Supporting as Death Draws Near

At some point in life, many of us are called upon to support a dying family member, friend, or client. It is essential to recognize that during such times, the more knowledge we have about how to be helpful, the more successful our efforts will be. In this article, I will outline important points to consider as you prepare for this responsibility. Understanding these will ensure that the support you give is of great value to the dying person, and personally rewarding for you.

1) Examine attitude and feelings

Prior to being with someone who is dying, it is essential to examine our thoughts and attitudes about dying and death in general, and to then review how we feel about this specific upcoming death. Pondering what it would be like to say goodbye to everyone and everything that is of value and meaning to us can help us get in touch with some of our deepest feelings. This is especially important to consider if the person who is dying is about our age, the age of our partner, or the age of our children, or if their life circumstances are very similar to our own. It is crucial to recognize and acknowledge the realness of our feelings, rather than attempting to deny or ignore them. Death affects us and we get in trouble if we think it does not. When feelings are ignored, they tend to sneak out when we least expect them to; causing the situation to then become more about us, than about meeting the emotional and soulful needs of the other.

2) Acknowledge what dying people want

Dying creates numerous changes in all aspects of life. The more control we have over any situation, especially during times of change and uncertainty, the better we cope and adjust. It is important to allow the dying person as much control as possible. One way to do this is by frequently asking what the person wants, and from whom it is wanted. Fulfilling these requests may then require you to advocate on the dying person’s behalf; even to the point of meeting with the Chairman of the Board for something as simple as getting permission for the person’s Border Collie to be at the death bed.

3) Recognize the difference between pain and suffering

When pain is unmanageable, despite narcotic usage, the source of the suffering may be deeply rooted in unresolved emotional or spiritual concerns. As dying people review their lives, there is a need to bring peaceful closure to all significant relationships. Unresolved emotional and soulful issues, such as a need to explain one’s point of view related to a past incident, or the need to forgive or to seek forgiveness are often the sources of the suffering. Alleviating this suffering can happen by inquiring about a need to call a specific person to the bedside.

4) Support the Life Review

Erik Erikson described the Life Review as a process of examining one’s life to determine if the Gods are pleased. Dying persons become deeply engaged in this soulful process to determine where they did the best they could have, and where they felt the need to make amends. The Life Review can be stimulated by visits, music, photographs or through the process of reminiscing. Dying people value “Remember When” narratives of our positive experiences with them.

Every life is made of positive and difficult events. When the life is being reviewed, the seemingly insurmountable difficulties can saturate consciousness and the person can become fixated on them. When the dying person seems anxious or despairing, it is therapeutic to invite the relating of the most challenging times. As the person does so, help them explore any positive outcomes that may have resulted from each of the difficult events. A circular form of questioning works well to achieve this. “And then what happened?” can be asked following the first report of the difficult event, and asked again following each description of the outcomes that followed. In doing so, you help the person to more readily see any silver linings behind the cloud that moments earlier, appeared to be extremely dark and impenetrable.

Our goal in assisting with the Life Review is to help the dying person see their life as a meaningful whole, yes even with difficulties; but also with many positive circumstances. By aiding the movement of despairing moments into more positive ones, we help the person to die in integrity and with dignity.

 

©Jane A. Simington PhD

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One Response to Supporting as Death Draws Near

  1. Rev. Susan Wallace Hermann says:

    Having had both parents on Hospice, I can say that the experience made me a better Spiritual Counselor. I now hear everything we usually say to family members as a daughter and not just a Hospice professional. I can reflect now on what we say that is not very helpful, or at least more complicated than the simplistic comments. I appreciate the family members who are caregivers because I now know how absolutely difficult the job of caregiving is. So saying, “ Take Care of Yourself as you care for your loved one” is not only trite, but not helpful. There are situations where a family member may not have people to call on, or the finances to hire someone. They also have the emotional tie that causes them to wake up no matter how exhausted they are. So again, I have a deeper understanding of our hospice families born out of my experience as a daughter of hospice patients.

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