When a loved one enters into the “actively dying” phase, family and friends can feel lost. They often don’t know ways to comfort the dying. Or how to maneuver through this situation, simply because it’s brand new. Our society doesn’t welcome thoughtful preparations around death and dying, and so we don’t know what to do when faced with this reality.
Part of a death doula’s job is to convey how being with someone in their final days is a great privilege. A sacred time. Doulas help loved ones feel more prepared and get quickly up to speed on the best ways to comfort the dying.
1. Create a loving environment.
Some people want peace and quiet. Still, others prefer to be surrounded by loving friends and family members. Most of the time, we should avoid loud noises and instead try to keep the volume low. Music or other noises, beach sounds on television for example, softly played in the background. Small water fountains or aromatherapy diffusers on the bedside table can be a comfort. We also encourage visitors to turn off their phones.
2. Be okay with silence.
While your dying person seems to be sleeping, they’re doing a lot of thinking and working through this experience. This inner work can be exhausting as someone looks back over the entirety of their lives and lets go. Sometimes the best thing to do is sit with them and not say a word. When or if they open their eyes, smile at them. Let them feel your love and support. If you pray or meditate, incorporate that into your silence as well.
3. Speak softly and simply.
Use simple messages with soft tones when speaking to someone who’s actively dying. Here are some examples:
- “I love you.”
- “You’ve lived a good life.”
- “It’s okay to go when you’re ready.”
- “I’ll remember you always.”
Just one or two, in a low and comforting tone of voice, is perfect.
4. Lower the lights.
Bright lights can annoy or disturb dying people. Therefore, turn off overhead lights and use small lamps in the corners of the room for any lighting needs. If they’re a candle person, get some unscented candles for the room. They can be quite peaceful and lovely. Natural light can comfort the dying. If so, open blinds, curtains, or windows. Make sure they spend some time on their side if necessary to see outside when they open their eyes.
5. Be alert to discomfort.
For example, is your loved one’s mouth dry? Then use sponge sticks dipped in water to frequently moisten the mouth and lips. Our bodies dehydrate during the dying process, which can cause uncomfortable dryness. This simple gesture makes all the difference in the world and is one of the best ways to comfort the dying.
6. Touch gently.
Before you move or turn your loved one, softly tell them what’s happening. Be gentle. Hold your loved one’s hand or gently massage as long as it seems soothing. In the last few hours of life, stop touching so they can focus on dying rather than continue a connection to a physical realm they’re leaving.
7. Listen and observe.
The most important way to comfort the dying is to pay attention to their state of being. Listen and observe to know when they’re uncomfortable. They can no longer tell you verbally so you must be in tune with non-verbal forms of communication. Use empathy and kindness to guide you as you gently change things (taking away a heavy blanket, for example, or providing ice chips) to help provide comfort.
8. Support spiritual needs.
Allow your loved ones to reflect on their life, beliefs, values, or faith. Do not appear alarmed or judgmental. Certainly, let them ask about ways they’ll be remembered or celebrated. Provide comfort if they need to be forgiven or loved. Listen and provide space for this type of inquiry.
You can also ask if they want something specific to read, like prayers or poems to comfort the dying. Some songs, instrumental music, or religious traditions might also comfort the dying. Do not be attached to any sort of answer, just do what they ask or provide a listening ear to whatever concerns they have. This is most helpful.
9. Recognize when death is near.
It’s not always easy to know when someone is about to die. Here are some familiar signs that death may be days or hours away. These include:
- Lots of sleep or drowsiness
- No longer eating or drinking
- Irregular breathing
- Pauses in breathing
- Coldness, swelling, or blue colors in the extremities
- Visions or conversations with someone who is already dead
- Gurgling or rattling sounds with breathing
Here are some common issues at this phase of dying, and ways you can provide comfort:
|Issues||What you can do|
|Not eating||Don’t over-encourage dying people to eat. Give ice chips if needed.|
|Dry face||Use a damp cloth on their face. Apply lip balm or petroleum jelly to dry lips.|
|Labored breathing||Gently turn the person’s head or body to the right or left. Adjust pillows or raise the head of the bed. Use a humidifier or inquire about medication and/or oxygen.|
|Skin rashes||Gently apply lotion or baby oil to dry skin. Carefully adjust the person to avoid bed sores.|
|Incontinence||Change incontinence pads or inquire about a catheter.|
|Terminal agitation or confusion||Be a calm and reassuring presence. Remind the person where he or she is and who is there. Inquire about anti-anxiety medication if necessary.|
|Pain||Give pain medication as needed.|
|Too cold or hot||Adjust the temperature and bedding as needed.|
10. Keep vigil
Sitting with someone in the last hours of life shows support and love. Continue to talk to your loved one, hold hands, and provide comfort in similar ways to the above suggestions. Invite other loved ones to sit with you or take turns so the care team feels rested.
If you’d like support for these and other ways to comfort the dying, please contact us at Anitya Doula Services. We are happy to help.