I want to die in my sleep…but you shouldn’t

By Tani Bahti, RN, CT, CHPN
From her website blog of August 21, 2015

   “If I had my choice, I’d rather to die in my sleep”
Pretty common preference, right? Here’s the good news: Thanks to the wisdom of our body and how it shuts down to take care of you, that’s exactly what happens at the end of an illness or old age.
   Over time, the individual has less and less energy, sleeps more and more, until he finally slips into a coma. While in that coma, the body continues to shut down and die. Depending on the illness one is succumbing to, that coma may last seconds or weeks. So most people die in their sleep, as they wished!
   Now here’s the perplexing news: Although this is something we hope for ourselves, we often don’t trust or honor this process when it is our loved one that is dying. The reasons can be simple: not understanding the dying process, the pain of letting go, the fear that there is something we need to do, or not do, to keep our loved one with us a bit longer.
   When terminally ill individuals don’t want to get out of bed, or when they sleep more often, many concerned families declare they are over-medicated or perhaps giving up and willing themselves to die. This can ignite a desire to stop a process they believe is hastening the dying.
   There is also talk about ‘conscious dying’ and the belief that using any medications as death draws near will rob that person of final communications. There is fear that medications are hastening death. These fears must be acknowledged and addressed. It’s not an easy balance: we want our loved ones comfortable, but worry about over-medicating. We want to honor the natural process of dying, but we miss the conversation and hugs as they sleep more.
   In my 40 years as a nurse, I have witnessed very few ‘Hollywood-type deaths’ where the person could say a few words just before dying. Usually they are in the coma, still able to hear you and feel the energy you bring to the bedside, but unable to respond beyond an occasional grasp of fingers, or a single tear of good bye.
   Navigating the dying process and comfort needs requires the compassionate guidance and support of those trained in palliative and hospice care. There are many individuals who will experience no uncomfortable symptoms at all and never take any medications in their finals days, yet the gradual increase in sleep occurs just the same.

   This is the natural process of the body shutting down.
The presence of any symptoms depends on the illness and medications are there if needed to keep the person comfortable, not ‘knock them out’ or hasten death. No one wants to think they or anyone they love will experience discomfort before death because needed medications are being withheld simply due to lack of understanding. It’s that fear of physical suffering that can cause folks to say they would prefer a hastened or assisted death.
   Know that increasing sleep is a natural part of dying. Honor that process. Provide necessary meds to promote comfort. Surround them in your love as they slumber. You are committed to the comfort of your loved one, just as you hope others will be committed to your own comfort when your time comes. If you want to die in your sleep, let them die in theirs.

For more information about the dying process- Get her book “Dying to Know – Straight Talk About Death & Dying” and read the content on her site Pathwayseol.com