Doctor explains what happens during 'peaceful' death and why we shouldn't be scared of it

A palliative care doctor revealed that sometimes death is so gentle that families don’t even realise that it’s happened

Dr Kathryn Mannix believes we should be changing how we approach the subject of death
Dr Kathryn Mannix believes we should be changing how we approach the subject of death

Death is something a lot of us fear for a multitude of reasons. From what happens during the final few minutes to the unknown that follows – it’s a subject that rarely finds itself at the centre of discussion during a casual chat.

But one palliative care doctor is hoping to break the taboo after a frank talk about the very thing we often shy away from thinking about.

Dr Kathryn Mannix, author of With The End in Mind, sat down with BBC ideas to discuss death – particularly, what happens during a peaceful death.

She said: “In my humble opinion, dying is probably not as bad as you’re expecting.”

She begins by talking about the way that we talk about death, or rather, the ways that we don’t talk about death. What she says is true, many of us simply don’t mention the ‘D words’ and in place of saying ‘dead’, we might go for an alternative like ‘passed away’.

Conversations around dying have – dare we say – died away. We’re often not sure what to say, don’t know what to expect and generally are not sure how to approach the situation.

The problem is, Mannix says, that when we don’t use the correct words, families may not understand that death is approaching and then could find themselves in a situation where nobody knows how to act or what to say to a loved one who is dying, let alone what to expect. But it doesn’t need to be like that at all.

Mannix said: “We’ve lost the rich wisdom of normal human dying and it’s time for us to talk about dying and reclaim the wisdom.”

The clip sees Mannix discuss what is often the pattern of a ‘peaceful’ death, even comparing it to childbirth.

She added: “Dying, like giving birth, really is just a process. Gradually people become more tired, more weary. As time goes by people sleep more and they’re awake less.”

So with this increasing need for sleep, what can it look like and how can it present itself?

Mannix continues: “Sometimes a visitor might happen or a medicine might be due during that sleep and that is when we can discover that a change has taken place, it’s tiny but it’s really significant and it’s just instead of just being asleep, this person has temporarily become unconscious.

“When they wake later on, they tell us they’ve had a good sleep, so we know that this coma doesn’t feel frightening. That lapsing into unconsciousness just isn’t noticed by us when it happens.

“So as time goes by, people are awake less and asleep more until eventually they’re just unconscious all the time.”

“Dying is something that we should be reclaiming”

We’ve all heard the words ‘death rattle’ interpreted as being something that is scary, morbid or even uncomfortable for the dying loved one but Mannix goes a step further to describe what exactly a death rattle, what causes the phenomenon and why it’s not to be feared.

Talking from the perspective of the one dying, she says: “We will be so relaxed that we won’t bother to clear our throats, so maybe we’ll be breathing in and out through little bits of mucus or saliva at the back of our throat, it can make a rattly, funny noise.

“People talk about the death rattle as if it’s something terrible but actually it tells me that my patient is so deeply relaxed, so deeply unconscious that they’re not even feeling that tickle of saliva as the air bubbles in and out through it from their lungs.”

The build up to death is one thing but even the last few breaths drawn by someone can be peaceful according to Mannix.

She continues: “At the very end of somebody’s life, there will be a period of shallow breathing and then one ‘out breath’ that just isn’t followed by another ‘in breath’. Sometimes it’s so gentle that families don’t even realise that it’s happened.”

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Mannix believes that we need to normalise conversations around death in order to educate each other and ultimately console each other in the best ways that we possibly can.

She finishes by saying: “Normal human dying, just a really gentle process. Something that we can recognise, something that we can prepare for, something that we can manage and this should be something that we can celebrate.

“This is something that we should be able to console each other with but because it’s become impolite to talk about dying, it’s the really best kept secret in medicine.

“Dying is something we should be reclaiming, we should be talking about, we should be consoling each other about.”


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