The process of life is a journey. It is the glorious time when our souls were given the most amazing vehicle of transportation ever created.- The Human Body. We are in a state of consciousness which is the “now”. Most of us recall nothing before being born. Where was the soul during this period?
I imagine I may have been a seahorse with the wings of a butterfly and able to explore the mysterious depths of the ocean. When I grow tired of the dark ocean floor I could arise up out of the water and spread my butterfly wings. I could fly over the land and enjoy its natural beauty. This is a place where I can soak up all the sunshine I want without fear of sunburn or skin cancer. Perhaps this is a state of euphoria. Perhaps when I die, I am returned to this glorious Heaven I’ve created in my mind.
I like to think that once again, I shall have butterfly wings. I’d like to think when I leave this human vehicle I shall once again return to being a seahorse with wings. This is the state of my imagination. I am able to mold and bend and create anything I wish.
I choose to begin this topic by expressing the path of my personal journey. Mine is filled with a lifetime of love, caring family, wonderful sons and imagination. My final path is colorful. Grief lingers in all of the shadows. I try to avoid those as much as I can. I am focused on leaving pieces of myself behind. I’d like to think the memory of my life will walk this Earth for 1 or 2 more generations. This is my Real Path.
However, I decided to share the “generic” process of dying. I doubt a person who was actually in the process of dying actually wrote this article. Although, I do know it is a true generic account. For many years I worked with the elderly. Often I sat and held the hand of someone while they were passing over.
In fact, years ago, if I were to write down the process of dying, it would have looked very much like this (below). I think I may write down my various “stages”. One day, if someone chooses to do so, they can compare these notes. We will see how close the chart below hit its target. – Renee Robinson
Ladies and Gentlemen, I give you – The 5 Tasks of Dying by Angela Morrow, RN, former About.com Guide When most people consider the tasks that a dying person must accomplish they think of wills,trusts, medical arrangements, and funeral planning. In reality, there is much more important work to be done to achieve closure in relationships and a peaceful death. The most important thing in life is our relationships with those we love.
The five tasks of dying seek to complete and reconcile these relationships. In his book The Four Things That Matter Most , Dr. Ira Byock teaches us four vital things that a dying person must do before saying goodbye to loved ones. While these tasks shouldn’t only pertain to dying people – we should all remember to complete tasks 1-4 often in our own lives – they are an important part of the work of the dying.
Task #1: Ask For Forgiveness: We’ve all done things in our lives that have hurt those we love, either intentionally or unintentionally. We all carry wounds with us that family and friends have inflicted on us and we’ve all been the inflicter of wounds on those we love. The most important healing at the end of life isn’t physical healing, but rather the healing of those emotional wounds.
Dr. Byock compares the healing of emotional wounds to physical wounds. For a physical wound to heal, all dirt and infected tissues have to be washed away; for an emotional wound to heal, all the toxic material between two people needs to be washed away. The best way to cleanse your relationships of their toxic pasts is to seek forgiveness. Asking for forgiveness isn’t easy, especially if we feel that we were misunderstood or justified in our actions. But regardless of how you feel about your rift, asking for forgiveness can be a freeing experience and can prepare your relationship for the rest of the work that needs to be done.
Task #2: Offer Forgiveness: This is another difficult tasks for many of us to complete. Offering forgiveness to someone who we feel hasn’t earned it is extremely hard. But it’s important to know that forgiving someone we love isn’t excusing that person’s behavior. Forgiveness is ultimately a gift we give ourselves; when we forgive, our spirit is set free of anger and resentment.
In addition to forgiving others, it’s equally as important to forgive ourselves. You have undoubtedly done things you’re not proud of. All of us have done things that we regret, we’ve made serious mistakes, and we all harbor shameful secrets. We are imperfect humans! But we are often harder on ourselves than others. Even if a friend or family member has granted you forgiveness, you might still find it difficult to forgive yourself. But forgiving yourself is the ultimate act of self-kindness, allowing you to find self-acceptance and love.
