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April 20, 2020
by Ruth Gordon, MA, MSW, LCSW

That Last Breath

April 20, 2020 11:27 by Ruth Gordon, MA, MSW, LCSW  [About the Author]

Across cultures it is accepted that it is a terrible thing to die alone.  During the present covid-19 epidemic the televised vision of refrigerated trucks filled with the dead has been especially disturbing.  Why is that?  Of course it is tragic when large numbers of people die.  It is also frightening.  Part of what appears to be at play here is that the fear of being unknown and alone is projected on to what an individual,who is a witness, has conjured up in his/her mind as a picture of lives uncelebrated and discarded.

This vision is bolstered by the awareness that during the quarantine family and friends have not been allowed to visit those who are sick and those whose lives are ending. It is understandable that the current situation leads to the belief that people are dying, unmourned and alone, but it is not, necessarily, true.

It is likely that friends and family have been notified that someone that is cared for and about has died and that mourning has begun for thousands of of people.  This begs the question:  Does the individual who is passing on know or care if the last breath has been observed?

At birth there is always at least one witness, the mother.  Death brings with it an entirely different set of elements.  Research has shown that the preponderance of  belief that the last breath, should and must be seen.  Why?

Leaving religion out of this discussion, what evidence proves that the dying individual is aware of the presence of others?

There are reports that loved ones ,who preceded the individual in death, appear to the person who is dying some time before this life is over.  Many conclude that this heavenly presence is there to accompany the departed into the next world.  If this is true, then the the need for the presence of those still living is, likely, irrelevant.

There is no scientific confirmation that any of the above is true.  Multiple reports of near death, out of body experiences ,are to be found in medical and other records.  The aggregate information that has been collected about these reported glimpses into the afterlife confirm one interesting common thread.  Regardless of the cause of near death, all reported that the experience was peaceful.  There is little confirmation of a rerun of events in an individual’s entire life.

Some believe that if the moment of death is not witnessed, then the last chapter of life has been missed.  For some it is seen as a loss of control over the dying process.  In Japan this is called kadokushi — lonely death.  The occurrence is attributed to the void that has been left by 21st century mobility that has physically separated families and dismantled neighborhoods.

There are those who believe that an individual does have some control over the moment of death.  They speculate that someone who takes pride in independence and personal strength may choose to leave this world unattended.

An elderly individual who has a Ph.D. in psychology was asked by a client what to do if the actuality of death is near.  This therapist had a one word answer — Live!  This point of view correlates with the opinion of other mental health professionals who believe that if one perseverates on the fear of dying alone, then the opportunity to live a fully engaged life has been lost.

It is important to understand that even those who have loved ones throughout life, have no guarantee that their passage into death will be witnessed.  Those who form a support system may well expire first.  Someone may leave the “room of death” to go to the bathroom or get a cup of coffee or speak to a medic about prognosis.  Suppose that the nearby individual is someone who is particularly irritating — would that be a wished-for companion at such a time?

The guilt felt by people who, for whatever reason, have not made it to the death bed in time may be crippling.  Some mental health professionals believe that it is a mistake to tell the grieving individual to not feel guilty. In this perspective, it is more helpful to accept that the grief that is felt is normal.  It needs to be accepted and integrated as a legitimate feeling.

Just because an individual feels guilty does not mean that he/she is guilty.  It is important for those who grieve to really understand that they are not defined by their guilt.

For many it is unacceptable to concede that life ,itself, is disorderly.  If blame can be attached to someone, even one’s self, it may bring relief.  The relief comes from the reassurance that if there is blame, then there also is order.

One client beat herself (emotionally) for years.  Although she had been attendant to her mother’s needs, she could not bear the fact that the last time she saw her mother alive she did not say, “I love you”.  The shame and guilt enveloped her for years.

During that period of time it was hard for her to fully enjoy her life.  In fact, she believed she did not deserve to have a happy life.  Years later, during a session with her therapist, the therapist pointed out that her mother did not know that it was to be their last meeting.  Her mother did not think to herself “Why didn’t Jane (made up) tell me she loved me? After all, I was scheduled to die before I saw her again”.  Jane had never thought of it from that angle.  When she looked at it this way, she knew it was true.  Thereafter, Jane was free to miss her mother without feeling the self-loathing that usually accompanied that memory.

During this time of pandemic, fear of the unseen predator has become the rule.  The need to isolate has intensified the magnitude of the “new order”. Responses to the horror of the hard to predict scope of covid-19, the uncertainty of who comes next, and visions of people seeming to be abandoned and discarded has stirred up terror even in normally laid back individuals.

 When health and economic safety have taken center stage, it is sad to know that, additionally, blame and demise have become twins. Life’s events are uncertain, they have always been uncertain.  It may be time to make peace with that and get on with living.





(04/07/20)“At 89 She Fears Dying Alone More ThanCoronavirus Itself,

Blake, J. “If You’re Afraid of Dying Alone, Remember These 11 Things. bolde,com


Maki, K.(04/09/12) “Afraid of Dying Alone”


McCarthy, D. “Why You Shouldn’t Be Afraid of Dying Alone”  over


Syrdal, K (07/12/16)“Why Your Fear of Dying Alone Means You’re Not Really Living”


Thomson, H. (06/26/14)”Near Death Experiences Are Overwhelmingly Peaceful” new           

About the Author

Ruth Gordon Ruth Gordon, MA/MSW/LCSW

I bring with me +30 years of experience as a clinician. My Masters degrees are from: Assumption College, Worcester, MA, Master of Arts in Psychology & Counseling/ and Boston University School of Social Work, Boston, MA, an MSW in Clinical Social Work. This is the 11th year I have written a monthly newsletter that is sent to approximately 500 individuals. The archive can be found on my website,

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The OC Building, 11983 Tamiami Trail, N., Naples, FL 34110
Naples, Florida
United States
Phone: 239 293-4314
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