How Do Aging Adults Know When They’re Dying?


Death remains somewhat of a mystery to man and medical science. It's one of the only parts of human existence that medical science has yet to conquer. Everyone will eventually die, but how or when it'll happen is still a mystery.

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Aging adults who are conscious during the dying process can and often do know when they're dying. The body experiences many changes as it goes through the deterioration process. Some people will feel indescribable pain for several hours before death; in contrast, others will die almost immediately. Death awareness is more prevalent in people who have terminal conditions or who are of advanced age.

Additionally, although it's difficult for medical doctors to pinpoint when a person is entering into the last days or weeks of their life, some people survive near-death experiences and live to tell about what it feels like to know you are dying.

Do Aging Adults Really Know When They’re Dying?

Nearing death awareness (NDA) describes the dying person's experiences with the dying process. It generally refers to a range of incidents that occur as a person is nearing the end of life. Most familiar to these experiences is having life dreams or deathbed visions.

NDAs are separate and distinct from a state of deliriousness. Delirious states often produce hallucinations, whereas NDAs occur during moments of clear consciousness. A person who experiences an NDA reports what they've shared with great clarity, detail, and organization. Most often, they experience feelings of comfort and love rather than distress or anxiety.

Some common experiences relating to NDAs include: 

  • Communicating with or experiencing the presence of a deceased loved one
  • The need to prepare for travel
  • Describing another realm
  • Knowing when they'll die

So do aging adults know when they are dying? Or do we presume they know based on their advanced age and other physical or medical factors?

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Aging Adults’ Common Reactions to Nearing Death

In aging adults who consciously recognize the signs occurring within their bodies, they know that death is near. They may not know precisely when it'll be, but they're aware that it's soon. The body's biological breakdown often starts to occur in the weeks and days before death. Sure signs occur, which are indicators that the end is looming. 

In a medical setting, doctors and their staff have specific indicators they look for in a person with declining health due to advanced age, accident, or injury. Aging adults or terminally ill patients outside of a hospital setting also start to see those same biological changes signaling that the end is near. Some common emotional reactions in people who are nearing death are:

Changing attitudes

Older people's attitude towards death is different than someone who faces the end of their life at a younger age. Many aging adults coping with their mortality have a differing view on death because of changed perspectives on what it means to live and die.

Many people who have lived a long life begin to feel that they've lived a long life and are ready for whatever comes next. Their declining health may be an indicator to them that their time is almost over, and they begin to look forward to a peaceful death. 

Conscious awareness

As death approaches, many aging adults face the reality of the situation by embracing the physical and emotional changes. They have a conscious awareness that death is near and begin to prepare for it psychologically. While some older adults may begin to fear death, others nearing death awareness have come to terms with this final transition.

You may notice that a person who’s nearing the end of their life begins to exhibit what appears to be hallucinations. They may start having conversations with others who are not physically present in the room or see and hear things no one else can. 

Social withdrawal

Recognizing and understanding social withdrawal and nearing the end of life is essential for the families of the aging person and their caregivers. As a person approaches the end of their life, they may desire to withdraw from social interaction. When the body begins to shut down, a person facing death may lose interest in socializing with people around them.

They may stop talking or interacting with others or start having rambling conversations that make very little sense. This part of the dying process may last for several days. Remind yourself that it's not personal to those around them but a natural and normal part of the final transition to death.

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Hyperfocus on planning

Another emotional response to someone who’s nearing the end of life is wanting to die at peace, knowing that everything is taken care of at the end. An aging adult may wish to discuss their funeral and other issues related to their end-of-life care. They may start mentally preparing for death by talking about who gets what out of their estate and making sure the family carries out their last wishes.

Making detailed end-of-life plans is an emotional response to accepting the inevitability of death. Ensure that you give the proper attention to your loved one who wants to discuss their final plans. Doing so lends support to your dying loved one and shows them that you respect their feelings.

Fear of dying

Most people at the end stage of their life no longer have a hard time letting go. For those who do, you may want to reassure them that everything will be okay so that they can make a more peaceful transition. Consider sitting with them to discuss the philosophical, spiritual, and religious views regarding death and dying.

Offer to have these open discussions with them. Try keeping an open mind regarding your loved one's opinions without being judgemental. 

You can ease their fear of dying by reading scripture, talking to them, and reassuring them. Most hospice and hospitals have clergy on staff that can assist you with answering some of the more difficult questions your loved one may have. Always get their permission first before inviting in a chaplain or volunteer.

How Can You Support an Aging Loved One Who Knows They’re Dying?

Many times when we know that a loved one’s dying, it feels uncomfortable and sometimes scary to face the reality that they're dying. We want to be there for them, but at the same time, we're afraid of what comes next.

Experiencing bouts of anxiety when forced to face the reality of the impending death of a loved one is a natural part of the grieving process even before your loved one dies. Here are some ways that you can support someone who knows that they're dying.

Sit with them 

One of the greatest gifts you can give someone at the end of life is spending time with them, comforting them, and showing your support. Your presence alone is often enough to make your loved one feel loved and supported.

If it makes you feel more comfortable spending time in silence, consider bringing with you activities that'll occupy your time while you're there. For example, you can get puzzles, magazines, books, or even play some music so the two of you can sit and reminisce on some of your combined favorites.

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Have open conversations

A person who’s dying will benefit from having an open and honest conversation about their impending death. This may be the last opportunity to sit with your loved one to talk about things that have been left unsaid and to find closure before they die. 

Some suggestions for getting the conversation flowing are talking about their past experiences, fears, and anxieties. You may also want to allow them to steer the conversation to speak freely on anything they feel necessary to share with you. Try not to be judgmental or steer the conversation in the direction you want it to go instead of where your loved one's hoping that it goes.

Offer to help them

Imagine yourself bedridden facing your end of life. Depending on how you got to that point, it may very well be that you left some things pending or unfinished. Don't be afraid of talking to your loved one about how you can help them find closure and tie up any loose ends before they die. Offer to help them with whatever they need you to do so that they can experience a more peaceful death.

Express your feelings

If you had the opportunity to say your final goodbyes to a loved one before they died, what would you say? Would you tell them how you feel about them and what they meant to you in your life, or would you leave things unsaid? P

articipating in deathbed conversations is an ideal time to express how you're feeling not only towards your loved one but with having to face their impending death. These conversations can be very healing to you both as you cope with the pain of knowing these are your final moments together.

Discuss spirituality

Even some of the most ardent atheists may experience searching for a spiritual connection at the end of life. There's something about death and dying that causes people to question the meaning of life and the reasons for their existence. You may want to encourage this conversation to explore your loved one's state of mind regarding their spiritual beliefs and how they feel about death.

Deathbed etiquette asks you to consider seeking their permission before inviting the chaplain or other religious leader to come in to offer spiritual guidance. You may also find it comforting to listen to spiritual music, mantras, or chanting as your loved one transitions to the end of life. These are all ways of comforting a dying loved one.

Nearing Death Awareness in Aging Adults

Nearing death awareness is part of the dying process in aging adults and those who are facing terminal illnesses. Many people who are close to death will experience this phenomenon in one form or another.

When impending death becomes apparent, the dying person has reached this level of understanding that death is imminent. Knowing that the end is near can be a moving part of the dying process for someone who has come to terms with their mortality.

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