NHPCO Hospice Innovator, Barbara Karnes, RN speaks to those who are unable to be with their loved one at the time of death. www.bkbooks.com

How To Say Goodbye When I'm Not There

People are dying and in a manner we are not used to. We, in America, have become accustomed to having our loved one either at home with family close, or in a nursing facility with some family, or in a hospital, hopefully with family present.

In the next weeks and months some of our loved ones may be dying basically alone...

People are dying and in a manner we are not used to. We, in America, have become accustomed to having our loved one either at home with family close, or in a nursing facility with some family, or in a hospital, hopefully with family present.

In the next weeks and months some of our loved ones may be dying basically alone. They will probably be in a hospital ICU with health care attendants clothed like astronauts, who are overworked and short of time.

Sorry, I know this does not paint the picture we want for those we love. What can we do? I’m going out on a limb here (but I think we are in out on a limb times).

One of my teachers said “Thoughts are things” and "Thoughts originate before actions can follow”. So let’s use thoughts to send support, guidance and love to our loved one if they are alone in the ICU, nursing home, field hospital, or wherever they may be.

Quiet yourself, sit in a comfortable position, close your eyes and think of your loved one. See in your mind your loved one in bed, sleeping. Again, in your mind, sit beside them, hold them, their hand or cuddle, whatever you are drawn to doing. Now start talking. Say what is in your heart. Talk about the good times, talk about the challenging times (every relationship has challenging times). Offer them love, gratitude for their life, for your relationship (if it is true).

In your mind create a gentle passing. What is a gentle passing? The person is non responsive, breathing gets slower and slower, eyes are partially closed, there's no agitation, no talking, then there's a facial expression of a grimace (maybe a smile but generally a grimace), one or two more breaths, and they are gone.

What I described is how humans and animals die. I described what the last minutes of most people will be as as they die. No matter where they are, why or how they are dying, that is what their last minutes will be like.

Whether in the hospital underneath the ventilator mask or in bed at home, this is how the body dies. There are other bodily things, lowered blood pressure, decreased urine output or lack of, slowing/weakened heart beat, that occur up to the moment of death but almost always, if you have the presence of mind (most of us don’t at a moment like this), you will notice the last minutes are generally as I described.

Now back to saying goodbye while you are unable to be present with your loved one. Obviously, this isn’t perfect, some would even say it is silly and non productive, but what do we have to lose? Nothing! If, by some non physical explanation, we can be there, giving love and comfort, why not try it?

Something More... about How To Say Goodbye When I'm Not There

Understanding the dying process helps families process their grief. Families who have a loved one dying at home, the nursing home, the ICU, the emergency room, or hospice, need a non-medical, concise tool. That's why I made my dvd kit, NEW RULES for End of Life Care. It's 25 minutes long without medical jargon that can be confusing for those who aren't medically trained. We have it available to rent on Vimeo as well as in hard copy dvd to be mailed. Help those who are struggling with this video.

8 comments

barbara

Hi Esther, it is always good to hear from you. I am sorry it is under personal circumstances this time. This virus has changed the way hospice gives service. We have always relied on the personal, close touch (often literally) way of supporting our families. With social distancing and sheltering in place hospices have to reorient how they provide care. I have been doing 30 minute sessions with hospices around the country to give them ideas of how to provide care in this challenging time.
Keep safe. My blessings are with you always. Barbara

Hi Esther, it is always good to hear from you. I am sorry it is under personal circumstances this time. This virus has changed the way hospice gives service. We have always relied on the personal, close touch (often literally) way of supporting our families. With social distancing and sheltering in place hospices have to reorient how they provide care. I have been doing 30 minute sessions with hospices around the country to give them ideas of how to provide care in this challenging time.
Keep safe. My blessings are with you always. Barbara

Esther Ideker

Barb: I sent this to my cousin who is in a nursing home where she and her husband of 61 years are residents. He is in the dying process and under Hospice care. Before Hospice came in, with all the regulations, she cannot go into his room. They did take her outside – place her husband in a wheel chair and brought him to the widow. She shared with me that he did not respond – she is about beside herself not being able to be at his bedside. I shared with her that when Hospice care begins, they may advocate for her to be able to go in to his room. I don’t know all the circumstances of the whys but am so hopeful she will be granted her wish. I thought this article would be of help to her and so thank you for this timely blog. Even Hospice has had to make changes in this difficult time. Our Hospice (I am a volunteer now) are not sending out volunteers. It is hard to imagine we are in situation where compassion is even hindered. Our family are phoning her often – even my two adult children in Olympia and Dallas are supporting her – our cousin’s Pastor is it he hospital so am hoping the Chaplain will be able to come in and talk with Kay.
Thanks for listening friend, I know you understand. Blessings! Esther

Barb: I sent this to my cousin who is in a nursing home where she and her husband of 61 years are residents. He is in the dying process and under Hospice care. Before Hospice came in, with all the regulations, she cannot go into his room. They did take her outside – place her husband in a wheel chair and brought him to the widow. She shared with me that he did not respond – she is about beside herself not being able to be at his bedside. I shared with her that when Hospice care begins, they may advocate for her to be able to go in to his room. I don’t know all the circumstances of the whys but am so hopeful she will be granted her wish. I thought this article would be of help to her and so thank you for this timely blog. Even Hospice has had to make changes in this difficult time. Our Hospice (I am a volunteer now) are not sending out volunteers. It is hard to imagine we are in situation where compassion is even hindered. Our family are phoning her often – even my two adult children in Olympia and Dallas are supporting her – our cousin’s Pastor is it he hospital so am hoping the Chaplain will be able to come in and talk with Kay.
Thanks for listening friend, I know you understand. Blessings! Esther

barbara

Hi Heather, about your request for the booklet “How to say Goodbye”, there is no booklet. It is just a blog post. However, you can download and share the article with staff. You might find my booklet “The Eleventh Hour” helpful for family support and guidance during the last days to hours before death. Blessings! Barbara