Task #3: Offer Heartfelt Thanks: We all have an innate need to express gratitude and feel appreciated. Many of us mistakenly believe that we don’t actually have to say the words “thank you” out loud. We assume our loved ones know how thankful we are for all they have done for us. The truth is, often our loved ones really don’t know how much we appreciate them.
Offering gratitude for the acts of kindness others have extended to you is quick and easy. It takes little time and effort to say “thank you,” yet it can have a tremendous impact on completing important relationships. You can find something to be thankful for in every relationship in your life. In The Four Things That Matter Most, Dr. Byock gives the example of Avi and his father Simon. Simon had been horribly cruel to Avi growing up. Despite this, Avi was able to forgive his father and even thank Simon for giving him life. Just the act of Simon giving life to Avi was enough to be thankful for. Surely you can find something to be thankful for in each relationship in your life. Now is the time to tell them “Thank You!”
Task #4: Offer Sentiments of Love: Uh oh. Now we’re getting mushy and sentimental. Before you skip over this task thinking it’s too “feminine” or “touchy-feely,” stop for a moment and think of those relationships that matter to you most. Can you recognize feelings of love for each of these people? Although it may differ from person to person, love for others is the most natural and important of human emotions. But saying the words “I love you” can be incredibly difficult for many people to say.
If you are in touch with your “sensitive side” and find it easy to express your feelings by saying “I love you,” then just go ahead and do it. If you, like many people, find saying those three little words more terrifying than jumping out of an airplane without a parachute, there are other ways you can express sentiments of love. Some people might be more comfortable expressing love in a written letter or card. Others find less obvious, but equally meaningful ways of expressing love. In The Four Things That Matter Most a story is told about Gunter who’s father was dying. Gunter didn’t feel comfortable expressing his love for his father – it just wasn’t done in their German Lutheran home. Gunter later recognized his father’s request for Gunter to shave him as a way to invite physical touch and affection. Gunter began grooming his father every day and picking up more and more of his physical care as his father declined. The simple act of care giving with loving touch was a profound way for Gunter and his father to express their love. In what ways can you get creative in expressing your love?
Task #5: Say Goodbye: Goodbye is a powerful necessity for many dying people. Those of us who work with the dying can tell stories of dying patients who held on longer than should have been possible in order to say goodbye to loved ones. Amazing stories of this phenomena can be found in the bookFinal Gifts by Maggie Callanan and Patricia Kelley. Stories of people who have lingered in between life and death, waiting to say goodbye, are reminders that we shouldn’t wait until the last minute to take steps 1-4.
We’ve all heard touching stories of people who go to incredible lengths to say meaningful goodbyes – the mother who bought and wrapped presents for her daughter to open on every birthday and her wedding day; the child who wrote his parents a book of poems; the father who made a video diary for his children chronically his life and professing his love for them. All goodbyes don’t need to be this elaborate. Once you’ve made it through the first four tasks, all that’s left to do is recognize the precious impermanence of life and enjoy the presence of those you love. Saying goodbye is painful but it doesn’t have to be tragic. If you’ve completed your most important relationships by doing tasks 1-4, saying goodbye can be a bitter-sweet way to remind those you love how fleeting life is. It can be a wonderful way to remember to live life to the fullest and focus on the things that matter most – the relationships with those we love. The dying process usually begins well before death actually occurs. Death is a personal journey that each individual approaches in their own unique way. Nothing is concrete, nothing is set in stone. There are many paths one can take on this journey but all lead to the same destination. As one comes close to death, a process begins; a journey from the known life of this world to the unknown of what lies ahead. As that process begins, a person starts on a mental path of discovery, comprehending that death will indeed occur and believing in their own mortality. The journey ultimately leads to the physical departure from the body. There are milestones along this journey. Because everyone experiences death in their own unique way, not everyone will stop at each milestone. Some may hit only a few while another may stop at each one, taking their time along the way. Some may take months to reach their destination, others will take only days. We will discuss what has been found through research to be the journey most take, always keeping in mind that the journey is subject to the individual traveler.
