Understanding the Dying Process Common Patterns of Dying When I studied thanatology (the study of death, dying, and bereavement), one of the questions students con- sidered was, “When does dying begin?” The answers, of course, ranged from birth to the visible onset of illness, to last days and hours. The answer I always liked best was, “At 40, when the dog dies and the kids leave home!” (At this point I am 60ish and still hoping to get a dog. The kids have come back home!) In fact, dying begins differently for each person, depending on the illness and the person’s own health. What does dying look like? To answer this question, you might observe the physical changes the person experien- ces in their last days and hours. However, understanding what dying looks like in this century requires that you look further back than the last days, back to the weeks, months, and perhaps years prior to death. To answer the question “What does dying look like?” you need to understand the changes in the way people are dying in the 21st century. This chapter explores common patterns of dying and dis- cusses the reality that a dying person is still very much a living person. Palliative care is now seen as a valuable service from time of diagnosis. Why? Because the dying person may have many needs for holistic care early on. 1