Final Moments: Crafting Realistic Natural Death Scenes (Part 2)

Does your character know what to expect with a natural death? Is it painful? How long does it last? What does it look like? Did you know the death rattle is not the last breath a person takes? I have got you covered. Learn about all of this and more in today’s episode. 

Transcript

Does your character know what to expect with a natural death? Is it painful? How long does it last? What are the signs death is getting close? Did you know the death rattle is not the last breath a person takes? Do you need a timeline for your story, with some real-life examples? I have got you covered. Learn about all of this and more in today’s episode. 

Welcome to Writing Rural with Alley, the fiction writer’s weekly inspiration station for rural life and lifestyles, from historical to post-apocalyptic, helping you bring your rural stories to life! I’m Alley, and this is episode #89, Writing A Natural Death (Part 2). Stick around to the end to find out all the ways things could possibly go wrong. 

For my weekly viewers, I’m so sorry to have missed a couple of weeks. I was sick, and didn’t have a voice. I’m still a little off with the voice, but we will make the best of it. 

A quick disclaimer, I am in no way shape form or fashion a medical anything. This is not medical advice, death advice, or anything thing other kind of advice. This is solely for the purposes of fiction writing, and nothing else! 

I have some experience with this topic, and will be passing it along while it is still fresh in my memory. For any family or friends listening or watching, that is your cue, that I might talk about my family, and if that bothers you, you might want to skip this one. For everyone else, I will do my best not to cry, but no promises. With that said, let’s pick up where we left off.

Hallucinations. They are also common, but fall under the title delirium. Delirium is a bit of a broad range of things. This can be hallucinations, yes. The most common one I know of is, asking if someone in the ceiling (usually someone they know, dead or alive) to help them up, they want to walk around or leave. This can be referred to as the death reach. People do not always say anything, but they hold their hands out like they are reaching for something. 

Another one is restlessness. They might pick at their bedsheets or clothing. My first, and favorite, experience with this was my in-law. She was holding her IV line, and “sewing” with it. Ok, not a literal sewing, but you could see her make all the movements like she was sewing. It was something she loved to do. It was not distressing her, and she seemed quite happy doing it. My other in-law. I am not sure what he was doing, but he was definitely turning a screw driver. I have also seen people making all the motions of eating even though nothing is there. 

The last is the surge. This is a burst of energy they get and will want to do something. My grandmother wanted to have tea. If you go to YouTube, Hospice nurse Hadley tells a story of a man who cut down a tree with a chainsaw. Pretty impressive for someone about to die. 

Many times when this happens, the family might think they are getting better as they “look” better. However, that is not the case. This is a short-lived burst of energy that usually only lasts a few hours, and this is often the last physical thing they do before they fall into unconsciousness. 

And that is the next thing to happen. At some point in the days or even hours before death, the person will become unconscious. They will not wake again. Most of the time, it just looks like they fell asleep. 

Now there are usually a few hours, to a few days, between the time they are unconscious to the time they actually die. During this time, a few things will happen, and your character will be the one needing to care for them, or if they are in a hospital or nursing home the people there can do it. 

First, is to take care of any bodily functions they have. Some people think they stop having body waste expelled from the body, but this is not true. They can and do. When this happens, they will need to be cleaned up. Keeping them clean and dry will help keep them comfortable, and make their death more peaceful. 

Since they are unconscious, they will need to be turned, sometimes called rolling, every few hours to prevent bed sores. While they are unconscious, it doesn’t mean they can’t feel pain, and open wounds on the body would be painful. 

One thing I was surprised about was how much they will sweat. Wiping this sweat away can help keep them comfortable. 

Something physical that happens at this time is that they will relax their jaw and their mouth will be open. It takes a lot of muscles to keep the jaw closed, and these muscles relax at the end of life. This leaves them breathing through their mouth. 

Since they are mouth breathing, their mouths can become dry and chapped. Something that is often done it to use a sponge on the stick, or in a historical setting perhaps a damp cloth, to wet the inside of their mouth. Lip moisturizers can be used to keep their lips from becoming chapped. 

Many times, their eyes will be somewhere between open and closed. Not fully either. They will not be looking at anything, as they are unconscious. This is the death stare. 

Thier breathing will become irregular. It can be fast, then slow. There can be long pauses between them, and they can look like they are gasping. I have seen several cases where they take half breaths very quickly for a time. My mother, as she was passing, would take several quick half breaths, then a huge pause, before gasping and going back to several half breaths. And yes, this is a part of death that once you have seen it, you will not forget. 

A weird side note. I have personally found their breath smells a bit different, but there isn’t a smell to be placed to it. It just smells off. I was told this is because their blood oxygen can change in the last few hours. 

While these sounds scary, and can feel scary to the loved one, remember this is not painful to the person dying and is a natural and normal part of dying. 

Around this time there can be blotchy looking areas of skin around their feet and hands. This will slowly start to work its way up their arms and legs. It is normal and not painful. 

Finally, they will stop breathing, and their heart will stop. If you are writing a modern story, if a hospice worker is at home (At least here in tornado alley), they will listen for two minutes to make sure there is no heart beat before pronouncing them dead. If they are at a hospital, two doctors will listen to the heart for one minute each and then pronounce them dead. 

