Messages from Doula KaseyResources, motivation, and tools to help you and your loved ones have a well supported death
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I hear versions of this question a lot. And I get it. We don’t want to suffer at the end of our lives. We don’t want our loved ones to suffer. So I’m here to tell you what to expect. And then tell you a little story to demonstrate that it is perfectly normal to be surprised when you see signs and symptoms of active dying. Every death is different. And yet, there are patterns! When I was a freshly trained end-of-life doula and hospice volunteer I had been at the bedside of someone actively dying one time.
But I’ll tell you something, I am a good student. 👩🎓 I paid attention in those doula classes and hospice training sessions when they talked about signs and symptoms of active dying. I thought I knew what to expect. You know where this is going right? ❗ The first time I met with a client who was transitioning into active dying, I misread the signs. When I came to the house to meet with “Bob” his wife explained that he was having a difficult day and we might have to have a short visit. Bob was standing behind his chair holding a breathing cannula to his mouth (he hated the way it felt in his nose). He said he was having a harder time catching his breath. He was fidgety. Not in pain, but he kept sitting in his chair and getting up again. He just needed to move. As we settled in to talk, Bob continued to get in and out of his chair. Sometimes pacing a bit. At one point he even jumped with surprise. When I asked what was wrong he said “Nothing, the cat just startled me. It’s always climbing in and out of the window.” I looked around and couldn’t see a cat. Nor any way a cat could get in and out of the window since there was an AC unit installed. As I left that day I encouraged Bob’s wife to let the hospice nurse know about the changes in his symptoms, thinking his medications were making him hallucinate. I got a call a few days later that Bob passed. Bob was restless, his breathing was changing, he was seeing people and animals in the room that others could not. These are classic signs of transition. Which I had been trained on, but I missed them. The reality of death can be so different from what we expected in theory. It’s normal to miss interpret what you are seeing. A lot is going on and each sign or symptom could have a variety of causes. Plus you might be physically tired. Plus you might be emotionally drained. Knowing physical signs and symptoms of active is a lot less scary than not knowing. I made a PDF for you of the Physical Signs of Active Dying, so you can have an idea of what to expect. But there is also an amazing TEDX talk by Dr. Kathryn Manning on YouTube explaining what happens as we die. It’s a wonderful tool and I highly recommend watching.
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AuthorKasey March is a Death Doula, End-of-Life Educator, & Advocate ArchivesCategories |

Doula Care for Dying, LLC. serves southern Vermont, New Hampshire, and nationwide virtually.
Call (802) 546-1110
Email: [email protected]
Call (802) 546-1110
Email: [email protected]