Eighteen Ways to Be Present When a Loved One is Near Death

By David Tillman – May 2021

As a loved one nears death, there is a sacredness to become aware of and present with. Naturally, we focus most of our attention on our loved ones, others, and our own emotional grief and loss. Bringing in the sacredness of life and death into our thoughts, words, and actions can shift the sadness, fear, and anger that is in the room to include more love, joy, and hope. Lift up memories of the love and joy your loved one had shared with each of you, and so many others, during his or her life.

As a hospice, hospital, and volunteer sheriff chaplain, I have been present with many families at the time their loved one is nearing death and finally died. My experience at the VA Home in Minneapolis of holding my father’s hand when he took his last breath touched my soul and called me to chaplaincy. At that moment, I realized how sacred the process of dying and death is. A few hours before my father died, a chaplain joins my father and our family. She introduced herself and asked for us to share stories of my father, which we did. Then she said an uplifting and hope-filled prayer. The energy in the room shifted from sadness to love and hope.

As a loved one is near death, I experience a sacredness that is so loving and life affirming. A sacredness in being present with family, friends, and caregivers at the bedside of a loved one who has lived an amazing life. They have navigated so many different worlds which include many, or all, of being in a family, going to school and making friends, dating, marrying, or partnering, raising a family, grandparenting, working at home or away from home, having good adult friends, being active in their community/politics, having lived by their values and faith, being active in a religious/spiritual community, became an elder/mentor, and so much more.

I most often see this sacredness in the stories and kind words people share to their loved one. In these stories the personality of the loved one, and his or her family, comes alive. It fills the room. As the loved one’s life is being shared through the memories of her or his life, most often include words of gratitude and joy.

I feel the sacredness in letting go and letting God. To welcome God’s presence into the room through prayer, favorite hymns/songs, meditation/silence, sacred text readings, and more. To honor our loved one’s life. Hold her or his hand and say, I love you. Tell him or her that you forgive them so he or she can die peacefully. Ask for his or her forgiveness so you can let any tension between her or him go. If he or she is not able to respond, trust that she or he have heard you.

Find time to take a moment in silence. Envision what is next for your loved one as he or she transitions from this life she or he has lived. Feel in your heart what your faith, or understanding, speaks to you of where your loved one will transition to. Take a breath and realize that you to will be at this same place in your life. At that time, how will you want to envision what is next for you? What will you want to hear your family, friends, and caregivers say to you then? You may not have answers, as they can be difficult questions to answer. Allowing God’s love and presence into your heart may shift the energy from a heavy, grieving heart to a feeling of sacredness, that God loves each of us, always has and always will, even after death.

As a hospital chaplain, and volunteer sheriff chaplain, I have been with families and caregivers where their loved one’s life ended suddenly and unexpectedly. How difficult it can be to be present while your emotions are all over the place. Just trying to make sense of what just happened when doctors, nurses, medical examiners, chaplains, and others all want some of your attention right now.

My perspective and experience are primarily from a Christian point of view. I have been present with loved ones from different religious and spiritual traditions. However, I am not qualified to speak about their unique religious and spiritual beliefs, rituals, and traditions. In some cultures, it is not appropriate to talk to the loved one about dying and death or to acknowledge that he or she is near death.

The journey of grieving your loved one’s death, dealing with regrets, and so much more is another topic only discussed briefly below.

Here are eighteen ways of “creating a peaceful, and sacred space for your loved one” as he or she is nearing death.

1 – Create a sacred space, however that works for you. This can include prayers, space for meditation and rituals, space for displaying sacred and meaningful object(s), quiet and uplifting music, hymns, scripture readings, and poetry. You can position the chairs around the bed and have a tray of beverages and food outside the door.

2 – Be present and open to all feelings and emotional expressions like sadness, anger, regret, deep love, fear, blame, feelings of helplessness, anxiety, and loneliness. Acknowledge the emotions underneath their words rather than what is said. As I learned in my chaplain training, “Show up and shut up.” Let the person speak if he or she can. “When you do talk, speak directly to him or her about what you are grateful for in his or her life. Talk about the good times you have had, the lessons you have learned from him or her, and anything else that offers comfort and support.”

3 – “Have only one or two people speak to him or her. Keep things simple and calm.”

4 – Take conversations that are not needed to be heard by your loved one out of the room. This would include any conversations about her or his care, the details about what you have learned from care providers, and funeral home preparations. Eliminate talk about challenging family drama. It is all right to ask aides and other staff to take emotionally charged conversations outside the room.

