Someone asked me about deathbed rituals. They wanted to know what to say and do when someone is in the moments before death and what to do before the funeral home arrives. Here are my suggestions:
In the hours to minutes before death, gather family and significant others. Encourage each person to spend some time alone with the person dying. This is the time to talk from the heart, to talk about the good and the challenging times, to speak of love and forgiveness. This is a private time.
The person dying will be non responsive, breathing erratically, probably with their eyes partially open. I believe they can hear but are so removed from their body they can’t respond.
After everyone present has had the opportunity to say their private goodbye, gather everyone back into the room. This is vigil time. Explain to those present what will probably be happening, such as fish out of water breathing. They will likely frown or grimace before their last breath.
The lights can be on with their favorite music playing. They can hold their special person’s hand, lay beside them, have the dog or cat on the bed, reminisce, tell stories. This is “we are here with you as you make your special journey" time. It is also a time to support each other.
Breathing will get slower and slower. There will often be a frown, a grimace and sometimes a tear just before the last few long spaced out breaths occur.
Give everyone the opportunity to really comprehend that their special person is gone. Then suggest that you would like to tidy and have everyone come back and say another goodbye before you call the funeral home.
Clean and tidy the body. A bath is not necessary although it can be a beautiful gift the family can give, a hands on expression of love. Following the tidy, position the body with the head of the bed slightly raised and encourage each person to return to say their final goodbyes.
When goodbyes have been said, call the funeral home. While waiting, reminisce with life stories. When the funeral home has taken the body, return to the room. Make the bed, even if it is a hospital bed, with clean sheets and put a memento upon the pillow. The memento can be a flower, their rosary if appropriate, or a stuffed animal. It can be anything you can find in the room to ease the pain of seeing an empty bed. Leave a small light on in the room when you leave.
Rooms have memories and you want to soften the memory that will be in that room from now on.
The goal of our supporting a family and significant others during and after the death is to create for all a sacred experience. They will carry that memory with them forever.
Something More… about Family Guidance In The Final Hours and After…
I go into further detail about deathbed care for the patient and family in my book The Final Act of Living, Reflections of a Longtime Hospice Nurse. You can get your copy here: Book
4 comments
Lynn
I am a nurse and at the time of her death, I was a hospice nurse. My Mom died in ICU after a stroke. She was unresponsive. She was going to be transferred to hospice that evening but she died beforehand. My Mom had a tear down her cheek before she died, which was strange because they were putting drops in her eyes that morning because they were so dry. I choose to believe and I told my family, she knew what she was leaving but also knew where she was going and she would be reunited with her parents and siblings. I want to thank you for the wonderful messages you offer grieving families. God bless you
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BK Books replied:
Thank you Lyn for sharing. I too believe your mom knew she was dying. My blessing to you and your family. Barbara
I am a nurse and at the time of her death, I was a hospice nurse. My Mom died in ICU after a stroke. She was unresponsive. She was going to be transferred to hospice that evening but she died beforehand. My Mom had a tear down her cheek before she died, which was strange because they were putting drops in her eyes that morning because they were so dry. I choose to believe and I told my family, she knew what she was leaving but also knew where she was going and she would be reunited with her parents and siblings. I want to thank you for the wonderful messages you offer grieving families. God bless you
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BK Books replied:
Thank you Lyn for sharing. I too believe your mom knew she was dying. My blessing to you and your family. Barbara
Sydney
If only- my personal experience was the complete opposite of this description when my husband died in hospice care. My dog and I found him deceased, the staff nurse had left him alone after promising me that she would not if I went for half an hour for some food, the hospice nurse had not yet seen him that day and was a stranger( on weekend duty). Our only son was at a friend’s wedding in California and I couldn’t reach him by phone. After years I still remember every detail- bad memories. It really was bad and I think traumatic. I know I must live with it yet it feels sad and bad. I realize many people have had worse experiences & I need to suck it up. He died on Oct. 29 so this time of year conjures up the memories.
