I am fascinated with death. It is not an obsession, but I do find there are many interesting aspects of the dying process.
Today, I will write about one of these: there is some evidence that people who are seriously ill can – in some unclear way – determine the timing of their death.
Interviews with people who work in hospice care and other sources
When carrying out what are known in the trade as ‘in-depth’ interviews, the people interviewed can sometimes raise issues that were never part of the initial research.
This is what happened when I undertook a series of interviews with nurses, doctors and others who worked in hospice care for a book on the subject. My principal interests were their motivations, how it felt to do such work and its impact on their lives.
But in the course of such discussions, many referred to particular patients who they remembered well – and issues arising from their interaction.
And one of these issues was the matter of the timing of deaths. All of the patients involved were necessarily gravely ill and in the process of dying, as that is why they were receiving hospice care.
Timing over a matter of days or weeks
The first phenomenon in this respect was the ability of some patients to hold off dying until some particular event of importance to them had happened.
For example, one nurse spoke about a very ill man, who was expecting his family to come to London from Australia to see him. To her surprise, he managed to stay alive until their arrival and then, shortly after, died.
But there were others. Hospice patients were keen to see a granddaughter married or a new grandchild born, and they also managed to stay alive until the event. There were said to be more deaths following certain holidays, such as Christmas.
No one interviewed had an explanation for these events, but they were stated as facts – and happened too often to be taken as mere coincidence.
Since undertaking this research, I became aware of some wider discussion of the timing of deaths in the course of a year. It seems that there are notably more deaths at the beginning of a year than in the last days of the previous year, suggesting that dying people ‘hold on’ to see the New Year arrive.
Indeed, there was particular evidence of this at the turn of the Millennium. Evidently, there were strikingly more deaths in the first week of 2000 than in the last week of 1999, as reported in the Guardian Newspaper (17 January 2000). The Associate Director of the National Council on Aging, commenting on the ability of seriously ill people to hang on until a significant event, said “The mechanisms are something of a mystery but the phenomenon is very real.”
Then there is the case of Thomas Jefferson and John Adams – both American Presidents and, famously, ‘Founding Fathers’. Each was known to be seriously ill in 1826 and each man died on the same day: 4 July 1826. This was, of course, the 50th anniversary of the Declaration of Independence (4 July 1776), which both had signed.
Just a coincidence?
And finally, of no historical significance, there was my father. He was not trying to stay alive for a particular date or event but I think he was trying to avoid a particular course of action. He hated all medical interventions and was even scared of ordinary injections. At age 90, he was diagnosed with bladder cancer and told he needed chemotherapy. He told me on a long-distance phone call that he was dreading it, but he came down with a bad flu and it had to be cancelled. Then the flu got worse and he was hospitalised. His condition quickly deteriorated and he died two or so days later.
I had flown across the Atlantic to get there, but I missed him by one hour. As I stood next to his still body, a nurse explained that they never knew what he died of – he had had kidney failure, then a heart attack (I think, I was very tired from the flight and wasn’t taking it all in) and they tried to save him but didn’t succeed.
In my view, he died because he didn’t want chemotherapy – and all its attendant implications for his quality of life in his last months or years. Who will say me nay?
Timing over a matter of hours
But hospice staff also noted that some people seemed to find the right moment to die. Several cited examples where patients died at the exact time when certain circumstances changed.
A number seemed to want to die alone.
A large family, for example, had been spending a lot of time with their dying relative over a period of days. But at one point, they needed to deal with parking problems and the entire family went off to the car park for a few minutes. Strangely, this was the time when the patient suddenly died.
Another nurse told of a wife who asked her very anxious husband to go make her a cup of tea. At the time, she was not able to eat or drink so it was an odd request. But the husband, wanting to please her, went on that errand. Before he could come back, she had died.
It was thought that patients wanted to make their passing easier for their relatives.
We shall never know.
Lessons for the living
And what can we learn from these stories?
It is possible that they are all a matter of mere chance and one shouldn’t make too much of the issue.
But it is also possible that our internal make-up is much more complicated than we tend to think. Links between mind and body are little understood.
I happen to find it fascinating.
A version of this article was initially published by SixtyandMe.com
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I worked in a Nursing home passing medications for 20 years and witnessed many deaths and it's fascinating. I have seen many touching moments and some that were cold and void. But death I come to realize is not the worst thing to happen and lingering and suffering is devastating and soul crushing. I feel that being beside the dying is as important and needed as when a new life is born. I feel satisfied knowing that although I could not save them or heal them I can make that last part of their journey less lonely and more peaceful and it's a blessing to do that and I miss it.
Ann, my husband Sam Harrington (retired physician) especially liked this post. For anyone reading. don’t miss this Q&A with Ann! https://debbieweil.substack.com/p/on-savoring-old-age-writing-and-sex