Death is simply a shedding of the physical body like the butterfly shedding its cocoon. It is a transition to a higher state of consciousness where you continue to perceive, to understand, to laugh, and to be able to grow.
Dr. Elizabeth Kubler Ross On Death and Dying

Death is a personal journey that each individual approaches in their own unique way. Nothing is concrete, nothing is set in stone. There are many paths one can take on this journey but all lead to the same destination.

As one comes close to death, a process begins; a journey from the known life of this world to the unknown of what lies ahead. As that process begins, a person starts on a mental path of discovery, comprehending that death will indeed occur and believing in their own mortality.

The journey ultimately leads to the physical departure from the body.

There are milestones along this journey. Because everyone experiences death in their own unique way, not everyone will stop at each milestone. Some may hit only a few while another may stop at each one, taking their time along the way. Some may take months to reach their destination, others will take only days. We will discuss what has been found through research to be the journey most take, always keeping in mind that the journey is subject to the traveler taking it.

One to Three Months Prior to Death

As one begins to accept their mortality and realizes that death is approaching, they may begin to withdraw from their surroundings. They are beginning the process of separating from the world and those in it. They may decline visits from friends, neighbors, and even family members. They are beginning to contemplate their life and revisit old memories. They may be evaluating how they lived their life and sorting through any regrets.

Food becomes less appealing as the body begins to slow down. The body doesn’t need the energy from food that it once did. The dying person is sleeping more now and not engaging in activities they once enjoyed. They no longer need the nourishment from food they once did. . The body does a wonderful thing during this time as altered levels of chemistry in the body produce a mild sense of euphoria. They are neither hungry nor thirsty and are not suffering in any way by not eating. It is an expected part of the journey they have begun.

One to Two Weeks Prior to Death

Mental Changes

This is the time during the journey that one begins to sleep most of the time. Disorientation is common and altered senses of perception can be expected. One may experience delusions, sometimes thinking others are trying to hurt them. They may also have a sense of grandeur, thinking they are invincible.

They may also experience hallucinations, sometimes seeing or speaking to people that aren’t there. Often times these are people that have passed on before them. Some may see this as the veil being lifted between this life and the next. The may pick at the sheets and their clothing in a state of agitation. There movements and actions may seem aimless and make no sense to others. They are moving further away from their starting point in their journey: their life on this earth.

Physical Changes

The body is having a more difficult time maintaining itself. There are signs that the body may show during this time:

• The body temperature lowers by a degree or more.
• The blood pressure lowers.
• The pulse becomes irregular and may slow down or speed up.
• There is increased perspiration.
• Skin color changes as circulation becomes diminished. This is often more noticeable in the lips and nail beds as they become pale and bluish.
• Breathing changes occur, often becoming more rapid and labored. Congestion may also occur causing a rattling sound and cough.
• Speaking decreases and eventual stops altogether.

A Couple of Days to Hours Prior to Death

The person is moving closer to their destination. There may be a surge of energy as they get closer. They may want to get out of bed and talk to loved ones. They may ask for food when they haven’t eaten in days. This surge of energy may be less noticeable but is usually used as a final physical expression before moving on.

The surge of energy is usually short lived and then the previous signs become more pronounced as death approaches. Breathing becomes more irregular and often slower. “Cheyne-Stokes” breathing, rapid breathes followed by periods of no breathes, may occur. Congestion can increase causing loud, rattled breathing.

Hands and feet may become blotchy and purplish (mottled). This mottling may slowly work it’s way up the arms and legs. Lips and nail beds are bluish or purple. The person usually becomes unresponsive and may have their eyes open or semi-open but not seeing their surroundings. It is widely accepted that hearing is the last sense to go so it is recommended that loved ones sit with and talk to the dying during this time.

Eventually, breathing will cease altogether and the heart stops. Death has occurred. They have reached their final destination in their journey.

I am standing upon the seashore. A ship at my side spreads her white sails to the morning breeze and starts for the blue ocean. She is an object of beauty and strength. I stand and watch her until at length she hangs like a speck of white cloud just where the sea and sky come to mingle with each other.

Then someone at my side says: “There, she is gone!”

”Gone where?”

Gone from my sight. That is all. She is just as large in mast and hull and spar as she was when she left my side and she is just as able to bear her load of living freight to her destined port.

Her diminished size is in me, not in her. And just at the moment when someone at my side says: “There, she is gone!” there are other eyes watching her coming, and other voices ready to take up the glad shout: ‘Here she comes!”

And that is dying.
Henry Van Dyke

Sources

The Hospice Foundation of America: The Dying Process: A Guide for Caregivers
Barbara Karnes: Gone From My Sight: The Dying Experience
Sherwin Nuland, M.D.: How We Die