The end of life isn’t something most of us want to discuss or think about most of the time. We don’t want to talk about dying either. The end of life and the transition leading up to it fill many people with unnecessary anxiety.
It’s understandable to feel this way; we don’t want to say goodbye to someone we love. This anxiety is due to our lack of understanding of the process, so it feels arbitrary or sudden even when it’s not. This knowledge gap is easy to fix.
The secondary reason for anxiety at the end of our lives is our fighting of the aging process. We deny we are aging. Western societies, in general, don’t have much respect for seniors. I hope that that can change.
Perhaps understanding what happens to our bodies as we age will allow us to be more comfortable with the process. In this comfort, maybe we can find appreciation.
When we think of aging, some afflictions are not a normal part of the process. Memory loss is not a normal part of growing older. Our reaction time, both mental and physical, will slow down, but diseases like Alzheimer’s are not normal aging.
Frailty is also something that has stages and is preventable if we understand what is happening. I will be covering that topic in an upcoming podcast episode.
Just as we are unique human beings, each person approaches dying in their way. However, we can see similarities or guidelines when we think their time is coming to an end.
First, there is a withdrawal from everyday life. Withdrawal usually happens slowly over time. Daily news, sports, much of what was of interest before gradually becomes less attractive. My paternal grandmother has been mostly blind for over 15 years. Unfortunately, because of her lack of sight, she doesn’t participate in special events. She refused to go to her great-granddaughters college graduation and her youngest grandson’s high school graduation.
The college graduation happened nearly seven years ago, leading me to believe that it was more obstinance than withdrawal at work in her decision. The high school graduation was more recent. One could argue that being unable to see makes participation difficult. I can also say that being surrounded by family that wants to celebrate with you present is an easy gift to share.
Typically, withdrawal isn’t something that happens over the years. At least, this is the common understanding of the process. My grandmother will be 103 at the end of March. When my daughters’ college graduation happened, she was 96. Could this have been the early stages of withdrawal? Most end-of-life scholars put withdrawal in the final one to three months.
If your loved one shows less interest in their daily lives, I would take this as a sign that they are entering their transition phase. During this phase, you can hold hands, reminisce, and create a few more cherished memories in the future. It’s a quieter time in their lives. Likely, they won’t want a lot of visitors or activity. My suggestion is to keep visits to one or two people for short periods.
Not Wanting to Eat
Withdrawal brings less of a need to communicate. Words connect them to the physical life they are leaving behind. Touch becomes a more important way to stay connected.
Another connection to this world is food. I became interested in the end-of-life process when people around me were force-feeding a loved one who should have been on hospice.
Food is what we need to energize our bodies. During the transition, our loved ones have less desire for food. Nothing tastes good. Cravings come and go. Expect them to tell you they aren’t hungry. They may verbalize this, or you may have to pay attention to other clues. A lack of appetite is normal and okay. Accepting this will help you to avoid anxiety during their transition.
Sleeping more and more brings on another step in the transition; disorientation. At this point, they have one foot in each world. A person becomes confused, talking to people that are unknown to others. Agitation is also common. There is a seeming aimlessness to all physical activity. Their focus is changing from this world to the next. All of this is normal. It may not be easy, but acceptance is essential.
Other Physical Changes
During this part of the transition, we may notice physical changes in their bodies. It may seem like a positive change when their blood pressure decreases, but it’s a sign in combination with withdrawal.
Sometimes our loved ones’ body temperature fluctuates. They can experience increased perspiration and changes in skin color. Another physical change is their breathing changes. Their respiration may increase from a normal sixteen to twenty breaths every minute or decrease to nine or even fewer inhalations per minute.
All of this is normal. Becoming familiar with the transition process will make it less scary. Brining in hospice as early as possible is also essential to an anxious free transition. We owe it to our loved ones to understand the process and do what we can to make it as easy for them as possible.
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