5 – Think about what your underlying reasons are for being with your loved one at this time. This is a time for him or her to feel loved. A time to believe that his or her family will be all right after her or his passing. Offer words of forgiveness, love, comfort, and peace. Let your loved one talk. Listen and honor what he or she has to say.

6 – “Give him or her some time to be alone with no one else in the room. Sometimes the soul needs complete privacy to rest deeply and commune with God as part of the transition process. Give her or him a half-hour of privacy several times a day. This can also be a time for self-care, to go relax, have a breath of fresh air, or a cup of coffee.” I have also heard stories of people dying shortly after their family left for the evening or to get a cup of coffee. Some people may prefer to die alone or have no choice in the matter. Do not take it personally. My experience is that many people have more control over when they die than we might think. Many times they are waiting for a specific date, a particular sign, or a conversation with a loved one. 

7 – In point eight below are some phrases you can say to your loved one that hopefully will bring comfort and closure. A person’s hearing is one of the last things to go before they die. Bring your chair near her or his bed, gently hold his or her hand and talk so they can hear your loving and heartfelt words. Notice if your loved one is communicating through her and his hands or body language. If your loved one gets agitated, acknowledge the discomfort, and stop talking.

8 – Sit with your loved one alone and say the phrases below or meaningful phrases of your own. You may say one, or a few, of the phrases below. Then sit in silence with your loved one. Watch for his or her verbal or non-verbal response. This is not a time for a lot of words. You can say other phrases at a different time.

      “I love you”                                 “Thank you”

      “I will miss you”                          “I (we) will be ok”                

      “Please forgive me”                    “I forgive you”

      “It is ok for you to go”

I often suggest to family and friends sitting around their loved one’s bedside to each take turns being alone in the room. Not everyone will want to be alone with their loved one. That is fine and not a time to pressure anyone to stay in the room. There are some things that a person being alone will say to their loved one, or hear from their loved one, that may not be said in a larger group. Often these few words said, while being alone with your loved one, can help in closure and the grieving process. If the words are not available as death approaches, speak them to a picture of your loved one after they have died. This is part of the grieving process.

9 – Notice if there is anything special about the day or time of year as you sit with your loved one. Especially with elderly people, I have seen so many times that a person will wait to die on his or her birthday, anniversary, month and day a loved one was born or died, a holiday, and other special dates. I have seen many people wait to die until a daughter or son, another relative, or friend has arrived from across town or from out of town. My mother was in hospice care and we celebrated her 92nd birthday around her bedside almost three weeks before her actual birthday. She enjoyed her birthday, as we all did. She died peacefully two days after her birthday celebration.

10 – “Have times of prayer when you pray familiar prayers, spontaneous prayers, read psalms or other sacred text, read poetry, or sing [play] hymns.” Invite your religious leader, to join you at your loved one’s bedside. Others may want a time of quiet meditation or other types of spiritual ritual.

As a chaplain, I was taught to honor the beliefs that have taken a lifetime for him or her to develop. This is his or her life. Honor that with him or her. With that said, I will talk to them about their faith journey. With his or her permission, I will read from their sacred texts or contact their spiritual leader to coordinate a visit.

With Christian patients, I find reading from the Bible, singing or playing hymns, or reading daily devotions often brings comfort, joy, love, and peace. I have been at a loved one’s bedside where the person has died as a family member, or myself, were in the middle of reading Psalm 23. I have seen the presence, prayers, and words from a religious leader, and others bring love, grace, comfort, hope, and peace to the dying person, his or her family, and the caregivers.

11 – “Your gentle, loving touch can also communicate more than words. Soothing touch conveys a sense of feeling of peace and lets them know you love and support them.”

12 – “Let your loved one know that everything will be all right after he or she dies. The person needs to know that practical matters will be taken care of. Sometimes a loved one will linger on if there is anything unresolved. Have these conversations sooner rather than later.”

13 – “The tone and feel of the room are important. Quiet, soothing music and soft lighting foster relaxation. Also, reduce clutter within their eyesight.” Let your loved one see any meaningful pictures and remembrances of his or her life. Turn off all screens: TV’s cell phones, computers, and others.

14 – Around your loved one’s bedside, tell uplifting stories about him or her. Tell stories about her or him in your life — stories of being on vacation, holidays, and difficult times when he or she was there for you. Share how much she or he meant to you, times of laughter, and times of celebration. Trust that your loved one can hear and understand what is being said. Most often, I notice that at times family share stories the loved one near-death becomes less agitated. He or she may say a few words, sounds, or body motions that indicate her or his reaction to what is being said. If telling stories does not feel right for that time, trust your instincts.