Hi Heather, about your request for the booklet “How to say Goodbye”, there is no booklet. It is just a blog post. However, you can download and share the article with staff. You might find my booklet “The Eleventh Hour” helpful for family support and guidance during the last days to hours before death. Blessings! Barbara

barbara

Hi LeAnn, I will hold you and David in my thoughts and heart as you continue your journey. If I can support you in any way just write. Use my personal email barbara@bkbooks.com Blessings! Barbara

Hi LeAnn, I will hold you and David in my thoughts and heart as you continue your journey. If I can support you in any way just write. Use my personal email barbara@bkbooks.com Blessings! Barbara

Heather Burton

I would like to get a copy of " How to say goodbye when I’m not there" booklet to see if it is something we need to add to our resources we use with patients and their families.

I would be happy to purchase.

Please contact me at the above email address.

Thank you- Heather

I would like to get a copy of " How to say goodbye when I’m not there" booklet to see if it is something we need to add to our resources we use with patients and their families.

I would be happy to purchase.

Please contact me at the above email address.

Thank you- Heather

Heather Arps

I was very close to my grandmother. She was in a ‘nursing home’ when she died with no one: family or staff in attendance. At about 3 am that morning, I woke, sat upright and saw an image of her with hr radiant loving smile. I think she came to say goodbye. If they can travel with their intentions, why can’t we? There are several modalities that use distance contact with great success and I believe that a loved one, closer to the spirit side of life can sense our love and intentions.
And, although we believe that no one should die alone, it has been my experience after 40 years working with end of life care, that for some people, that is their wish…no one at hand to inhibit their already tricky journey. I have had clients who wait and wait….until their vigil person steps out to the bathroom or for a cup of coffee…then in a matters of minutes they take their last breath alone.
From my experience, I truly believe that each person dies in the manner in which they they need to or choose.
Heather

I was very close to my grandmother. She was in a ‘nursing home’ when she died with no one: family or staff in attendance. At about 3 am that morning, I woke, sat upright and saw an image of her with hr radiant loving smile. I think she came to say goodbye. If they can travel with their intentions, why can’t we? There are several modalities that use distance contact with great success and I believe that a loved one, closer to the spirit side of life can sense our love and intentions.
And, although we believe that no one should die alone, it has been my experience after 40 years working with end of life care, that for some people, that is their wish…no one at hand to inhibit their already tricky journey. I have had clients who wait and wait….until their vigil person steps out to the bathroom or for a cup of coffee…then in a matters of minutes they take their last breath alone.
From my experience, I truly believe that each person dies in the manner in which they they need to or choose.
Heather

LeAnn Wiederanders

Hello, I hope this finds you well. I have been holding my husbands (of 22 years this Aug) as lightly or as firmly, as slow or as fast as is comfortable for him, on this particular Alzheimer’s path now for 9 years.
I have yet to find a belt strong or long enough to hold me still in the ever shifting, bumpy, whip lash speed that we encounter on a daily basis- sometimes several times daily.
Discovering Mrs. Karen’s months ago and speaking with your wonderful assistant and reading, embracing all your knowledge and heart so generously, graciously provides for me what I seek, crave and yearn for – how to best take care of my husband and myself and others I encounter that are also looking for the guidance , comfort and a soft place to know how best to serve those in need from this life to the next as well as all the nooks and crannies that exist in the living of life in between. All of life’s experience are significant moments.
Warmly and most sincerely from my heart and soul.
Thank you.
David and LeAnn Wiederanders.
Please take care ~ give care in and for all.

Hello, I hope this finds you well. I have been holding my husbands (of 22 years this Aug) as lightly or as firmly, as slow or as fast as is comfortable for him, on this particular Alzheimer’s path now for 9 years.
I have yet to find a belt strong or long enough to hold me still in the ever shifting, bumpy, whip lash speed that we encounter on a daily basis- sometimes several times daily.
Discovering Mrs. Karen’s months ago and speaking with your wonderful assistant and reading, embracing all your knowledge and heart so generously, graciously provides for me what I seek, crave and yearn for – how to best take care of my husband and myself and others I encounter that are also looking for the guidance , comfort and a soft place to know how best to serve those in need from this life to the next as well as all the nooks and crannies that exist in the living of life in between. All of life’s experience are significant moments.
Warmly and most sincerely from my heart and soul.
Thank you.
David and LeAnn Wiederanders.
Please take care ~ give care in and for all.

Anonymous

I work for a hospice and what you describe is beautiful. I also am learning Healing Hands and I know the dying will hear our thoughts and feel us nearby. Please anyone who is reading this, try it. It is wonderful.

I work for a hospice and what you describe is beautiful. I also am learning Healing Hands and I know the dying will hear our thoughts and feel us nearby. Please anyone who is reading this, try it. It is wonderful.

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