Is Dying Always Painful?

Although pain is a relatively common symptom for those with advanced stages of terminal illness, dying is not always painful. As a matter of fact, the moment of death may prove to be a more positive experience than most people imagine. 

For example, in a study published in Science Direct, researchers examined what occurred in the brains of dying rats and found a threefold increase in levels of serotonin, a neurotransmitter that elevates mood. The researchers surmised that this surge of serotonin might help to ease fear or anxiety associated with the actual moment of death. 

Near-death experiences may also give us clues as to what happens in the brain as we die. While not predictive, they can provide insight into what might occur since those who live to tell about it were once considered clinically dead. Although no clear explanation exists to explain these phenomena, they rather consistently suggest that the moment of death is a transcendent and quite pleasant experience. 

All this notwithstanding, many people who are in the final stages of a life-limiting illness suffer moderate to severe pain. Pain may occur due to the disease process itself, or it may be related to other factors such as immobility and associated musculoskeletal pain. Psychosocial factors also influence the experience of suffering. Anxiety, fear, social isolation and preparatory grief may cause significant distress and exacerbate physical pain. 

Managing Pain in the Dying 

Pain is a subjective experience, and each person will respond to the physical, emotional and spiritual challenges of dying differently. But if pain is an ongoing symptom, appropriate pain management is crucial to ensuring that the dying person and their loved ones do not suffer unnecessarily. The best way to accomplish this is to enroll the dying person in hospice as soon as possible. Hospice providers are uniquely skilled in the assessment and treatment of pain at the end of life, and can assist the patient and their caregivers in finding the best pain management tools for their end of life experience.  

Sources 

“Elevation of brain serotonin during dying.” Science Direct. https://www.sciencedirect.com/science/article/abs/pii/S0304394011005234 

“Providing care and comfort at the end of life.” National Institute on Aging. https://www.nia.nih.gov/health/end-life/providing-care-and-comfort-end-life