Each person approaches death in his/her own way, bringing to this last experience his/her own uniqueness. What is listed here is simply a guideline, a roadmap. Like any map, there are many roads arriving at the same destination, many ways to enter the same city.

Use this guideline while remembering there is nothing concrete here; all is very flexible. Any one of the signs in this information may be present; all may be present; none may be present. For some, it will take months to separate from their physical bodies, for others, only minutes.

Death comes in its own time; in its own way. Death is as unique as the individual who is experiencing it.

If the following signs were to be put on a time table, a very flexible time table, we could say these changes begin one to three months before death occurs. The actual dying process often begins within the two weeks prior to death. There is a shift that occurs within a person which takes them from a mental processing of death to a true comprehension and belief in his/her own mortality. Unfortunately, this understanding is not always shared by others. 

ONE TO THREE MONTHS PRIOR TO DEATH WITHDRAWAL

As the knowledge that, "Yes, I am dying." becomes real, a person begins to withdraw from the world around them. This is the beginning of separation, first from the world - no more interest in newspapers or television, then from people - no more neighbors visiting. "Tell Aunt Jessie I don't feel like company today.", and finally from the children, grandchildren, perhaps even those persons most loved.

This is becoming a time of withdrawing from everything outside of one's self and going inside. Inside where there is a sorting out, evaluating one's self and one's life, but inside there is only room for one.

This processing of one's life is usually done with the eyes closed, so sleep increases. A morning nap is added to the usual afternoon nap. Staying in bed all day and spending more time asleep than awake becomes the norm. This appears to be just sleep, but know that important work is going on inside on a level of which "outsiders" aren't aware.

With this withdrawal comes less of a need to communicate with others. Words are seen as being connected with the physical life that is being left behind. Words lose their importance - touch and wordlessness take on more meaning.

FOOD

Food is the way we energize our bodies. It is the means by which we keep our bodies going, moving and alive. We eat to live. When a body is preparing to die, it is perfectly natural that eating should stop. This is one of the hardest concepts for a family to accept.

There is a gradual decrease in eating habits. Nothing tastes good. Cravings come and go. Liquids are preferred to solids. "I just don't feel like eating." Meats are the first to go, followed by vegetables and other hard to digest foods until even soft foods are no longer eaten.

It is OK not to eat. A different kind of energy is needed now. A spiritual energy, not a physical one, will sustain from here on.

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ONE TO TWO WEEKS PRIOR TO DEATH - DISORIENTATION

Sleep is most of the time now. A person can't seem to keep his/her eyes open. They can, however, be awakened from that sleep. There is literally one foot in each world. A person often becomes confused, talking to people, and about places and events that are unknown to others. They may see and converse with loved ones who have died before them. There may be picking at the bedclothes and agitated arm movements. There is a seeming aimlessness to all physical activity. Focus is changing from this world to the next, they are losing their grounding to earth.

PHYSICAL CHANGES

There are beginning changes which show the physical body is losing ability to maintain itself:

	The blood pressure often lowers.
	There are changes in the pulse beat either increasing from a normal of 80 to upwards of 150, or decreasing anywhere down to zero.
	The body temperature fluctuates between fever and cold.
	There is increased perspiration, often with clamminess.
	The skin color changes - flushed with fever, bluish with the cold. A pale yellowish pallor (not to be confused with jaundice) often accompanies approaching death. The nail beds, hands and feet are often pale and bluish, because the heart can't circulate the blood through the body at a normal rate.
	Breathing changes also occur. Respiration may increase form a normal 16 to 20 to upwards of 40 - 50 breaths every minute, or decrease to 9 or even 6 breaths a minute. There can be a puffing, a blowing of the lips on exhaling, or actual stopping of the rhythmic breathing only to resume again. This generally occurs during sleep. Congestion can also occur, a rattly sound in the lungs and upper throat. There might be coughing with this, but generally nothing can be brought up. All of the these breathing changes and congestion have a tendency to come and go. One minute any or all of these symptoms may be present, the next minute breathing may clear and be even.

ONE TO TWO DAYS - TO HOURS PRIOR TO DEATH

Sometimes there is a surge of energy. A person may talk clearly and alertly when before there had been disorientation. A favorite meal might be asked for and eaten when nothing had been for days. A person might sit in the living room with relatives and visit when they hadn't wanted to be with anyone for quite awhile. The spiritual energy for transition from this world to the next has arrived and it is used for a time of physical expression before moving on. This surge of energy is not always as noticeable as the above examples, but in hindsight, it can usually be recognized.

The one to two weeks signs that were present earlier become more intense as death approaches.

Restlessness can further increase due to lack of oxygen in the blood.

The breathing patterns become slower and more irregular. Breathing often stops for 10 to 15 to even 30 to 45 seconds before resuming again. Increase in mouth breathing occurs.

Congestion can be very loud. It can be affected by positioning on one side or the other. It still comes and goes.

The eyes may be open or semi-open but not seeing. There is a glassy look to them, often tearing.

The hands and feet now become purplish. The knees, ankles, and elbows are blotchy. The underside of the arms, legs, back and buttocks also can be blotchy.

Generally a person becomes non-responsive (unable to respond to the environment) sometime prior to death.

How we approach death is going to depend upon our fear of life, how much we participated in that life, and how willing we are to let go of this known expression to venture into a new one. Fear and unfinished business are two big factors in determining how much resistance we put into meeting death.

The separation becomes complete when breathing stops. What appears to be the last breath is often followed by one or two long spaced breaths and then the physical body is empty.