Excerpt from Dying: A Natural Passage by Denys Cope

I’ve been a Registered Nurse for over 40 years, and a Hospice nurse for about 20 years. Several years ago I decided that the most important part of the job that I do when I am with an individual family, is teaching them about the dying process so they can get comfortable being with their loved ones. People are often not comfortable around dying. And it can help to be familiar with the actual dying process, the physiology of it and the spiritual experiences of it, to know what is really going on. So I will describe what happens when Hospice gets called in, when people are counting their life in weeks or months rather than years.

The main thing I would like people to know is that the dying process is not something to be feared. It is a tremendously sacred experience, and there is tremendous spiritual support for the transition. What I have learned over time is that the dying process is perfectly and naturally orchestrated, just like the pregnancy/labor/birth process. It’s just exquisite how the body naturally goes into the dying process.

No matter what brings you to the dying process, whether it is cancer, old age, lung disease, heart disease, whatever, the process is the same. I get the picture of a funnel: everybody gets brought to this place, and then they begin the same process; it becomes very recognizable. Many people say to me, “How do I know when my loved one is ready for hospice?” Or, “When have they begun dying?” I ask if the person has changed their relationship to food, because what I see is that the body has this natural withdrawal from that which sustained physical life. It’s really switching from a physical energy source to a spiritual energy source, so usually there is loss of appetite with some degree of weight loss.

That’s one of the criteria when we are assessing if we can put someone on Hospice. If there is a valid weight loss and other factors, we can say okay, they have probably started the process. The other thing we do as we enter the dying process is we start to withdraw from the outer world and turn inward. There is a disconnecting from social things, from those out-in-the-world kind of things; people in the dying process don’t have energy for that anymore.

The first thing to go — it goes in layers — are our social connections; we stop having energy for that.

Next to go is our close circle of friends, and then pretty soon the only people we have energy for are our core people, the people for whom we don’t have to put on a social face.

Throughout the dying process, we are doing what conserves energy. Eating lighter food because our body can’t digest the food. And energetically or physically, withdrawing from activities, doing less and less and spending more time doing what we the living think is sleeping. We say they are sleeping, and the truth is they are doing a lot of this internal work, the work of dying.

Dying is a lot of work, it is hard work, and some of that is the work of introspection. I believe that not all of that is done on a conscious level. Just like our dreams are healing, I believe we go into these different states of consciousness, and we are able to do clearing or reordering, for want of a better word. This introspective work takes place on a lot of levels.

From what I observe, one of the things that we do is to start taking stock of our lives, our relationships. We ask, “What has our life meant?” “Does anything feel unfinished?” We start to think about the things that we haven’t done, the relationships where we may not feel complete, or wish we were in a different place. We start to do that, and from what people have told me as they get closer to actually dying, there is an experience of getting to see the “other” side.