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The findings suggested that dying is a 4-D experience, with typical physical, social, psychological and existential components, depending on the illness trajectory. We found that people with progressive cancer, although often quite healthy physically at diagnosis, typically had acute anxiety and existential distress at four times: around coming to the diagnosis, after initial treatment, as the illness progressed, and in the final days. In contrast, people with advanced lung, heart or liver failure tended to have intermittent episodes of acute physical deterioration, associated with social and psychological distress, and sudden death could occur during one of these episodes. People with frailty or a progressive neurological disease typically experienced a gradual physical decline, but worries, loss of dignity and social issues were often harbingers of death.

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