Now UBC researchers have evidence that some people may still be able to hear while in an unresponsive state at the end of their life. This research, published recently in Scientific Reports, is the first to investigate hearing in humans when they are close to death.

Life and death (死活) is a fundamental concept in the game of Go, where the status of a distinct group of stones is determined as either being “alive”, where they may remain on the board indefinitely, or “dead,” where the group will be lost as “captured”.

The meaning of life is to live. It is a simple answer and is so appropriate in that the complex interactions and causal reactions that make up our existence are summed up in something that is both so simple and very difficult to quantify.

1 : the irreversible cessation of all vital functions especially as indicated by permanent stoppage of the heart, respiration, and brain activity : the end of life — see brain death. 2 : the cause or occasion of loss of life drinking was the death of him.

Starting at the moment of death, physical changes begin to take place in the body. The classic rigor mortis or stiffening of the body (from which the term “stiffs” derives) begins around three hours after death and is maximal at around 12 hours after death.

Being there at the end. Remember: hearing is thought to be the last sense to go in the dying process, so never assume the person is unable to hear you. Talk as if they can hear you, even if they appear to be unconscious or restless.

Reality: Pain is not an expected part of the dying process. In fact, some people experience no pain whatsoever. If someone’s particular condition does produce any pain, however, it can be managed by prescribed medications.

Instead of peacefully floating off, the dying person may cry out and try to get out of bed. Their muscles might twitch or spasm. The body can appear tormented. There are physical causes for terminal agitation like urine retention, shortness of breath, pain and metabolic abnormalities.

Death is not like falling asleep. It is something very different. If you are not sure about death, you should ask questions about it. It’s hard for people to talk about death and ask questions about it, but getting answers will make you feel better and have less stress.

So, what does it feel like to die? As these studies record, death by cardiac arrest seems to feel either like nothing, or something pleasant and perhaps slightly mystical. The moments before death were not felt to be painful.

The dying person will feel weak and sleep a lot. When death is very near, you might notice some physical changes such as changes in breathing, loss of bladder and bowel control and unconsciousness. It can be emotionally very difficult to watch someone go through these physical changes.

The first organ system to “close down” is the digestive system. Digestion is a lot of work! In the last few weeks, there is really no need to process food to build new cells.

A life review is a phenomenon widely reported as occurring during near-death experiences, in which a person rapidly sees much or the totality of their life history. It is often referred to by people having experienced this phenomenon as having their life “flash before their eyes”.

“Death is not the greatest loss in life. The greatest loss is what dies inside us while we live.” However, there are actually seven stages that comprise the grieving process: shock and disbelief, denial, pain, anger, bargaining, depression, and acceptance/hope.

They could have:

• Different sleep-wake patterns.
• Little appetite and thirst.
• Fewer and smaller bowel movements and less pee.
• More pain.
• Changes in blood pressure, breathing, and heart rate.
• Body temperature ups and downs that may leave their skin cool, warm, moist, or pale.

And particularly when you’re human, you are more likely to die in the late morning — around 11 a.m., specifically — than at any other time during the day.

In the last hours before dying a person may become very alert or active. This may be followed by a time of being unresponsive. You may see blotchiness and feel cooling of the arms and legs. Their eyes will often be open and not blinking.

Family members and caregivers play an important role by supporting a loved one through the dying process: If the patient can still eat or drink, offer small sips of water/liquids, ice chips, hard candy or very small amounts of food via spoon.

“God, thank you for being with us right now. We confess that we don’t understand why things happen the way they do. We don’t understand why illness comes into our lives, but we do know that you walk every path of life with us. Remind Joe that you are walking with him right now.

• Why do changes happen at the end of life? When someone’s dying, the body slows down and shows signs that the person is approaching the end of their life.
• Losing weight.
• Feeling weak and sleeping more.
• Feeling hot or cold.
• Eating and drinking less.
• Bladder and bowel problems.
• Breathlessness.
• Noisy breathing.

There are physical signs of dying Hands, feet and legs may feel cool or cold to the touch. Blood pressure gradually goes down and heart rate gets faster but weaker and eventually slows down. Fingers, earlobes, lips and nail beds may look bluish or light gray.

• Don’t say, “It’s going to be OK”
• But do say something.
• Do make clear that you’ll be there for them.
• Do be careful about saying, “I’ll pray for you”
• Do try to create a semblance of normalcy.
• Do ask how they’re doing — today.
• Do be a good listener.
• Don’t get squirmy at the end.

The end-of-life period—when body systems shut down and death is imminent—typically lasts from a matter of days to a couple of weeks. Some patients die gently and tranquilly, while others seem to fight the inevitable. Reassuring your loved one it is okay to die can help both of you through this process.

End-of-life care includes physical, emotional, social, and spiritual support for patients and their families. The goal of end-of-life care is to control pain and other symptoms so the patient can be as comfortable as possible. End-of-life care may include palliative care, supportive care, and hospice care.

Saying Goodbye

1. Don’t wait until the last minute.
2. It’s OK, even comforting, to let on that you know the end is nearing.
3. Follow the dying person’s lead.
4. The truth is good — but so is the little white lie.
5. Keep talking even if you’re not sure you’re being heard.
6. Try to stay present — don’t get ahead of yourself.

What not to say to someone who is dying

• Don’t ask ‘How are you?’
• Don’t just focus on their illness.
• Don’t make assumptions.
• Don’t describe them as ‘dying’
• Don’t wait for them to ask.

What to write to a dying loved one

• Thank you for the …
• I will never forget when we …
• You are the reason I learned to appreciate …
• I’ve been thinking of you. I remember when …
• Without you, I would have never discovered …
• I am so grateful that you taught me the importance of …