever). Once it was clear that I needed to call in hospice to help, I took their advice, they gave my mom a fentanal patch, along with the morphine increase enabled my mother to die as quickly as possible, as was her wish. I ONLY wish that the nursing home and hospice had told me that she would likely die that night. If ONLY I understood what these drugs were going to do, I would have stayed with her. I was so tired after hours of dealing with doctors, decisions and her pain that I went home, thinking I would come back in the morning. What an idiot I was. I will NEVER forgive myself for not staying with her and for being so stupid to not know that it was the end. I love my mom more than life itself and just wish that our healthcare system would be honest and communicate with patients and family about end of life. It was so obvious, but I was not there. And that is a crime. My mother would have done anything for me and I will never forgive myself for not being there when she died.

11 months, said...

Candace, you have all of my compassion. I was with my father, mother, and husband at their ends. My mother was in a coma, and my husband had requested to be sedated He and I had reiterated our love for each other. I sat by his bed all night and into the next evening holding his hand. I read to him from a book we had begun. I had been holding off using the restroom until it could no longer be delayed. When I returned, he was gone. My father was conscious and calm. He was holding my hand and trying to say my name, and just breathed out and was gone. It wasn't frightening. I did shout, "Papa!", trying, I guess, to call him back. He was 90 years old, and the first person I was with when death came, but Papa had a good death. I did some reading afterward. One book was Elizabeth Kubler-Ross "On Death and Dying." I think that is where I read that what is helpful to the person to have, as she says, "Those who have the strength and the love to sit with a dying patient in the silence that goes beyond words will know that this moment is neither frightening nor painful, but a peaceful cessation of a functioning of the body." That book might be helpful in your situation. Be strong and God bless. Hugs.

11 months, said...

My husband has been in the process of dying from end stage fatty liver disease...and many other diseases. I have never seen anyone die before. After 50 years of being married I am not sure how to handle the process.

about 1 year, said...

My grandmother died peacefully with me at her side. Her breath got quieter and quieter. It was like a candle being blown out by the wind. It was very peaceful and joyful because I felt the love of her and my already passed grandfather together. I was energized and joyful during her passing and yet after, now, I am so sad. I feel an immense hole in my life where she once was. We were very connected. I will miss her every day of my life.

over 1 year, said...

mdeyoung, please seek help for yourself. Losing a loved one is very difficult. However, it is a part a life. The feelings you have are not uncommon. We all grieve in our own way and your feeling of despair is valid. I do believe your dear mother would not want you to go with her until it is truly your time. Again, please seek help through support groups, professionals or your hospice team (if you have one).

over 1 year, said...

Because I was always sooo close to my mother (never got married) the thought of life without her is almost unbearable to me. I really don't know what I'll do after she's gone; I feel like I'll want to go with her...I love her that much and am also terrified of my own future.

over 1 year, said...

My husband passed away being diagnosed with Stage IV lung cancer. I remember sitting in the recline next to our bed and hearing an odd noise that I could not recognize, but which I learned was his labored breathing. I had contacted Hospice and the nurse came and was making arrangements for the hospital bed, nurses, and medication while I went back and forth between the bedroom and the living room. At one point I asked her to come and look at my husband. She came in and stood next to me and looked at him and told me he was taking his last breathe. His passing was quiet and peaceful. I have often felt I should have been by his side the whole time, but did not realize he was dying. When the funeral home came, the man told us we could take all the time we needed. I remember looking at him and thinking that he had shrunk in size, although he was an averaged sized man, he seemed much smaller. As if his spirit had left his body and it was now empty. I still cry when I think about his death.

over 1 year, said...

My dad has stage 4 liver cancer. Hes been fighting it for a yr recently we stop chemo it wasnt helping the counts of blood it was hurting him. I noticed hes starting to lose muscle tissues in his face and body sleeping more and yellowness in his skin. Im not sure what the signs of the end are i dont see him everyday i dont know what to look for. Please can some one help me understand better.

over 1 year, said...

My brother is only 36 years old and has been battling Advanced Stage IV colon cancer for 2 & 1/2 years now. In home hospice care. I have had a dream recently that tonight would be the night. I have been through this with my Gram and father now my Big Brother. It doesn't get easier, but I know he will be at peace and fishing with Dad again. His stages are advancing rapidly and his radial heart rate is getting faint. Please help one another in these forums. Because these forums have really helped me in the past. Thanks to everyone for there own experiences and counseling. -GODSPEED.