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.

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