I have found that the stories told around a loved one’s bedside lift up the personality of the loved one and their relationship to each other in the room. I have been with daughters and sons who have been estranged from their dying mother or father for 5, 10, or 30 years. Their grief and feeling of loss will be much different than those who have been active in the life of their loved ones. A caretaker of the dying loved one is not only dealing with the death that is nearing, but also how her or his life and daily routines will change. Expressions of facing one’s own mortality are often underneath the words and feelings at the loved one’s bedside.

Coordinate family and friends unable to be present to talk (and see via Facetime, Zoom, etc.) with their loved one and other family/friends present. As my father was nearing death, we called his brother so he could say goodbye to his brother. We called other families too. What a sacred moment for the two of them and us. My mother talked to many family and friends on the telephone as she lay in her bed in the last few weeks of her life.

15 – It may be comforting to give her or him permission to release her or his body and move toward the light. “This helps him or her acknowledge and accept the reality of what is happening now.”

16 – In hospice, and often in the hospital, the actively dying process may take a day or more to die. There are physical signs that the doctors, nurses, and other care providers see that tell them where your loved one is in his or her actively dying process. Outside your loved one’s room, ask the doctor or nurse where they see your loved one is in the dying process. The more you know about the process, the more you can be present for your loved one.

How they are breathing is one way to monitor the dying process. Breathing may become very shallow at times. This may happen many times over many hours. There are medications that are often given to assist the patient as death approaches. Pain medication and medications to reduce the moisture in the throat are two that I have seen used. As death nears, or at the time of death, a person may take a deep breath or two. Even after death, the person may take a few breaths, as the body adjusts to death. I have seen this often.
 
17 – For yourself, after your loved one has died, be present with your love and emotions. Allow your emotions to naturally flow. Cry, weep, tears, numbness, anxiety, gratitude, love, connection, relief may show up for you. Take whatever time needed to be present with your and other people’s feelings.

After a person has taken their last breath, as a chaplain, I will be silent. Allowing people to experience sacredness and wonder. Over time, people will start to talk. I lift up the emotions I hear underneath the words and allow time for others to speak. Often it will become quiet again and I will feel an energy shift. I might ask the family and friends at their loved one’s bedside, “If ___________ could speak, what might he/she tell you at this time?”

What I have learned is I cannot predict what will come next. It is as if everyone’s stored-up emotions and energy come out. Some look at me with their piercing eyes and expression indicating that was a question I should not have asked. One person earlier told me in many emotional words that she will never get over her husband’s death. She then shared with me after I asked that question that her husband would say to her “I love you and you will be all right.”

Most often, the responses I hear lift up the personality of the loved one who had died and how it has impacted his or her family, friends, and caregivers. Many times, the celebration of their loved one’s life changes at that moment. From sadness to joy, even if it is for a fleeting moment. I sense and hear the deep love and hope that fills the room. Being at so many loved one’s bedside after death, I am always filled by the “peace that surpasses all understanding” that I see and feel as I look at the body of God’s beloved child, whom I believe God has taken home from love and grace.  

I often suggest this to families after their loved ones has died, to go individually into the room, be with your loved one, and say what is on your heart. In the hospital, there is always time to be with your loved one for as long as you need. I will often stand with the family in the hallway or waiting room while those, one by one, say their last respects in the room. If this does not feel right to do, then do not do it.

After you call the funeral home, they will coordinate everything with the hospital, facility, or home. Outside the hospital, in their home, or a nursing home, after you call the funeral home it will take them (or medical examiner if required) an hour or more to arrive. Usually, you and others will meet the next day with the funeral director to make final arrangements.

I would highly recommend meeting with a funeral director before your loved one dies. It is important that you and your family feel comfortable with the funeral home director and staff. It is alright to ask the funeral home about their services and pricing. Some funeral homes will work with you if you need financial assistance. Before your loved one’s death, you can finalize all the pre-funeral/memorial service paperwork and possibly get a pre-pay discount. This can remove a lot of stress at the time of death. Note most often, a “funeral” has a casket burial and a “memorial service” usually involves cremation burial. Funeral homes have a 24/7 after-hours call answering service.

In the hospital, I often hear people talk about their regrets, like “if we would if only gone to see the doctor last week as we had planned.” My sense is underneath these thoughts and words are expressions and feelings of grief and loss. Regrets are part of the grieving process.

