Eight Myths About the Dying Process

Join SevenPonds each month as Tani Bahti, RN, CT, CHPN, offers practical on-hand guidance to demystify the dying process. As an RN since 1976, Tani has been working to empower families and healthcare professionals to have the best end-of-life experience possible both through education and the development of helpful tools and resources. As the current Director of Pathways, Tani is also the author of “Dying to Know, Straight Talk About Death and Dying,” considered by SevenPonds to be one of the most practical books on the topic. Founder Suzette Sherman says this is, “the book I will have at the bedside of my dying parents some day, hopefully a very long time from now.”

When dying, the body has a natural wisdom built into it, to protect itself and promote comfort. Just like a body must go through certain stages to prepare to be born, it must also go through certain natural stages to shut down.

Understanding and honoring these changes can help lessen fear and avoid actions that may risk increasing discomfort. Because we want the best for our loved ones, it’s important to understand how the process of dying works. The following is a list of common myths and truths about what happens as we die:

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1. Dying is painful.

Pain is not an expected part of the dying process. In fact, many people experience no pain whatsoever. If your loved one’s particular condition does cause any pain, however, it can be managed by medications prescribed by a properly trained clinician.

2. If people don’t eat they should get a feeding tube or they will starve to death.

The needs of the body and its ability to process and utilize food change in the final months to days of life. People do not die because they are not eating; they do not eat because they are dying. Complications due to forced feeding and the use of tube feedings can actually hasten dying. One of several reasons why your loved ones will be more comfortable when not eating is that endorphins, the body’s natural pain killers, are released to promote a sense of well-being and comfort when the body is deprived of nourishment.

3. Not drinking leads to painful dehydration

Natural dehydration is comfortable and causes the release of endorphins. Providing artificial fluids near the end of life may actually increase discomfort due to accumulation of fluid in the body. The benefits of natural dehydration can include less nausea and vomiting, swelling, incontinence and lung congestion. 

4. By staying in bed or sleeping as much as they want, the dying person is giving up and will die sooner.

Energy diminishes throughout an illness. To push people beyond their natural limits will not strengthen them and may further deplete what little energy they have left, thus putting increased strain on their already fatigued body.

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5. People should be conscious until the moment of death. If they are increasingly tired or confused, they are being over-medicated.

The dying process almost always causes the person to sleep more and more, until they drift into a coma. Sleepiness and possible confusion are often due to natural chemical and metabolic changes in the body as it begins to shut down, and they occur even when a person is not taking any medications at all. Proper management of medication can keep your loved one comfortable while not contributing to confusion or sleep.

6. The use of narcotics will cause loss of control or even hasten death.

Adequate pain medication can actually give your loved ones more life, providing better rest and therefore more energy and comfort to do things. Inadequate pain control can harm the body and even hasten dying due to damage from stress hormones, increased risk of clots, or complications of immobility because the person has too much pain to get out of bed. Properly prescribed medications do not hasten death. They keep your loved ones comfortable during the dying process.

7. It’s too late to say goodbye if the person is in a coma.

Your loved ones can hear you and benefit from touch until their final breath. Now is the time for loving actions such as reminiscing, holding tenderly, telling them what they meant to you, letting them know you will be sad but OK when they die, and saying goodbye.

8. If I’m not there when my loved ones die, I failed them.

One of the amazing mysteries of dying is the timing of death itself. Sometimes a loved one will wait for someone to arrive or for everyone to leave the room before they die. Make no judgments about whether you were there at the final moment or not. Their knowledge of your love, not your physical presence, is what is most important.

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By understanding and honoring the dying process we promote the best care possible.

Take a look at a copy of Tani’s book “Dying to Know — Straight talk about Death and Dying” to help demystify the process and offer words of wisdom on the many aspects of dying.