I learned the hard way, that if a person is in the hospital hooked up to the machines, there will look to still be a heartbeat on the monitor, but that is just the residual electrical activity of the heart, and it is not really pumping. It was a bit hard the first time, but I did know what to expect after that, making the next few not as hard. 

There are a few things that can happen with the body. They can have a last bowel movement, or even urinate. This is normal. There can be grunts, groans, farts and other noises that the body can make, and let me tell you, when they groan after being pronounced dead, it is hard on the family. At least it was on me! 

All of their muscles will relax. They don’t become instantly stiff like you see in the movies. I have seen a few times where the body makes extra lubrication for the eyes as the person is passing. This sometimes is expelled at death the same way other bodily fluids are. This can be mistaken as the person crying as they pass, and is a sad and heartbreaking thing if your character doesn’t know this is common. 

After the heart stops moving blood through the body, the blood will settle at the bottom of the body in whatever position they are in. This will leave the body looking pale and waxy as the blood starts to settle. 

In modern times, many times hospice or the hospital will clean up the body before sending it to the funeral home. In history or even some cultures today, the family will wash the body. 

There are a few more overall things to talk about. Death bed confessions are a real thing, but not as common as the TV makes them out to be. Last words can be very important to some people. It was important to me that my last words to my parents were I love you, and that was their last words to me. However I have been to one where their last words were “That feels wonderful” and another that was “Mmm, mashed potatoes.”

Historically, families took care of them, at least here in the US, we have hospice. Here in the US, medicare (Which is the medical insurance of the elderly) pays for hospice, but does not pay for any room and board when on hospice. This means that the person will have to stay at a hospital or nursing home out of pocket, or go home. At least that is the way things are as of the time I am writing this in 2024 in my state, unless something happened and no one told me. 

Some of the services hospice includes are doctors, nurses, medications, any equipment they need, caplin services, respite care, and comfort care. Basically, comfort care is a broad term for everything I listed. respite care is a short-term relief program to help the caregiver of the dying person. This is usually an hour or two of someone caring for your character’s loved one for an hour once, maybe twice a week. Yes, that is an insanely small window of time, and as someone who has been a caregiver repeatedly, it was not worth it in most situations, and that was very depressing and disheartening for me. 

Keep in mind that religious and cultural beliefs can affect the way people look at death. As a Christian, I am not scared of dying. I have met people who believed they would come back as an animal, and were terrified of dying, because they were scared of spiders and didn’t want to come back as one. Mortictian Catlin Doughty says that she was in South American where the people she stayed with kept their mummified loved ones in the home until they were ready to part with them. There are many cultures who saw death through battle or death while giving birth as the only honorable types of deaths. 

Another thing is that some people will not die until a certain thing happens. Some example are they are waiting for a person to graduate, the birth of a grandchild, a special holiday, so they have one more. My in-law held out until her husband came one last time, and then she passed away within the hour. They had been married over 60 years. My father fought and held out until I gave him permission, so to speak, and told him it was ok, I would be fine, and see him when I get there. 

And living people can also act oddly, as they are grieving sometimes before the person even passes. Some people refuse to see their dying loved one wanting to remember them the way they were. Others will stay by their side every second. Some people stay until right as they are dying. All of this is normal. That said, it can lead to guilt or hurt feelings. Especially for people who are over thinkers. 

Remember, dying people are still people deserving of dignity and respect. Will your dying character get that? I don’t know. 

Now, some of the best resources I found in my many years of going through this have been on YouTube. First is Hospice Nurse Hadley. She is sweet and covers more of the emotional side of things. Next is Hospice Nurse Julie. She does a great job covering more of the physical side of things. Last is what to expect right after with mortician Caitlin Doughty. She does a great job explaining what happens to the body, and how they are cared for in many eras. And a quick warning these three are not kids’ channels, and some might find their content disturbing, and in the last case, it might not be something they don’t want to hear about for religious reasons. 

Before we get to the best part, if you enjoy this podcast, and listening on YouTube, subscribe, hit the like button, and drop me a comment; I love to hear from you and answer questions! Don’t forget to share with a friend. 

Now is time for the what can go wrong, and since this is about death, buckle up, this might get dark. Just a fair warning. 

Likely to go wrong: The dying character could say something inappropriate. This can be because they do not care if people are upset or they do not have the ability to understand if something is appropriate anymore. 

Possible to go wrong: Your dying character’s caregiver cleans up their poop, only for them to immediately poop again. Many dying people can no longer control their bowel movements. 

Unlikely to go wrong: Your dying character becomes aggressive. This is not common, but can happen. 

Improbable but still technically in the realm of possibilities: Your dying character screams and dies, looking like they are in horrible pain. This is a very rare thing, but is something I have heard about from people who work at nursing homes. 

I promised a Black Friday deal all months, and I might be extending this to make up for the time I was sick. Anyone interested in a special one year membership to my buy me a coffee page can email me at Alley@alleyhart.com with the phrase FREE ONE YEAR MEMEBRSHIP, and I will send them a link to a free one year membership. This is only open for the month of November in 2024. My membership includes exclusive behind-the-scenes access to my projects, opportunities to influence the content you want to see, bite-sized pieces of rural wisdom, and unique and entertaining personal stories that you won’t find anywhere else. I hope to see you all there. 

Thanks for listening! Until next time, happy wordsmithing.