The last goodbye

Often when a person is at the last stage of their disease and dying they are in an altered state of consciousness. Most people understand consciousness as either awake or asleep. Yet there are ranges of consciousness that most people don't give much thought to. We can often be in an altered state of consciousness when we are waking in the morning or just when we are going to sleep. These are often times when our dreams are most vivid. A time when we are neither awake or asleep, yet a place where activity continues.
During my time as a palliative care nurse I've often been with people who are in these altered states. Most palliative care nurses who have worked in the field long enough would agree, that helping a loved one move from this life often involves 'giving permission' to die and saying goodbye. Usually this scenario is where a person is in an altered state of consciousness. This unconscious state could be for hours or days. What frequently happens is that the person who has been given 'permission' dies within hours.
My understanding of this behaviour is that a person is in an altered state of consciousness. They are still able to process information around them as well as internally. It is in my opinion a sacred space. A place where healing can still occur. (not cure) I don't think it is a co-incidence that frequently people in these states will still be alive until a loved one is next to their bedside, or they die at a particular time or wait until Christmas.
Saying good bye it is often the hardest words ever said. Yet it is often the most freeing for the person experiencing eminent death.
Most my understanding of this topic I've experienced during my work in palliative care, yet there are number resource if one wishes to explore the topic more fully.
::One book which I would recommend is by Australian Dr Michael Barbato a Palliative care physician, Reflections of a setting sun.