How can I support someone who is dying?

By taking everything they're going through seriously. By listening, and I mean really taking time to listen to what they're going through -the frustration, regret, rage, preparation. Helping them use this precious time to make peace with what's about to happen.

When my father was dying and in a really shitty mood, I spent the time while he was still able to interview him about questions of faith that he had never let himself ask before. He was a Holocaust survivor and had all these unasked, bottled up frustrations about faith and God and how that could've happened. He'd never allowed himself to ask it, but now he was old and dying and I asked him: Do you have any unfinished business? And he said, "yeah, I've got a few questions". So I devoted time and we spent a few months talking about it. I recorder them and will at some point publish it. If we can give people the gift of our time and our serious interest to let them do the hardest things to wrap up their life in ways that are meaningful to them, that's a huge gift to them and obviously to us.

And if someone is not able to do things like this in a cognitive sense, then just spend the time with them. Hold hands, listen to their favorite music, read out loud to them.

Make sure they have everything they need, tangible aspects like things they need to close out their life and make sure their wishes are known, and also their emotional aspects. Find out what they believe is going to be happening when they start to die so you can create the best atmosphere possible for them. You need to really listen and follow their wishes. Let them lead; this is their experience. Be as present as possible to let them voice what they need and help them carry it out.

Let's say that they're in the last week and they're starting to sleep a lot and dip in and out of consciousness. One thing to know is that you're helping the dying by helping everyone around them. I give family and caregivers permission to create a very sacred, soft, quiet space around them as much as they possibly can. Even in hospital with staff coming in and out to do their jobs, we can ask them to please be as quiet as they can and move as slowly as they can in the room. 

When someone is dying at home and there are a lot of people coming and going, we can just advocate for our dying loved one. It's ok to say, "we are going to just have shorter visits now," or "we just want to be quiet," or "would you like to just read to mom from this book we've been reading". The room where one is dying could be made like a nursery almost because they are going into a forever sleep. So we want to lights low, the music soft and our touches so gentle that we're almost not even touching. You want very little stimulation.

Be present, create plenty of space for THEIR experience and remember that yours is secondary to theirs. You can call a doula if you need additional support, too.

One of the most important things a companion to the dying can do is be very clear about their own agenda and their own bias. We all have ideas about what death "should be,” should look like, feel like. We all have ideas about what another person should do. So,when we get to the doorway of that room where the dying person is, we need to stop and do a little self-monitoring. We have an opportunity to ask ourselves, "What am I bringing into the room?" What’s my should? Do I have an expectation of what should happen here?” Be very honest with yourself about it. Maybe what you're carrying in the room is anxiety. Maybe it's a plan, a fantasy about what it should be like. Maybe you're carrying in the room a lot of real aversion to the whole process or how they're choosing to do their whole process. Or, as many people do, you may be carrying in guilt, or regret or a need for closure or farewell of some kind. Whatever it is, notice that you're adding something to this process.

Most people are a little blind to their own stuff. If you said, "Do you want to hurt and upset your loved one," they would say no. But then they go in and beg for forgiveness for an old slight, for example, which can be hurtful and distressing to many people. The dying person may not even remember the event and they're being required to come out of their own space to acknowledge. Dying is work, we forget that too. This is labor that people are doing, and it takes a lot of energy. The dying person may look very still and quiet, but it's because they're internally doing a lot of work. When we come in with our own stuff, and our own requests, we're pulling them out of that and into something else.

Another important part is saying goodbye once; don't say a painful farewell every time you leave the room. If you've really got a lot of old stuff that's coming up and you need work with it, work with it outside that room. Talk to the social worker or the nurse or a counselor. Let the dying person have this time to do their work. We get very confused about what's our work to do and what's their work to do. Try to come in as empty as you can. Dying is a solitary act, maybe the most solitary thing we do. And it's so easy for us to lay our ideas about it on somebody else. One of the most important things we can do to support somebody is get out of their way and allow them to do it their way. That first requires us to understand what our expectations are.

It is important to be clear about our own agenda. We all have ideas about what death "should be.” So when we get to the door, we need to stop and do a little self-monitoring. 

“What am I bringing into the room? Do I have an expectation of what should happen here?” 

Be very honest with yourself about it. Maybe you're carrying in anxiety. Maybe it's a fantasy about what dying should be like. You might have aversion to death itself. You may be carrying in guilt or regret, the need for closure or farewell of some kind. 

No one wants to upset their loved one. But then they beg forgiveness for an old slight, which can be distressing. The dying person may not even remember the event, and they're busy elsewhere. Dying is work. It takes a lot of energy. The person may look very quiet, but they're doing a lot of work internally.

If you've got old stuff that's coming up, work with it outside that room. Try to come in as empty as you can. Dying is a solitary act, maybe the most solitary thing we do. Say goodbye once; don't say a painful farewell every time you leave the room.