Recently I talked with a number of people who are taking care of loved ones who are dying. Being with someone you love while they die is difficult work. It can be both emotionally draining and physically exhausting, especially if you are the primary caregiver. I don’t think it matters if the person is elderly and frail, so that death is not unexpected, or if they are younger and struggling with an illness that will take their life in an earlier season. If you love this person, it is a lot to process. Different people in this situation are asking me a similar question: what should I be doing right now?
My reply is to ask people to consider three questions:
What do you need to do?
There is a lot to do when someone is dying. You have to talk to professionals. Doctors can help you understand if your loved one needs nursing care or hospice care and whether your loved one needs to be in a care facility or with you and some nursing support at home. Equipment may need to be rented. Arrangements will have to be made. It will be an initial flurry of activity. Many of these services will necessitate long conversations with insurance companies to understand benefits and what is possible.
A lawyer can help you with all those documents people meant to create but postponed. We tend to put off things related to the topic of death as long as we can. While many people have a Will, an Advanced Medical Directive and Power of Attorney documents, more do not. A recent Gallop poll states that only 44% of us have a Will.
A funeral home director can help with funeral planning. The main questions you might want to ask your loved one is whether they would like to be placed in a coffin or cremated, and where they would like to be interred.
A pastor can help you think about a funeral. I have found this to be the basis for a conversation that is memorable and important. When people talk about their funeral, they begin to express the values that they hold. They talk about texts from the bible they want read or hymns and songs they want to be a part of the service. They often know exactly whom they want to speak about their life. When you ask them why they made these choices, you often hear some of the sweetest memories of their life. And sometimes, they simply say, you take care of it. If that happens, the pastor can help you so that the task does not seem overwhelming.
I know these are not fun questions or tasks. But they are important. We all die. We have to talk about these matters so we don’t spend time later wondering if we did the right thing for those we love. There is much more to do, but that list is a good start.
What do you need to say?
Here is the problem with death: it is rather permanent. If you have something to say, now is the time. No one wants to sheepishly begin a conversation in heaven with “when you were dying and we spent all that time together what I meant to say was…”
Let me add one caveat. It is probably not the time to do a review of past conflicts or unresolved family issues. If they are not resolved by now, it is probably best to find a good counselor after the funeral and think it through on your own. Time with someone who is dying can be very sacred. Often dying takes days or weeks rather than hours. During that time, if you have some word of appreciation, some memory you want to share, or a simple “I love you,” this is when you do it. I am surprised sometimes at what people don’t say to each other that they later say they wish they had said. There is this line in the movie, “On Golden Pond” where Jane Fonda’s character complains to her mother that she always hoped she and her father (played by Henry Fonda) would have these great conversations, but never did. She realizes that her father’s health is beginning to fail. Katharine Hepburn says something like, “Your father is 80 years old. If you don’t have these wonderful conversations now, when exactly do you think you are going to have them?”
One way to figure out what you need to say is to sit down with a paper and pen and take some notes. Jot down phrases, topics, memories and things that feel a bit urgent and begin to organize your thoughts.
If you are a Christian, this is a time to ask your loved one what they believe about God and the afterlife. I am not advocating some form of coercive conversion. I am suggesting that people who are dying are often pretty focused on what comes next, and if they have not spent much time thinking about eternity, it often has their attention now. You can be a resource to them. Your faith can be a blessing to them if it is communicated lovingly and respectfully. Curiosity is typically the door that will open this exchange. When I ask someone what they believe about God and the afterlife, I may hear that they have a lot of beliefs that I did not know they carried. They may turn the question around and ask me what I believe and why I believe it. The conversations that follow are of great depth and importance, times when I can talk about my relationship with Jesus and assurance of salvation. It is helpful if you know some basic scriptures that might assist you; John 14, Psalm 23, Revelation 21 and many others will help you offer assurance and comfort. I find that people, some who are not even Christians, find comfort and hope in such scriptures when they are facing the ultimate questions of life and death. The key is gentleness in tone and delivery. You are sharing your faith, not closing a deal.
What do you need to pray?
