The 3 ways people choose to die

There are some people who just know when they’re going to die. I don’t know how they know, but they know. There are others who even seem to choose when they’ll die. Of course, not everyone appears to have control over their time of death, but when they do, I often see one of three things happen:

1. The person waits to die until every last one of their family members or friends arrives to be present with them.
2. The person waits to die until every last family member or friend leaves the room or the house.
3. The person waits to die until after a milestone has occurred.

All of these scenarios are so common in my experience, and I’ve seen each of them play out many, many times. Let’s take a closer look at them.

The Person Dies When Everyone Has Arrived

Sometimes a person will wait until all of their loved ones have flown or driven in from other places to say goodbye before they die. Or they’ll wait for every person to be physically present in the room with them and then they’ll let go. This most often happens with a person who’s social and extroverted, who thrives off the energy of others.

Rachel had turned one hundred just five months before I met her when she came on hospice. At that time, a huge crowd of children, grandchildren, great-grandchildren, and even a few great-great-grandchildren gathered to celebrate the life of the family matriarch.

When I evaluated Rachel, it was very evident that she was in the stage of actively dying. All the signs were there. I saw it in the pallor of her skin. I heard it in her breathing. I noticed it in her lack of interest in or ability to eat food. The end was near.

“So,” I explained to Rachel’s two daughters who were in the home when I stopped by to do the admission. “What I’m seeing is that she’s actively dying. That means that in the next few days, she’ll die. So whoever needs to be here, get them here.”

Nodding, the sisters, who were in their seventies, agreed to mobilize everyone who’d want to come and say goodbye to Rachel.

Over the following two or three days, family members flooded into Rachel’s home to say goodbye. Although she was unresponsive, I was still glad to see the love that was surrounding her. When one of Rachel’s daughters told me that one of the grandchildren couldn’t make it from New Jersey until the following week, I knew she’d get there too late to say goodbye to Rachel. But maybe she’d be there in time for the funeral service.

When I came to the house a week after I’d predicted Rachel had just two or three days to live, I met this granddaughter. I was very surprised Rachel had lasted a week. A week later, another grandchild, living in a different part of the state, who hadn’t even planned on coming, had a three-day weekend and showed up to say his final goodbyes. How Rachel had lasted two weeks, fully unconscious, without food or water, baffled me. Whenever I’d visit, I could hear Rachel’s daughters giving her updates about who still wanted to come to say goodbye to her, and Rachel kept living.

In the end, Rachel lasted seventeen days in that state of actively dying, without food or water. Just hours after the final family member came to say goodbye, Rachel finally let go. I’d never seen anything like it. Rachel absolutely decided when she was going to die.

The Person Dies When Everyone Has Left

Conversely, some people wait until their loved ones have left their bedside before dying. Sometimes these family members have kept vigil for hours or days, yet it’s when they finally step away that the person dies. Whether they leave to go home and rest for the night or just step out to grab a cup of coffee, that’s when the person — often someone who’s more private or introverted, who prefers time alone — dies.

When someone chooses to die when no one’s around, family members have confessed to me that they feel guilty, as if somehow they’ve failed their loved one by not being present with them in the actual moment of their death. They might wonder, “Is he punishing us?” or “Is she trying to get back at me for something?” No. Likely not. This is just something they needed to do for their own dying process. Much like in life, in death, a person’s behavior isn’t usually about us, but about them and what they need. If we imagine that the person who is dying was “holding on” in some way for the sake of those in the room, then giving the person the space and solitude they need to let go is the most gracious thing we can do for them. I don’t think anyone who’s spent any kind of time with the person who’s dying should feel guilty for not being present at their last breath. It’s likely that that is exactly how the dying person wanted it to be. When this happens, you can take comfort knowing that it’s what they needed.

Take Walter. Walter’s wife made four phone calls to alert the couple’s four children that their father, who’d been on hospice care for months, likely would die within one or two days. In a scramble to book last-minute plane tickets, all four adults were able to make their way home to be with their father in his final days. Walter was showing many of the signs that let me know death was near. For days, he’d been eating and drinking less. He had become unconscious and unresponsive. His breathing had become irregular, and I detected the raspy death rattle. His pale skin had become mottled in places, and his body temperature was fluctuating. Walter was a textbook case of someone who is actively dying.

The day after Walter’s wife had alerted her children to his impending death, they’d all dragged in chairs from the dining room to be seated around him as he died. Among the five of them, they worked out a schedule so that Walter would never be alone — so that he wouldn’t die alone. One day of this vigil became two. Two became three. On the fourth day, a longtime neighbor brought over a small feast, around lunchtime, to feed the family. Although Walter’s wife had been stationed at his bedside, when she heard the doorbell, she scrambled to the kitchen to put plates, cups, and utensils on the table.

When the family was halfway through the meal, one of them remarked, “Dad would love this mac and cheese.”

And that’s when they realized that Walter was alone.

When one of his children hopped up to check on him, she returned quickly to let her family know that Walter had died. Sometimes people wait to be alone to let go.

The Person Dies after a Milestone

Sometimes a person chooses a date with personal significance — a holiday, wedding, birthday, or anniversary — and dies on that day. “I’m going to wait until after my grandson is born.” “I’m going to make it to my eighty-eighth birthday.” Then, they let go. Although not everyone is able to achieve it, I’ve seen many people who will hang on with a vengeance to make it to a special milestone. I’ve noticed that these people are often the ones who are very willful or independent (aka stubborn), as well as those who have deep connections to tradition or specific anniversaries that shaped their lives.

Mitzy, one of my followers on social media, shared this amazing story with me: Her mother was on hospice while Mitzy’s daughter was nine months pregnant. Mitzy was sitting in a chair beside her mom’s bed, reading, when she received a phone call that her daughter, who lived in another state, was having contractions. Mitzy was torn.

“Mom, I don’t know what to do,” Mitzy told her mother, who was still lucid. “I don’t want to leave you. I’m afraid if I leave, something’s going to happen, but I do want to see my grandson being born.”

With confidence, Mitzy’s mother assured her, “Honey, you have to go. If you don’t, you’re going to regret it. Don’t worry about me. I’m going to stay here until your grandson is born.”

Although Mitzy was conflicted about her decision, she took her mother’s advice and drove several hours to be with her daughter. When Mitzy checked in with her brother from the road a few hours into her trip, he reported that as soon as Mitzy left, their mother seemed to go into a deep sleep.

Late that night, after Mitzy arrived at her daughter’s home, they discovered that her contractions had not, in fact, meant that she was in labor. Instead, they were “false alarm” contractions called Braxton-Hicks. No labor. No grandson.

The following morning, Mitzy drove straight back home to be at her mother’s side. Even though her mother was unresponsive, Mitzy narrated the trip for her, explaining that the baby had not yet come. Then she remembered her mother’s promise. Gently, with kind assurance, Mitzy whispered in her mother’s ear, “It’s okay, Mom. You can go. It’s okay.”

But her mother held on.

A whole week later, her mother was still unresponsive. When Mitzy’s daughter went into legitimate active labor, Mitzy repeated her trip to be with her daughter and welcome her grandson.

After the baby’s birth, Mitzy phoned her mother’s home and asked her brother to put the phone to her mother’s ear.

“Mom, we have a healthy grandson. He has ten fingers and ten toes! Everything went great.”

Mitzy’s brother called her back fifteen minutes later to let her know that their mother had died. The family would always joke that Mitzy’s mother and the grandbaby high-fived each other, one entering this world as the other was exiting.