If you’re caring for someone who is dying, you are likely to have many questions and concerns. With death, just like birth, people often wonder how they’ll know when it’s close.
It can be a source of some anxiety for families sitting by the bed of someone who’s dying… “how will I know…?” People want to make sure other close family are around, need time to give them warning. As with birth, every experience is different, but here are some common signs that death is close:
- Restlessness, twitching
- Visions, confusion
- Increased pain
- Loss of appetite
- Loss of bladder or bowel control; less and darkened urine
- Loss of reflex in legs and arms
- Loss of vision, turning head towards a light source
- Skin cool to the touch, especially hands and feet; becoming bluish in color, especially on the underside
- Changes in breathing: rattling or gurgling sounds, irregular and shallow breathing
Soul midwives, death doulas and end of life companions
Trained end of life companions – nurses, soul midwives and death doulas – can support you at this critical time.
The medical profession calls support for dying people ‘palliative care’ and calls the role ‘end of life practitioner’. The more soulful, spiritual term is a ‘soul midwife’ or ‘death doula’. We use the general term ‘end of life companion’ for those whose practice is grounded in care and emotional support rather than medical support.
Trained soul midwives, death doulas and end of life companions are reviving a valuable and ancient craft. Like the wise men and women in tribal villages and communities of old, they accompany the dying on their final journey, helping people meet and accept death.
- If you’d like to be better able to support someone at the end of their life, check our Events page for upcoming courses.
- If you’d like someone to help support you or someone you care for near the end of life, see our marketplace to find an end of life companion.
A dying person often cycles through emotions – lonely, lost, scared, stuck, regretful, angry, resolved, resistant, submissive. An end of life companion can fill an emotional and spiritual gap by being alongside them at this challenging time. This is especially valuable as we live increasingly scattered, independent and mobile lives – often with no close family or friends to support at the end of life.
An end of life companion can help you prepare for death: literally hold your hand, help come to terms with letting go, work towards acceptance and release. Talking and planning together, the end of life companion brings care, compassion and companionship. Some bring nursing or counselling skills experience to their training. They will work alongside medics and family, always with the focus on the person who is dying, always with an eye on family dynamics to help smooth the path.
The role offered will depend on the companion offering the service and the needs and preferences of the person using the service. The range of support in preparation for death might include:
- help with writing and leaving messages;
- creating a ritual for letting go;
- performing blessings;
- carrying out a partnership ceremony for a couple.
Depending on beliefs, they might offer naming ceremonies, baptisms or blessings for a baby that has died. They can help resolve issues, create a safe space for families to make-up, acknowledge regrets and bear witness to a life.
All these things help release a person to death.
And at the end, they can help perform last rites… preparing the room with candles, music, essential oils. They can hold vigil, say prayers or read passages, offer final blessings. They can be there at the point of death, lay out the body, wash and cleanse it in line with beliefs, carry out other agreed rituals. They may later support family coping with bereavement and loss.
Hermione Elliot’s Living Well Dying Well run regular Doula training courses.
Felicity Warner’s Soulmidwives School runs soul midwife courses. Hear more from a soul midwife and trainer, Felicity Warner on BBC’s Women’s Hour. See Felicity‘s Facebook page and an article in the Express.
To make it easier for someone who might end up caring for you, leave instructions about your preferences and values in an Advance Decision and keep a copy in your Safe Deposit Box, sharing it with your Keyholder.