There is a lot of sitting in silence when someone is dying. Your loved one may be medicated or simply exhausted. It will feel terribly inefficient if you normally live a fast-paced and full life. People are often willing to be patient and wait, understanding that moments when very sick people are communicative are unpredictable. So you sit and you wait. This is one of the reasons that being with people who are dying feels so sacred. There are few times in your life that you are at rest in silence. Here you can pray. There are all sorts of prayers that need to be said when someone you love is dying.
Thanksgiving – I hope you can start here with integrity. I hope this person has been a blessing to you, one of God’s channels of grace into your life. Offer your thanks to God for favorite memories; times they supported you, the joy of holidays spent with them. Hold them in love and give thanks. Make a list of how they blessed your life and offer it up to God.
Forgiveness – Sometimes we have to start with forgiveness for all that a person was not. The father who did not protect you, the mother who did not nurture you, the brother who drank himself to an early grave, the spouse whose love was never what they pledged are all examples of people we will have to forgive. People can be terribly disappointing. We are an imperfect lot. We are both more than others expected and not all they hoped we would be. If you cannot forgive the person who is dying, try a first step: just release them. Release them of the harm they did or the disappointment you carry. Ask God to release you of the bitterness you may feel for the harm they did or the good they failed to do. When you pray this way, you will untether yourself from the hardship that has defined this relationship for too long. It is not forgiveness, but a first step in that journey.
Intercession – Pray for their pain or their suffering to end. Or pray that the friend or family member they are hoping to see takes time to visit. Pray for your ability to accept their death, or for their ability to know God’s comfort in their death. You are there with them. You know their needs and their desires. Ask God to meet them.
Finally, when you are with people who are dying, know that it is odd when you don’t talk about death and dying. If you are a Christian, it is time to talk about the power of Christ’s resurrection and the promise of heaven. Remember this one thing: we are all going to die. Our ability to talk about death as a normal part of life creates the climate that allows the best care for the dying to be offered.
Ginger Blair Seal/Preece
Thank you Tom for these messages. My husband died in early March this year and although his death was expected (he had multiple myeloma and heart problems) he passed sooner than we thought or wanted. So your message can be very helpful. Although Nigel died very peacefully and fast we were able to share a lot of what you have mentioned and I feel very blessed that we had this precious time.
I know your message will be helpful to so many.
Thank you for your wise thoughts and suggestions, Tom. In recent years, I’ve tried to make it a practice to say my “eulogies” while the people I love are still around to hear them. I don’t want to wait to share my memories and appreciation only with others after that person is gone. I tend to write a note, so that any awkwardness doesn’t prevent me from telling them all I want to say about them. For my mom’s 80th birthday last year, we gave her a “treasure box” filled with cards and notes from people from all stages of her life. I asked them to share a memory of her or something they appreciate or admire about her. I’m quite certain that some of those folks, like me, would have had a hard time expressing themselves face-to-face. What a wonderful pleasure it was to sit on a park bench with my mom and listen to her read every note aloud. Her expressions changed over those few hours – from laughter to tears to gasps over forgotten memories. It’s hard to describe how these words of affirmation washed over my mother with a healing grace. She still pulls out her treasure box every now and then when her spirits need a boost.
Thank you, Tom. It is good to have a starting point for this conversation. And to realize that we should not wait until the last few days.
Addie Haynes Walker
Having been in this place several times, you have given outstanding advice. It saves us from so many feeling we have failed and we can really celebrate the persons life.
My mother passed on May 27 after a week in hospice and 7 weeks in and out of the hospital. We were so blessed to have the time to hold her hand, stroke her head, kiss her face and tell her everything we knew she would love to hear. All 8 grandchildren, one grand-in-law, one great grand baby, three children and our spouses and her husband of 64 years either heard, or got to see her express, “I love you” in some way and we are all comforted in the blessed assurance that she is living in eternity ready to greet us one day! Your post is spot on Tom; and I would add – we often broke out in hymns for her, which we know she enjoyed and which calmed and fed our souls at the same time. We also gained a new appreciation for the role of the Pastor in all of this as he joined us at her bedside, her casket and her farewell to hold my Father’s hand, and take great care to be sure her service was filled with highlights we had of the woman she was. What comfort a caring Pastor is in these final moments.