Facing Death Together at the Bedside

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At some point in our lives, many of us will find ourselves at the deathbed of a loved one. Being there may well be one of the hardest things we will ever do. In our Western culture, we do not openly talk about death and certainly are not given guidance as to what to do when someone you love is dying. What do we do? What do we say? It can be uncomfortable and awkward, but your presence, whether you speak or not, is the greatest gift you can give the dying. Whether you say something or simply hold their hand, your presence is felt.

We tend to treat the dying as though they are not the person we know and love. We avoid them or avoid honest communication with them. There are many misconceptions about what goes on at the deathbed and what we should and should not do.

People have the belief that they should not talk about the illness and impending death because it will upset the dying and somehow hasten their death. Talking about death is stressful for the family and the loved one but much is missed if the opportunity is lost. Ira Byock (2004) states that there are four important things to be communicated between the dying and loved ones. They are: “Please forgive me,” “I forgive you,” “Thank you,” and “I love you.” I would add to this, “We will be all right.” Sometimes the people involved do not want to talk and there are certainly times when nothing needs to be said. It often surprises people that the dying do want to talk about what is happening to them. However, many times, they will not talk about it for fear of upsetting their loved one. Sharing thoughts and feelings at this time can be very therapeutic and healing for all involved.

Certainly not all conversation has to be so intense. There is also a place for talking about things the loved one enjoyed such as sports, certain movies, television shows, books, or sharing stories about family members or asking them to tell stories from their own childhood. Just ask them what they want to talk about. When there is silence, you can stroke their hair. Use light cream on their face, hands or arms. Light kisses are also important. It helps if you can create a calm and peaceful atmosphere for you and your loved one. You can play calm and relaxing music that you know your loved one enjoyed or sing and hum to them. If they are religious, say prayers or sing hymns. This is not the time for you to talk about your problems. Keep family arguments away from them. High drama has no place at the deathbed.

Most of us do not want our loved one to die alone. Families will go to great lengths to see that someone is always by the bedside. However, this belief seems to be born not so much from the feelings of the dying, but out of our own anxiety and fear of death. The truth is that the dying will often wait until there is no one in the room to die. This is something that is commonly seen in hospice and in other facilities where people are dying. It happens frequently enough that it does not seem to be a coincidence. It is as though the dying are protecting their loved ones from seeing them take their last breath. Knowing this can help to decrease the guilt that many feel if they have gotten up to go to the bathroom or to get something to eat. I was seeing a woman in outpatient treatment. Her father was dying. They brought him to her home so she could take care of him. A family member was with him literally every minute. He had lived much longer than the doctors had thought he would. One day when she was alone with him, the doorbell rang. She hesitated but had an important package being delivered so she decided to go to the door. She said she was only gone a few minutes. When she returned, her father had died. We cannot control when someone dies. The dying are in charge of that.

Joan Halifax (2008) states, “Being with dying often means bearing witness to and accepting the unbearable and the unacceptable.” It can also be the most profound and intimate of all the experiences you may have. Familiarize yourself with what happens at the end of life. There is information available from the web, hospitals and hospices. If you are sitting vigil with a loved one, be sure you are taking care of yourself as well. It can be exhausting and emotionally draining. Try to adequately hydrate yourself, eat and get rest. If you have a spiritual practice, now would certainly be a good time to engage in it. Just remember that you are giving your loved one the greatest gift you can give by being at their bedside.