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BK Books replied:
Sydney, I am so sorry you did not get the support from hospice that would have helped you understand his dying moments. You do not have to “suck it up” as you mentioned in your letter. You might write your husband a letter. Put all your feelings, thoughts and tears about you not being there and how his death unfolded down on paper. Burn the letter and scatter the ashes to the wind. Let how well you live your life now be the gift of love you give him. My blessings are with you. Barbara
If only- my personal experience was the complete opposite of this description when my husband died in hospice care. My dog and I found him deceased, the staff nurse had left him alone after promising me that she would not if I went for half an hour for some food, the hospice nurse had not yet seen him that day and was a stranger( on weekend duty). Our only son was at a friend’s wedding in California and I couldn’t reach him by phone. After years I still remember every detail- bad memories. It really was bad and I think traumatic. I know I must live with it yet it feels sad and bad. I realize many people have had worse experiences & I need to suck it up. He died on Oct. 29 so this time of year conjures up the memories.
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BK Books replied:
Sydney, I am so sorry you did not get the support from hospice that would have helped you understand his dying moments. You do not have to “suck it up” as you mentioned in your letter. You might write your husband a letter. Put all your feelings, thoughts and tears about you not being there and how his death unfolded down on paper. Burn the letter and scatter the ashes to the wind. Let how well you live your life now be the gift of love you give him. My blessings are with you. Barbara
Deborah
Moments before my husband died, he made a terrible grimace, which was unsettling. Could it have been because of the difficulty in getting out of his body? Thanks in advance.
Deborah Katz
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BK Books replied:
Hi Deborah, so many people have a grimace as they take their last few breaths. I think it is the final tug, the final push to release from their body. Nothing bad is happening. Blessings! Barbara
Moments before my husband died, he made a terrible grimace, which was unsettling. Could it have been because of the difficulty in getting out of his body? Thanks in advance.
Deborah Katz
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BK Books replied:
Hi Deborah, so many people have a grimace as they take their last few breaths. I think it is the final tug, the final push to release from their body. Nothing bad is happening. Blessings! Barbara
Sandra Avila
My mom passed a couple hours after I had left her room at the nursing home. I had spent the day with her, thinking she would “wake up” eventually, because we had just seen her in a lucid state days before. When I got the call that she was gone, I was startled and went straight back to her room.
I waited with her until the coroners arrived. I was able to see staff come in to say their goodbyes .
When the coroners entered, I left the room.
I looked back and saw her sheeted feet spinning like a rotisserie chicken as they moved her wrapped her body onto their gurney. It stunned me.
I wish I hadn’t looked back. She had been on hospice for two days. It was not the death I ever expected she would experience.
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BK Books replied:
Sandra, I am so sorry you now have the final memory of your mom being lifted onto the gueryny. Think about creating a phrase that you can say to yourself when the picture of your mom’s feet occurs in your mind. Something positive and loving “I love you mom. I wish you well on your journey”. Say the words and then snap your fingers as in letting go. Sometimes a little ritual can help us over some of the obstacles grief throws at us. My blessings to you. Barbara
My mom passed a couple hours after I had left her room at the nursing home. I had spent the day with her, thinking she would “wake up” eventually, because we had just seen her in a lucid state days before. When I got the call that she was gone, I was startled and went straight back to her room.
I waited with her until the coroners arrived. I was able to see staff come in to say their goodbyes .
When the coroners entered, I left the room.
I looked back and saw her sheeted feet spinning like a rotisserie chicken as they moved her wrapped her body onto their gurney. It stunned me.
I wish I hadn’t looked back. She had been on hospice for two days. It was not the death I ever expected she would experience.
———
BK Books replied:
Sandra, I am so sorry you now have the final memory of your mom being lifted onto the gueryny. Think about creating a phrase that you can say to yourself when the picture of your mom’s feet occurs in your mind. Something positive and loving “I love you mom. I wish you well on your journey”. Say the words and then snap your fingers as in letting go. Sometimes a little ritual can help us over some of the obstacles grief throws at us. My blessings to you. Barbara