Do people commonly experience pain near the end of life?

While there is not a clear-cut answer to your question, I will try giving some insight into pain and death. Death is an obvious terminal process that all living organisms must go through. Causes of death can include illness, injury, or "natural death" in which their body reaches a state where it simply gives out.

Each cause of death involves different processes, some of which we have subjective data from the individual and some that we do not. It is rather difficult to know how much, if any pain is experienced during a rapid traumatic death. The same can be said for "natural death". Most knowledge has been gained in areas where individuals can report their experience or we can interpret physiological responses to the death process.

From my experience in both emergency and hospice settings, I can say that most people do experience pain during death during injury and illness processes. Often this pain is overcome by stress and fear which causes a release of endorphins. During a quick death process, this release of endorphins is enough to block pain. During a longer death process, endorphins cease to be released and pain becomes a very real problem.

My first concern as a hospice nurse is always with pain control. Personally, I seek to alleviate all pain. This often results in a semiconscious or unconscious state. With that being said, I do consult with the individual and their loved ones regarding their desire for pain relief and end of life wishes. Some people want to endure the pain so they can spend time with family and find closure. Pain is a very subjective and personal experience. For a person who has a quick onset death, pain may be extreme. For someone who has had a terminal process for an extended period, they may have built a tolerance to the pain, this allows them to cope effectively with the pain and require less intervention. Ultimately, caregivers must understand the needs of the individual and help them to find a balance between pain control and addressing their end of life needs.