As a hospice chaplain, as a loved one was near death, we would offer the family to lead a Bedside Memorial and/or Procession of Honor at the time of death. The Bedside Memorial would take place at the bedside of the loved one. Often this was in a senior care facility.

We would time the Bedside Memorial to start about fifteen minutes before the funeral home attendants arrived to transport the loved one’s body to the funeral home. Gathered around the loved one’s bedside would be family, friends, caregivers, and a chaplain or leader. The leader would say “We gather at this time to say goodbye to ______________ and give thanks to God for his/her life. We look to God for comfort, guidance, and hope in Christ (Christian Bedside Memorials).” The leader would ask each person in the room to state their name and relationship to the loved one. The leader read scripture. The leader said a prayer which began as, “Eternal God, before whom generations come and go, we thank you for the opportunity to have known and served ___________________. We commend him/her to you…” The leader may say “At this time, we invite you to share a meaningful memory, family experience, or value lived by ___________________.” We recited Psalm 23 together. Note, each person attending was given a pre-printed 4-page Bedside Memorial program with scriptures, prayer, etc. for everyone to follow along. To close the Bedside Memorial, a scripture verse was read.

This is one way to have a Bedside Memorial and can be adapted to be in alignment with your loved ones’ religious/spiritual/non-spiritual beliefs. The Bedside Memorial gives the family, friends, and caregivers the opportunity to meet each other, hear stories, scripture, prayers, and words of love, hope, and peace.

The Procession of Honor often takes place right after, or shortly thereafter, when the funeral home attendants arrive. In the senior care facilities, everyone would leave our loved one’s room and stand in the hallway while the funeral home attendants cared for our loved one’s body (at times, I as the leader, or a family member, would stay in the room to assist the funeral home attendants). The care facility had a special “pall” or cloak, that was draped over our loved one’s body (often his or her body had been placed in a transport bag, resting on a gurney).

As the funeral attendants transported our loved one’s body to their hearse/van we would all follow in silence. We would stop at the front door and circle around our loved one’s body. According to the family’s wishes, at the care facility, the receptionist had previously alerted residents about their loved one’s death. Often several residents would join the people who were at the Bedside Memorial to pay their last respects. Scriptures are read and a prayer said. The pall, or cloak, would be removed and returned to the facility office to be laundered.

As the leader, I would encourage the immediate family to process with their loved one’s body to the hearse/van and say any last words. Often at this time, a family member will have scheduled a time later that day, or the next day, to meet with a funeral director and a few family members to discuss funeral/memorial service, burial, casket, or cremation/urn, and other plans. This is a very emotional time for family, friends, and caregivers. Continuing to share stories about the loved one may be helpful at this time. Other’s may want to be alone. Some need some space and find comfort getting back to their routine to process all that has happened.

After my mother died, I lead a virtual Bedside Memorial (Facetime/Zoom/etc.). I had left the night before to fly home. Many family members and the hospice chaplain were present at my mother’s bedside. I followed the Bedside Memorial outlined above. For me, it gave me a chance to see my mother’s body lying in her bed and acknowledge she had died. What a sacred time to lift up my mother’s love and life with family and the hospice chaplain. Often the family will connect via phone with other family or friends so they can be part of their loved one’s Bedside Memorial.

18 – Take time to grieve. Hospitals, hospice, religious organization leaders, and neighborhood organizations offer grief support. Either one-on-one support or small group grief support. Dealing with grief will be different for everyone. Stay in contact with each other. Find someone you can talk to about how you are feeling. Birthdays, anniversaries, and holidays can bring up grief that you had thought were behind you.

Grieving takes as long as it takes. You might have some trouble sleeping and anxious feelings those first few weeks after a loved one have died. Seek professional help if you have trouble sleeping, anxiety, or other grief symptoms more than a few weeks or months after a loved one dies. If you were the caregiver, you are grieving the loss of your loved one. At the same time, you are making a difficult transition from having the responsibilities and emotional pressures of being the caregiver to looking at what is next for you to do. Practice self-care.

Blessings on your sacred journey.

Note, parts of this article in quotations were taken from “Creating a Peaceful, Sacred Space for Your Loved Ones,” Optage Hospice, Roseville, MN, (3,6,10,11,12,13, 17), and “As Death Draws Near” from Allina Health, Minneapolis, MN (8), where I previously worked as a hospice chaplain and hospital chaplain. Special thanks for these uplifting words.

© 2021 David Tillman, all rights reserved, www.lifesjourney.us