When Death Knocks at the Door

"Some people seem to understand they are dying a few months or weeks before death through an intuitive sense, even without discussing it. This is particularly remarkable in patients with severe illnesses, such as cancer, or following a major myocardial infarction (MI) or stroke, as well as in older individuals. Studies in hospitals have shown that more than 80 percent of cancer patients who died were aware of their terminal condition."

"A few months before death, some elderly or critically ill patients may experience specific signs. However, this time is not definite and may vary from person to person. They may lose their appetite, even for their once-favorite foods and drinks. Weight loss may occur. They constantly feel fatigued and tend to sleep more because their bodies begin conserving energy. They often like to be alone and avoid friendly or family gatherings. It is surprising how quickly they lose their balance."

Systemic inflammation from severe illness and aging can disrupt the brain's reward system and reduce the will to live. The reward system functions as the biological engine of motivation by making life feel pleasurable and driving behavior toward survival. Severe illness and aging produce systemic inflammation that impairs reward circuitry, causing anhedonia and diminished motivation. Many patients with terminal conditions demonstrate intuitive awareness of dying, with high prevalence among cancer, cardiovascular, and respiratory disease patients. In the months before death, individuals may show appetite loss, weight loss, fatigue, increased sleep, social withdrawal, balance decline, and intense mood changes including anticipatory grief.

Read at Psychology Today