Critical incidents in the timing of the moment of death
To determine what might be involved in a dying person's ability to control the timing of death, retrospective interviews were held with family members of patients who reportedly died under one of two circumstances: death was delayed until an event of some emotional significance occurred, or it was hastened after such an event occurred. Twenty such cases were investigated, involving the deaths of 10 men and 10 women with a mean age of 70.5 years. The psychological autopsy method (Shneidman, 1969; Weisman \& Kastenbaum, 1968; Weisman, 1974) was used to structure the one to one and a half hour interviews, conducted by the researcher, a marriage and family counselor with eight years of hospice experience. Ten of the subjects interviewed were spouses of the person who died and ten were children. In half of the cases a second family member was also interviewed. Transcripts of the interviews were the basic data of the study. The critical incident technique (Flanagan, 1954; Dachelet, et al, 1981; Woolsey, 1986) was used to identify and categorize those events which were deemed crucial by the family to the delaying or hastening of death. One hundred and fifty-nine incidents were identified under four headings: (1)~Bringing Life to Conclusion, (2)~Releasing Relational Bonds, (3)~Opening to Death, and (4)~Relating to the Process of Dying. Incidents were also categorized according to how close to the moment of death they occurred. Events of an interpersonal nature, having to do with the relationship between the dying person and his or her family and friends, made up 55\% of the total number of events and accounted for 81\% of those that occurred in the last 24 hours of life. These interpersonal incidents, particularly the arrival of children at the family home, seemed to have the most potent affect on influencing the timing of death. Given that acceptance of death is an appropriate developmental phase of the dying process (K\"ubler-Ross, 1975; Pattison, 1978), the results of this study offer ways in which family members and caregivers can support and even influence the transition from holding on to life to letting go toward death.