As an end-of-life doula and hospice volunteer, I am honored to ‘sit vigil’ with someone as they are actively dying. Healthcare providers may call this ‘transitioning’. This is the tender time as death draws near, and your loved one continues their journey away from their earthly body. What should you do? What can you expect?
Remember, death is typically not a medical event. Death will come to all of us; it is part of our life from the day we are born. Take your time to sit with your loved one. Say the things you want and need to say – most likely they are still hearing even if they don’t appear to be awake. Maybe you are ready to say you are sorry and you love them. Are you able to forgive them? Now is your opportunity.
Occasionally our loved one wants permission to leave. Reassure them that you will miss them, you will be ok, and they can leave when they are ready. Hold their hand, cradle them in your arms, stroke their hair. They won’t break, but be watchful of signals if they are uncomfortable such as wincing, flinching, or trying to move away. They will let you know. Tears are ok; you can let your tough side go for a bit. Your loved one might want to die alone. You could sit for hours and hours, and the moment you take a break (and you should!), they could take their last breath. You didn’t fail them by taking care of yourself and leaving their bedside. They wanted you to step away.
If possible, honor the wishes they outlined in a vigil plan. It might be music, readings, photos, candles or essential oils, touch, visitors, and rituals or celebrations. Soften the lighting in the room. Cover them gently with a fresh sheet or blanket. Do they have a favorite quilt? Open a window if they want to hear birdsong. A little fresh air will go a long way for them and for you. Gently put a little lip balm on their lips so they won’t dry out as they breathe through their mouth. Find a closet to stash the medical supplies; you won’t be needing them – why look at them? The less ‘medical’ the room looks, the more peaceful it will seem.
On a practical side, educate yourself to the signs and symptoms of imminent death (a future post). Hydrate. Take breaks. Walk down the hall; better yet, walk outside in the fresh air. Meditate. Children are curious and may want to be in the room; if so, help them manage expectations. This is a gift you can give to children and grandchildren – understanding death is part of life. They can say goodbye in their own way. Encourage them to draw a picture, write a story, or sing a song. Leave their favorite candy alongside. If they ask to gently touch a hand or cheek, let them.
Once your loved one has died, take the time you need to sit with them. There is nothing urgent right now. The funeral home does not have to come immediately. Call the hospice team if they were receiving hospice services. If in a nursing home or hospital, alert the nurse. If they died at home and didn’t have hospice services, call the police. Make sure to tell the dispatcher it is not an emergency.
This is the time to lean on friends and family to assist. Have a list of people who should be notified and ask someone to make a few calls for you. There is no need to rush. Many of us feel the need to do something. Now is not the time. And remember, be gentle with yourself – you have witnessed a very sacred time in your loved ones’ time on this earth. Reach out to a grief support group, the hospice team, or a counselor if your feelings are overwhelming you. And take all the time you need. Grief is as unique as each of us and we all have our own way of walking through it and with it.