The Journey Begins: One to Three Months Prior to Death: As one begins to accept their mortality and realizes that death is approaching, they may begin to withdraw from their surroundings. They are beginning the process of separating from the world and those in it. They may decline visits from friends, neighbors, and even family members. When they do accept visitors, they may be difficult to interact withand care for. They are beginning to contemplate their life and revisit old memories. They may be evaluating how they lived their life and sorting through any regrets. They may also undertake the five tasks of dying.
The dying person may experience reduced appetite and weight loss as the body begins to slow down. The body doesn’t need the energy from food that it once did. The dying person may be sleeping more now and not engaging in activities they once enjoyed. They no longer need the nourishment from food they once did. The body does a wonderful thing during this time as altered body chemistry produces a mild sense of euphoria. They are neither hungry nor thirsty and are not suffering in any way by not eating. It is an expected part of the journey they have begun.
One to Two Weeks Prior to Death – Mental Changes – This is the time during the journey that one begins to sleep most of the time. Disorientation is common and altered senses of perception can be expected. One may experience delusions, such as fearing hidden enemies or feeling invincible.
The dying person may also experience hallucinations, sometimes seeing or speaking to people that aren’t there. Often times these are people that have already died. Some may see this as the veil being lifted between this life and the next. The person may pick at their sheets and clothing in a state of agitation. Movements and actions may seem aimless and make no sense to others. They are moving further away from life on this earth. Physical Changes: The body is having a more difficult time maintaining itself. There are signs that the body may show during this time:
- The body temperature lowers by a degree or more.
- The blood pressure lowers.
- The pulse becomes irregular and may slow down or speed up.
- There is increased perspiration.
- Skin color changes as circulation becomes diminished. This is often more noticeable in the lips and nail beds as they become pale and bluish.
- Breathing changes occur, often becoming more rapid and labored. Congestion may also occur causing a rattling sound and cough.
- Speaking decreases and eventually stops altogether.
Spirituality: Refers to a person’s sense of meaning and purpose in life. It also refers to a person’s relationship to a higher power or an energy that gives life meaning.
Some people do not think of spiritual matters often. For others, spirituality is a part of daily life. Facing the end of your life may cause you to confront your own spiritual questions and issues. Organized religion provides comfort to many people as they face death. Others may find solace in exploring nature, through community involvement, by strengthening existing relationships, or by developing new relationships. Think about what provides comfort and support to you. What questions and concerns do you have? Don’t hesitate to ask for support from friends, family, hospice, or spiritual advisers
Journey’s End: A Couple of Days to Hours Prior to Death:The person is moving closer towards death. There may be a surge of energy as they get nearer. They may want to get out of bed and talk to loved ones, or ask for food after days of no appetite. This surge of energy may be quite a bit less noticeable but is usually used as a dying person’s final physical expression before moving on.
The surge of energy is usually short, and the previous signs become more pronounced as death approaches. Breathing becomes more irregular and often slower. “Cheyne-Stokes”breathing, rapid breathes followed by periods of no breathing at all, may occur. Congestion in the airway can increase causing loud, rattled breathing. Hands and feet may become blotchy and purplish (mottled). This mottling may slowly work its way up the arms and legs. Lips and nail beds are bluish or purple. The person usually becomes unresponsive and may have their eyes open or semi-open but not seeing their surroundings. It is widely believed that hearing is the last sense to go so it is recommended that loved ones sit with and talk to the dying during this time. Eventually, breathing will cease altogether and the heart stops. Death has occurred. Sources:The Hospice Foundation of America: The Dying Process: A Guide for Caregivers Barbara Karnes: Gone From My Sight: The Dying Experience Sherwin Nuland, M.D.: How We Die