To many people who witness the active dying process of a loved one, it often appears that the dying person is not only unresponsive, but also unaware of what’s happening around them and unable to affect their situation in any way. Despite this perception, many people exhibit great control over the actual timing of their death, often choosing to wait for a loved one, who is traveling from afar, to reach them before passing, ensuring all family members are gathered in their room before taking their final breath, or waiting until a loved one leaves the room to spare them the experience of witnessing their passing. The following story is an example of the latter.

I had known Margie for about six months, providing light housekeeping for her and offering companionship as she declined with her disease.  She was in her late-eighties and living alone.  In her final few days, unable to care for herself in her apartment, Margie entered the hospice Care Center where she quickly entered the active-dying phase.  She stopped eating and drinking and became unresponsive.  On the afternoon of her death, I arrived at the care center at 2PM and learned that Margie had been moved there the day before.  I entered Margie’s room and found her son, David, at her bedside.  I introduced myself to him and he was very pleased to finally meet me.  It turns out that Margie had told him about my visits and the friendship we had developed over the past several months. 

Margie’s breathing was very labored, and she was exhibiting what is often referred to as “the death rattle”, the sound of air passing through fluid that collects in the throat during the active-dying phase.  While it is believed that such labored breathing is not painful to the dying person, it is often disconcerting to loved ones who witness it. David became very distressed witnessing his mother in this state.  Having reached a breaking point, David told me that he was going to run some errands and asked if I would stay with his mother.  I assured him I would and encouraged him to take as much time as he needed.  Once David left Margie’s room, I took Margie’s hand in mine, told her that David had just left to go run some errands, and that I was going to stay with her.  I then told her that if she was hoping to spare David from seeing her transition, she was now free to go.  Within 5 minutes, Margie’s breathing slowed, her body completely relaxed, and she exhaled her last breath.