Dear Barbara, you write about the signs of approaching death for what you call a “gradual” death. Would you write about what happens during a “sudden” death?
There are two ways to die: gradual, from disease or old age; or a fast, unexpected death. I’ve written a lot about gradual death and its process, about what to look for in the months, weeks, days and hours before death comes.
I haven’t written about sudden, unexpected death. There really isn’t a lot to say. There is no process, no preparation, no labor, no signs it is coming. The person is alive one minute and dead the next. Sudden death could come from a heart attack. It could come from a traffic accident, gunshot, or explosion, to name a few.
With immediate death there is nothing — no breathing, no awareness. BUT what about when death is going to be the result of a sudden incident, but death is not immediate? What happens and what do we look for when death will come in hours, even days? What does fast death look like then?
The signs of approaching death then are the same as a gradual death. If it is hours, there can be facial expression changes, eyes may be partially open, breathing may be erratic, and the person may be non-responsive. If it is days, the signs will be the same as days before a gradual death.There may be mottling (blueish, dark color to hands and feet), start-and-stop breathing, and a lack of awareness of their surroundings.
How do we interact with someone dying a sudden death? The same way we would react with someone dying a gradual death. In the minutes to hours before any death, I believe the person can hear — they may not be able to acknowledge or respond — but they can hear. Speak to them, tell them what is happening, what you or others are going to do. “I’m going to lift your body out of the car. We are taking you to the hospital. I’m going to hold your hand. You will not be alone.” Speak reassuring words that will bring comfort.
As I continually say, “dying is not like in the movies.” A person in the hours, even days before death, whether it is gradual or unexpected, is not going to be saying goodbye, or any meaningful words. They will not be aware of their surroundings. This physical world is no longer where their work is centered.
Something More about… When Death Comes Suddenly: What to Expect and How to Offer Comfort
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