What we need to know
Touches
Sometimes the dying person wants to feel a light touch of our hand, or they like to feel the physical closeness of another person. At other times contact may distract them. Let us try to feel what is pleasant. We can ask. We must not take refusal or distancing as a symbol of insufficient love. The dying person is occupied usually with themselves and their life and we are just gently, sometimes from close up, sometimes from afar, accompanying them. We should think about how the person felt during their life about the closeness of others, how they professed their feelings, how they handled being sick and how they got over pain and difficulties. Maybe it will help us better to understand them and learn to be as close as they wish us to be.
Food and drink
Through food our body gets its energy. We eat so that we can live. When the body begins to die it is absolutely natural that it does not want to receive any more food. Food habits slowly change. Nothing tastes good anymore and the appetite disappears. Liquid food is preferred over solid. First meat is disregarded, then vegetables and other hard to digest meals and in the end even soft foods. The dying person does simply not want to eat. For us relatives it is very difficult to respect this wish. Many are haunted by the thought: I won’t let daddy die of hunger! He always ate so gladly what I cooked and now he doesn’t want even his favorite dish!
It is a tough confrontation with our own helplessness and the approach of death: they will die if they don’t eat anything! or: It will be even faster without food! They have to fight! Surely they are so tired because they don’t eat! I can’t convince them anymore. It is my fault that they are so weak!
Let us face these doubts and persistent questions. We must realize that in this life period it is absolutely natural not to eat anything. Physical energy that we get through food is not needed anymore. The dying person now needs a different kind of energy. We, their relatives, must listen to their wishes try not to bother them. We must understand that otherwise we will cause suffering through our insensitivity, no matter how well intended our efforts are.
However, in this last phase of life the dying person may have a great urge to drink. When they are no longer able to drink using a cup with a spout we should try to administer small amounts of cool liquid using a tea spoon. We can also try a straw, baby bottle or a mineral water bottle with an extendable cap.
If the dying person is no longer able to swallow the liquid it is usually pleasant for them if we moisten their mouth – for instance with tea or pineapple ice cubes. Sometimes it is possible to moisten the lips by a damped clean handkerchief from which they can, if they wish, also suck some water.
Often relatives ask the doctor for infusions in this final time period so that the dying person does not suffer from thirst. It is necessary to know that at the time of close death such an approach is undesirable because it insensitively intervenes into the natural “departure“ of the body and it can make the situation worse for the sick person. It can for instance cause swellings, make breathing difficult or cause confusion. Infusion does not lower the feeling of thirst, but caring for and moistening the mouth does. Sometimes even just the feeling of coldness in the mouth can lower the feeling of thirst: sucking a small ice cube or ice ball made of tea or juice has been shown to work.
Communication
The dying person sleeps more and more. Sometimes it is difficult to wake them from their sleep. They are just a step away from death. They are losing the perception of time and they often do not even recognize the people who are present and this can be very painful. It is important to realize that this is not a sign of rejection, but of the dying person’s loss of contact with our reality. It also happens that they speak to God or about situations and people that we do not know. Sometimes they also see people that have already died and speak to them and feel drawn to them. It is important not to try to persuade the dying person that their reality is wrong or attack it as a hallucination, but to do just the opposite – involve yourself in their world and listen to them and learn something from it. This can broaden our view of life and show us previously unknown ways of communicating. The dying person is able to enrich us – they teaches us gentle delicacy when we try to understand the way in which they tell us their wishes.
It is also very important to carefully listen to our inner voice. Even a quiet reproach such as: I am sacrifying myself for you, I am doing it for your good, You would have never done it for me … is able to cripple the quiet and enriching attendance when a close one is dying.
A great and often very hard task of the accompanying person is to not succumb to the temptation of making decisions instead of the sick person. For instance we want to protect them from the truthful information about their sickness and about the fact that they are nearing death. Let us not be mistaken: even though they do not ask directly, they want to know the truth and they do not want to be deceived by their surroundings. Let us listen to their quiet, timid and sometimes very indirect questions and hide nothing. We should answer questions truthfully and without elusion. A person who is nearing their end is usually aware of the fact and if we are behaving as if it were not true and say they will “of course be here 20 more years” we only thrust them into loneliness. They will draw back from further communication and they will be alone to deal with the approaching of death. Our task is to go with them the last part of the way, support them, give them water. Now is no longer the time to lie to each other about anything. Now is the time to walk together truthfully and live through the moments that are remaining to us.
Restlessness
A dying person is restless in certain moments or days. They thrash about on their bed, they move aimlessly with their hands and feet, try to leave or without a visible reason twitch their fingers. These are also signs that they are losing the connection with this earthly world. When we calmly sit on their bed and through that make them feel that they are not alone they may calm down. However, we must not blame ourselves if it does not help. Restlessness can also be treated by medicine, but it is necessary not to neglect the effort to understand the dying person who is getting ready for the departure in their unique way. We should not intervene uselessly, nor disturb them too much – it is often better to do nothing.
One or more days before death, a final surge of energy sometimes awakens in the dying person. Even though they were sleeping and not communicating for a long time, they are suddenly wide awake, with a clear mind and taking part in their life asking for certain foods or trying once more to sit or stand up. We should make use of this time to fulfill their wishes, we should not be afraid to break their diet, and mainly we should talk to them and say our farewells. It is possible that precisely these moments will later in life be the light that will help us to chase away the darkness of loneliness and despair.
Farewells
The closeness of death can be recognized in various ways. Sometimes the dying person tells us that they were dreaming of being dead. Sometimes they urgently ask us if they are alive, or already dead. All this is normal. One of these quite often seen manifestations is the so-called “packing one’s bags”. It is filled with a sometimes even obstinately enforced longing to drive off, a specific need to pack for the trip, finish unfinished business. We should help in such moments to truly close matters up, round up our relations, say our goodbyes. Sometimes the dying person really needs us to let them go, to allow them to leave. We should tell them that we like them, ask for forgiveness, forgive them. But we should not be afraid to tell them that we are not holding them back and that they can go. It is sometimes very painful, but they are often waiting for our assurance that we will manage without them. The farewell may bring peace to them, and to us. The dying person often calms down and then leaves more easily, and so the path for peace to enter our soul becomes also less difficult.
See also
