A couple married 75 years lay side by side in bed, holding hands. They die an hour apart. A sonogram captures the image of twins in utero. She is dying while her brother holds her hand. These poignant images reflect the importance of touch as we begin and end life. Pioneering work done by Harry Harlow, working with primates and John Bowlby and Rene Spitz, who studied orphans in WW11, demonstrated how essential touch and connection are for infants in their emotional and physical growth. Indeed for most of us touch is important throughout our lives. It can be a source of love, comfort and support. But something seems to happen as we become elderly and approach death. There is a significant decrease in the amount of physical and emotional contact we receive.
At a time when more comfort and contact is needed, the dying are often ostracized by society and avoided by family and friends. The dying do not want others to be afraid to touch them or be in the same room with them. Imagine what it must feel like to be dying in a room alone. Often the closer one comes to death, the more distant others can become. Several factors contribute to this distancing. People do not want to face the reality that their loved one is dying. They are often uncomfortable around the dying because they do not know what to do or say and are afraid of doing the wrong thing. At times, it may be that the emotional intensity of the situation feels too overwhelming and there is a need to withdraw. Being with someone who is dying arouses our own fears of death. The intense pain that some experience while dying is frightening and heart-breaking to witness. There is also concern that the dying loved one is too fragile to touch or that touching will make the pain worse.
Of course, not everyone is comfortable with touch. For some, it is because of cultural norms. Some cultures touch more than others. The United States is considered a culture that does little touching when compared to high levels of touching in either France or Puerto Rico. Some people do not like to be touched as a result of having been physically or sexually abused. It is always best to ask permission to touch and to be respectful of the person’s wishes. If they are unable to talk, look for signs such as grimacing or furrowing their brows that might indicate discomfort. If touch is welcomed, warm your hands together before touching. Always let your loved one know what you are going to do. Your touch does not have to be a firm or strong one, a light gentle touch will do. Gentle stroking movements of their arms or their hair can also be very soothing. If there can be no touching, simply sitting close by and just being there for your loved one can be reassuring for them. Calling the person by their name and making eye contact are also important things to do when with someone who is dying.
Touch provides many benefits for the dying as well as for the one doing the touching. Touch increases levels of the hormone oxytocin which in turn lowers stress hormone levels in infants and across the life span. For the elderly and dying, touch has been found to promote sleep, decrease blood pressure and heart rate. Practices such as massage and healing touch are now being utilized by doctors more often due to the positive impact they have on the sick and dying. Touch can also decrease isolation, anxiety, and pain. It can help to ground the person and decrease sensory deprivation. But perhaps, most importantly, touch is a powerful form of communication. It can say "I love you," "I am here for you," "I care about you," and "I want to be with you in this time of need."
Being with the dying can be a difficult, yet rewarding place to be. We feel helpless and want to be able to do something for them. Touching is the answer. It is a concrete way in which we can feel useful, support our loved one, and express our love for them. As we die, our vision can become dim and blurry. Just as with infants who can only see objects that are 8 to 15 inches away, the dying also have a limited range of vision. Once again touch becomes important. As we begin our lives and end our lives, it is touch that helps ease our transition.