The last three days of his life, Iván Ilych screams in agony. But on the third day, he has a revelation. As his son touches his hand, Iván Ilych finally recognizes that the way he has lived his life has been hypocritical and empty. He falls through the bottom of his dream's black sack and sees a great light. The light is comforting. He accepts that compassion is the key to correct living, and tries to ask his wife for forgiveness. He feels not hatred for others, but pity. He retreats into his inner world at the end. Though he seems to be in agony, internally Iván Ilych is at peace as he dies. So is this a realistic death? It is far beyond me to point out what a realistic death might be. I think there is no lack of artistic unity here. Ivan's death is fitting for the man we have gotten to know. Some of the five stages of death you mention can be seen here. Regret, confession, comfort...are here. I think the five stages can certainly be refuted depending on the person and circumstance. For Ivan this little glimpse into comfort and acceptance seems to work just fine.