Common questions about dying

Saturday 1 February, 2014

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On this page:  How long have I got?What is it going to be like?How will I know that the end is near?


Knowing that you’re approaching the end of life raises many questions. This page answers some of the questions you may have.

  • Some people want to know how long they’ve got, others prefer not to hear the answer.
  • A doctor can only give a general idea about how much time you have left, not exactly what will happen to you.
  • You may want to decide what you value most: quality of life or amount of time.
  • Knowing about the physical process of dying may make it easier to cope and alleviate any fears you may have.
  • You may wonder how you’ll know the end is near. As the body shuts down, sleeping more and more is common. Slowly you let go of your attachment to living.

Often people who are dying have lots of questions. Sometimes they’re not sure if they want to know the answers. Here are some questions you may want to ask when you are ready.

How long have I got?

Some people want to know how long they have left to live while others prefer not to know. It’s a very personal decision. This question can be hard for your doctor to answer and you may find their response is vague. As everyone is different, a doctor can only give you an estimate (prognosis) based on what usually happens to people in your situation, not exactly what will happen to you. Sometimes doctors are hesitant to predict your prognosis because they’re concerned about over- or under-estimating a person’s remaining life span. But if it is important for you to have an estimate, ask your doctor for one.

You may want to think about whether quality of life or the amount of time left to live is important to you. Some people prefer to have less time if it means feeling relatively well, while others want as much time as possible, regardless of how they feel. Sometimes people find that near the end they change their minds and want to do everything possible to postpone death, if only by days. This is a natural reaction.

It is likely to be very difficult if you are told that the time you have left to live will probably be short. Even if it is only a matter of weeks, though, having a sense of remaining time can give you an opportunity to prioritise what you’d like to do.

If you live past the estimated time, you may feel unsettled and not quite know what you should do next. Or you might feel lucky to be living beyond that time. It may help to talk about your feelings with your family, the palliative care team, your doctor or a counsellor.

"It was like appearing in court expecting a death sentence and discovering the judge didn’t want to commit himself."
Richard

What is it going to be like?

It’s common to have misconceptions or fears about what dying is like. Many people say they don’t fear death as much as the unknowns of dying. Knowing what you might expect makes things easier – not being told what might happen can be distressing for you as well as for your family and friends.

If you’ve been with a person who has died, this experience may have left you reassured, sad, angry or scared. You may be worried by some of the physical changes that happened to them. For example, perhaps it appeared they were having trouble breathing, or they seemed to be in pain or uncomfortable.

It will help to talk to your doctor, the palliative care staff, or if you’re staying in a hospice, the staff there. They can explain the physical dying process and reassure you that you will be cared for. Modern health care means that people should not die in pain or distress. The following question also describes the physical dying process in more detail.

How will I know that the end is near?

For many, dying is a gradual shutting down of the body’s systems. Energy levels fluctuate and there are good days and days you can’t do much at all. Appetite reduces and sips of water or a teaspoon of food here and there may be enough.

As death gets closer, it’s common to have little interest in talking and the outside world. You may find your attention withdrawing from family and friends, and you may sleep more and more during the day.

Near the end, many people slip into unconsciousness before dying, although some remain alert almost until the end. Others may have phases where they are awake and can talk, and then slip back into unconsciousness.

No one knows how a dying person experiences the moment of death. Whatever happens, it is thought to be a peaceful moment.

"When patients ask me about the dying process, I describe it as the physical and emotional experience of gradually becoming weaker and letting go of their attachment to living."
Nurse


Reviewed by: Dr Melanie Price, Executive Director, Psycho-oncology Co-operative Research Group, Senior Research Fellow, School of Psychology, University of Sydney; Dr Erica Cameron-Taylor, Staff Specialist, Department of Palliative Medicine, Mercy Hospital and Calvery Mater Newcastle, NSW; Gabrielle Gawne-Kelnar, Telephone Support Group Facilitator, Cancer Council NSW; Helpline and Cancer Counselling Service staff, Cancer Council QLD; Judith Quinlivan, Consumer; Linda Wolfe, Consumer; and Dr Mary Brooksbank, Philip Plummer and Claire Maskell Gibson on behalf of Palliative Care Australia.
Updated: 01 Feb, 2014