Simple Tips for Being Present with Those Who Are

Dying

By: Norman Mitchell-Bereavement Coordinator- Memphis, TennesseeEdited by DeAnna Looper RN, CHPN, CHPCA. Chief Corporate Clinical Consultant/Certified Grief Recovery Specialist

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Learning Objectives

• Describe tips on offering presence at the time of death.

• Discuss ways to offer simple gestures of compassion.

• Identify non verbal cues to avoid physical touch.

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Facts

• A common fear for the terminally ill is “dying alone.”

• By nature, we are a species that prefer to be with others, seek meaning and fulfillment in relationships, therefore, why would death be viewed differently?

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• “As far as we know, we are the only species aware of the inevitability of our own death.”

~Elizabeth Kubler-Ross, M.D.

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Tips for offering presence• Introduce yourself- establish a rapport and

respect the surroundings.

• If the individual is not awake, alert and/or oriented, talk to them as if they are.

• Keep the environment comfortable-based on the individual’s wishes or preferences. • Use music meaningful to the patient/family• Use the environment to assist comfort (family portraits, knick-knacks, sentimental treasures such as a doll, teddy bear, blanket.

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Tips-continued• Keep the moments intimately personal.

• Provide care to the “individual” not the disease

• Listen unconditionally and attentively.• If the individuals is conscious and can communicate-listen.

• If they interrupt you-stop and listen• If the person is not conscious, be cognitive of changes in his/her physical condition.

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• Have empathy for the person/family’s suffering.

• Know and learn how to sit and be with emotional pain without having to eliminate it.

• Appropriately share your experience and emotions as it relates to your purpose in being there.

• Honor the spiritual / cultural aspects of the individual dying.

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Tips-continued• Reduce distractions in order to create a

calming and peaceful environment.

• Simple acts of compassion are some of the most special gifts you can give. • A cool cloth on a warm forehead• A soft tissue to wipe a person’s chin• Softly stroke the person’s hair.• Gently hold their hand.

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Tips-continued• Remember-the sense of hearing is the last to

go-continue speaking to the individual and others as if the dying individual can hear.

• Pay attention that your touch may be irritating or uncomfortable for the individual. Watch for non-verbal cues such as• Pulling away.• Jumping/startling when touched. • Grimacing or frowning.• Restlessness.

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Tips-continued• Slow down and share the silence

• Be comfortable in saying nothing-when nothing needs to be said.

• “What I have learned most from my experiences with the dying person is that the most important aspect of the vigil is that I am there with them and present in the moment.”

~Frances Weld Peabody

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• Be ready to listen again….and again

• Be respectful

• Be aware of feelings and attentive to non-verbal cues

• Be comfortable with silence

• Be human

• Be gentle

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• Most of all…be there!

• Don’t expect perfection from yourself when you are with someone who is dying, your presence just being there is the greatest gift.

• Be yourself, be real, be vulnerable

• The details of what you need to do will be come evident to you as you quiet your mind and still the static in your thoughts

~Kristi A. Dyer, MS. M.D.

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Remember:

“The dying hold up a mirror to our hearts and give us the opportunity

to see ourselves”

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Q & A• ??????

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References• Author unknown. “Supporting a grieving

person” Helpguide.org. www.helpguide.org/mental/helping_grieving.htm. 07 April 2013

• Education for Physicians on End-of-life Care. Participants Handbook. Module 12. Last Hours of Living. 1999. Print.