Signs of death.

A natural death doesn’t happen like it does in the movies. It is a slow, gradual process, and it is fairly predictable. It is all normal – but it isn’t normal to you if you haven’t seen it. Reading about it will make it easier to deal with.

The main goal is to keep the person comfortable and for you to remain calm.

These are some things that are likely to happen. Every person is different, so these may happen in a different order, or not at all. I have compiled these from various sources online and my own personal experience with dying people.

Be advised – the dying process can take around a week.

—- Loss of appetite
The person’s energy needs lessen. She may not want to eat, or want to eat only simple foods. Follow her lead, and offer liquids at least. You can use a lip balm on her lips to keep them from cracking.

—–Excessive fatigue and sleep, and increased weakness.
Because of her lessening energy needs, she will sleep more and more. Do not rouse her unnecessarily. Assume that she can hear everything that you say.

Do not talk about her in the same room.

— Mental confusion or disorientation
The person may not be aware of where she is or what is happening. Remain calm. Let her know who you are. Speak gently to her.

She may see people who aren’t there, especially people who have passed on before her. Do not argue with the person about this. This will make her agitated. She has one foot in this world and one in the other. What she is experiencing isn’t unusual – it is just something you aren’t experiencing. This doesn’t mean it isn’t real.

She may pick at her bedclothes. This “work” represents unfinished business. As long as the person is safe, let her do this.

— Breathing changes
It will get harder and harder for her to breathe. Oxygen may help with this, and sometimes a gentle fan blowing on her face will help too. The goal is to make the person more comfortable and relaxed. The person doesn’t need as much oxygen as before.

Later on, her breath may change to something known as Cheyne-Stokes. She will not breathe for a bit, and then sge will breathe in suddenly, gasping. It is distressing to hear, but not for the dying person.

Around this time the person will have difficulty swallowing, and there will be increased secretions in her throat. It will sound like gurgling or like marbles are rattling around. This is what is called the “death rattle”.

One option that I’ve seen is to use a Scopolamine patch. It will dry up the secretions, as a dry mouth is a side effect. These have to be prescribed.

It may help to have the person propped up or have her head tilted slightly to the side.

It is believed that the person is unaware and unaffected by the secretions and the different breathing.

—–Social withdrawal
The person may not be interested in doing anything with anyone. This is a very intimate and personal time and requires a lot of inward focus. Don’t take it personally if she doesn’t want to see you. Dying is hard work. However, she might be interested in some company, but not be able to reply.

Some people may get to the point that they can only answer yes/no questions. Be mindful of this, and change your interactions accordingly.

Sometimes there might be a burst of energy a few days before the person dies. She has saved up her energy and then it will appear that she is going to get better. Cherish this experience if it happens – it is fleeting.

—-Changes in urination
There will be less and less urine, and it will be more concentrated. Hospice may choose to use a catheter to keep the bed unsoiled. Loss of bladder and bowel control is normal.

—-Swelling in the feet and ankles
This is a natural result of the kidneys slowing down. This is normal.

—-Changes in the extremities.
Just like when the body gets colder, the extremities start to lose circulation minutes or hours before death. Hands and feet will become cooler and paler (or bluish) The veins may become mottled.

Talk with the person gently and calmly. Assure her that she is loved, and that you will remember her. Let her know that her life mattered. She needs to know that you will be able to go on without her.

Why he hits. Why she stays.

If you wonder “why she stays” or “why he hits” it is all the same. It is all about power. They both feel powerless.

She doesn’t leave because she thinks she can’t support herself without him. He makes all the money. He knows how to repair the cars and the house. But also he feels powerless. If he doesn’t have her then how is he going to get fed? How is his laundry going to get done? They stay together out of a sense of desperation and powerlessness.

If you want to address the cause of men hitting women and women taking the abuse, you have to address the root of power. You have to teach boys how to cook and clean and take care of the household in addition to teaching him how to use tools and repair cars. If you want to teach women to be strong you have to teach them how to use tools and how to repair cars in addition to teaching them how to cook and clean and take care of the household. Only when there’s a sense of equality will there not be a sense of powerlessness.

Men also abuse others because they have not been taught any other way to deal with their emotions. “Boys don’t cry”, remember? Boys are taught to roughhouse and to fight. They are taught to be aggressive. Anything less than this is seen as weak. If a guy shows any gentle tendencies he is seen as gay. He is excluded from the pack. Thus when guys feel powerless, they will lash out with the only tool they are allowed to use and that is violence.

Part of power is also about giving people a sense of worth and value. They have to feel like they can take care of themselves. This includes being able to get and keep a job. People need to feel like they are needed.

Address these issues and you have solved the reasons why he hits, and why she stays. Teach people how to be independent.

Time and calories and money

I’m for an accounting of time and money the same as how some people account for calories. I think it’s important for all of us to be mindful.

I know a guy who started to write again after his wife died. He started to write very good insights about our relationship with God. But then he died seven weeks after she died. He didn’t have time to write everything that he wanted to write. But then again, why did he wait so long to get started?

We never know when we are going to die. Every single day that you have is a gift that is given to you. It is important that you use it wisely.

When people say they don’t have time to write or to exercise, that is not true. Everybody has the same amount of time – it just depends on what you do with it. Just like with calories, it is important to be mindful about what you do. Do you hit the snooze button five times in the morning? Do you go out for lunch every day? Do you sit and watch three hours of television at night? Everything adds up.

You can find ways to use your time better. You can use dictation software while you walk. To learn something, you can listen to a nonfiction audiobook or podcast on your way to work. You can take your lunch to work and go for a walk at lunch. In giving up eating out, you’ll have enough money in order to afford the gym.

The old saying is true – you’ll either find a way or find an excuse.

The only way to find spare money and spare time is to start writing down what you do. It is the same thing people do to learn how to eat better. It is the best way to become mindful and aware. No one else has to see it. It is important that you are accountable and honest to yourself.

I knew a guy who was trying to save money. The newest video game came out and he immediately bought it. And I said how are you going to pay for it? It cost $40. He said “But I wanted it.” Like that made a difference in a budget. Of course he wanted it – the problem is how are you going to afford for it?

We cannot become (or remain) animals who mindlessly take whatever we want. The definition of being human is being able to control our appetites. If we are unable to stop ourselves doing whatever we want then we are just like zombies. We are in human shape but we don’t have any self-control. We are wild ravenous beings.

When you see someone who has gotten famous or done something amazing it isn’t an accident. They worked very hard to make that happen. Just like how water wears away the stone we have to work day by day and minute by minute to achieve our goals.

There is no shortcut to being awake – but there are a bunch of little steps. You can’t take a pill to get healthy or strong or famous, but you can do a little bit every day towards your goal and you’ll get there.