Watching a loved one die is one of the most painful experiences you’ll ever have. And unless you live in a cave hidden away from other human beings your entire life, it’s one you’ll go through at some point. How does one deal with such a significant challenge? And how do you help someone you love when they’re dying?
“Rage, rage against the dying of the light,” poet Dylan Thomas implores his father in “Do not go gentle into that good night.” This famous poem illustrates almost perfectly one of the worst possible things you can do when your loved one is dying.
Fighting death is impossible, and encouraging someone whose death is inevitable and near will only make them feel worse. Instead, you must accept their coming death and help your loved one accept it and feel comfortable, both mentally and physically, as this last stage of their life progresses and comes to a close.
Every death is different. For some, the end may come suddenly, while others may linger in a near-death state for anywhere from a few days to several months. Some feel their bodies weaken while their minds stay sharp, whereas others feel physically healthy while their cognitive function declines. According to a National Institute of Aging (NIA) article, “Providing Care and Comfort at the End of Life,” “People who are dying need care in four areas: physical comfort, mental and emotional needs, spiritual needs, and practical tasks” (1).
If your loved one is experiencing pain, alleviating it is the priority. Don’t worry about the long-term effects of pain relief. Give as much pain-relieving medication as prescribed by their doctor. Make sure to give the pain-relieving medication before the pain starts. While drug dependence or abuse aren’t concerns at this point, do discuss with your loved one and their doctor what the right amount of medication is. Too much, and they might feel “out of it” when they want to feel present.
Other issues of physical comfort that may arise include shortness of breath, skin irritation, digestive problems, and temperature sensitivity. In her article “How to Support a Loved One Who Is Dying,” written for AgingCare, Donna Authers suggests not asking how to help (2). This might seem counterintuitive, but your loved one may not be able to articulate what they need. She suggests that you should “anticipate ways in which you can be useful.” A soothing balm on chapped lips, ice chips for a dry mouth, or small amounts of their favorite foods may be welcome.
Mental and emotional needs
Treat your loved one’s emotional pain with as much seriousness as you do their physical pain. Your loved one most likely has a doctor to help them with physical pain, but they may not have one to help with mental pain. Their regular physician and the specialists who have treated them up to this point may not necessarily know how to treat patients needing end-of-life care. Their job is to fix physical ailments, but they sometimes avoid dying patients once their situation is unfixable.
Now is the time to turn someone who knows how to treat those at the end of their lives. The NIA suggests contacting a counselor who is familiar with end-of-life issues. Psychiatric medication to help with severe depression or anxiety may also be necessary. Your dying loved one might have specific fears and concerns that a mental health professional can help with. But just because they are in the care of a professional, you should still be present in their life.
“Some people are afraid of being alone at the very end,” the NIA explains. “These feelings can be made worse by the reactions of family, friends, and even their medical team. For example, family and friends may not know how to help or what to say, so they stop visiting, or they may withdraw because they are already grieving.” Being a good friend or life partner means staying by your loved one’s side until the very end, even if that’s hard for you. Put yourself in their shoes. Would you expect them to be present for you? The answer is almost certainly “yes.”
As your loved one get closer to death, they may begin to show an interest in spirituality. Even if they have been agnostic their whole life, they might show a sudden interest in spirituality. A connection to the spiritual dimension of life, whatever that means to your loved one, can make them feel that they are part of something much larger than themselves. This feeling of being a part of something large can give them an awareness of existing beyond the physical realm of the body and day-to-day pain. Spending time in nature, if possible, can be of enormous help.
The natural world helps us remember that we, ourselves, are part of nature, and we are an important, albeit tiny, part of our incredible natural world. The tremendous energy by which all things are born, unfold, evolve, and die operates within us. Seeing that death is just one part of life can be helpful to someone who is dying.
Beyond seeing their place in the natural world, “Spiritual needs may include finding meaning in one’s life, ending disagreements with others, or making peace with life circumstances,” the NIA explains. “The dying person might find comfort in resolving unsettled issues with friends or family.” Assist your loved one in this way as much as you can.
The business of life doesn’t end because a loved one’s life is ending. Food must still be prepared, dishes must be washed, dogs walked, and plants watered. Authors suggests you keep the area where your loved one is residing “free of clutter and harsh lights, try to hide or disguise medical supplies, and surround [your loved one] with their favorite things, such as pictures, flowers, artwork, music, and above all, people.” Going to the flower market to pick up tulips might not seem as helpful as talking about the meaning of life, but it can be just as beneficial.
As you help your dying loved one, don’t be afraid to ask for help from others. It’s normal to need some time to yourself and help with tasks like cleaning, preparing food, or running errands. To be fully present for your loved one, you’ll need others to be present for you.