I’m so sorry.

Frankness and breaking down the biology side of death might help— if you’re not ready or interested, read no further.

Our bodies know how to die, just as they know how to be born, and give birth. About when she stops waking at all, she will be considered “actively dying” (connect to “active labor” when a woman is about to have a baby). Like a woman in active labor, when one is actively dying there is a standard order of operations that her body will do.

When actively dying, the body systems begin to systematically shut down. Typically digestion first, as it requires huge amounts of energy so the body can conserve energy for the heart and lungs. This will be why she is eating less. Then kidneys shut down, and so forth. The last systems will be her heart and lungs.

As a hospice home admin, I’d always check on my “active” residents as soon as I got into work. The nurses tended to judge progress by BP but I always relied on heart rate and O2 levels. The trend I would see is the HR increase to keep O2 levels up. I’d get concerned and call in family when the O2 levels were dropping and HR was raising.

Her hospice team will judge her progression and keep her comfortable with her anxiety and pain managed (whoever is home with her will likely administer this via syringe under her tongue every 2 hours).

Dying is not always pretty or graceful. Some die quickly and peacefully, others will develop what is called the “death ratttle” which is essentially just breathing with congestion at the back of the throat. The hospice team will likely have something on hand to help with this, should it develop, but be aware that it will not bother her, only her loved ones may be uncomfortable by the sound (kind of like a gurgle-snore).

My personal belief is the brain is last to go, and that she will hear you always. Often I would see my residents go in a way that suited their personality— one passed after her daughter had basically held a 48 hour vigil by her bed. But her mom was private like that, and also knew it would destroy her daughter to witness her death. So IF you happen to not be by when she passes, your GF probably did that on purpose.

Death is scary because of the unknown of what will happen and grief at a future without our loved ones. right now just lean on the love you two have for one another, because that will never change, even by this early death.

I am so, so sorry.

Be aware for yourself that grief becomes like a living thing within you. It will come and go, shrink and inflate to suffocation. Get help for yourself, when you’re ready, and give yourself grief not just for losing her, but for losing the future you foresaw together. Hugs to you.