My dad’s final days

By Ken Dychtwald, Ph.D.

I grew up in the 1950s and ’60s in a mostly blue-collar community in Newark, New Jersey. My father, Seymour, was a fiercely hardworking guy who wanted to be successful. For him, work wasn’t about “finding his bliss,” it was about being a responsible husband and father. His dad had skipped out on him, his siblings and mother for almost 10 years during the Depression. In contrast, my dad was a reliable family man and wanted our family to live the American dream.

Ultimately, Dad rose from selling clothing and home furnishings out of the back of his truck to owning and operating a successful chain of women’s clothing stores. In their mid-60s, my folks retired and relocated to Florida.

Throughout my life, Dad and I had a loving but feisty relationship. He was very opinionated (I guess I am, too) and was skeptical of many of my lifestyle and career moves—from moving to California, from studying physics to the field of psychology and then to gerontology. But he had great love for my family and he eventually developed a deep respect for what I made of myself.

In the 1990s, my father started to lose his vision and with it, control over much of his life. Sadly, Alzheimer’s was also chiseling away at my mother’s mind. Dad loved Mom so much that he railed against the dissolution of her memory and her mind. He got depressed and angry.

“If I die before Mom, she’ll struggle terribly, and if she dies before me, I’ll go crazy. Just as we’ve lived together, we want to die together,” he said. That was quite a lot for me to digest.

One night, he asked me, “If I take my own life and Mom’s, would that be brave or cowardly?”

I said, “I don’t know, Dad. If I was in your situation, I can’t imagine what I’d think or do.”

So, for almost a year, every night I’d go to sleep not knowing if my parents would be alive in the morning.

In 2013, my brother Alan called me in a state of distress to report that our dad’s blood sugar was going haywire. And to make things worse, he’d lost his balance and fallen on his face, giving himself a big gash on his forehead. Alan was already on his way to Florida. I packed my bags and headed east.

Dad’s doctor admitted him to intensive care. He had internal bleeding and had suffered a heart attack. When he realized that his boys were there for him, he called out to us: “What’s going on? Get me out of here!”

Dad settled down a bit, and Alan and I went to see our mom. Later that night, the phone rang. It was Dad pleading with us to rescue him. 

We shot back to the hospital and went into our anguished father’s room. His arms, chest, face and hair were covered with blood because he kept pulling out his IV lines. In the morning, after a torturous night for both my dad and brother, and a sad night for me and for my confused mother, I returned to the hospital. Alan and I asked: “Dad, what do you want?”

“I’m scared,” he said, “but I know this: I’ve lived my whole life on my own two feet, and I’m not going out on my hands and knees. Please help me bring this to an end.”

Shortly after, Alan and I met with Dad’s physician. He was a kind and decent man who asked us if we wanted our dad to remain in intensive care or if we preferred to shift him to hospice car
Were we going to battle to keep Dad alive for a few more days, albeit in a ghastly, ghoulish fashion? Or were we prepared to make him comfortable and allow him to die a good death? 

What would he want us to do?

We had Dad transferred to the hospice floor, where the nurses and aides removed all the wires and tubes, lovingly sponged all of the blood off him and even gave him a shave and combed his hair. They asked him what his favorite music was and then put on Frank Sinatra.

Next, they began a low dose of morphine to ease his anxiety. My wife and kids all dropped what they were doing to fly to Florida and be with him.

As I contemplated the end of my father’s life, I reflected that even though we had often butted heads, there was not one instance in my entire life when he wasn’t there for me when I truly needed him.

I wanted to show Dad proper respect and kindness, but not knowing how I should handle the situation with my dad nearing his death, I called one of my closest friends, Stuart Pellman, who had already dealt with the death of both of his parents.

He wisely told me, “Get one-on-one time with your dad. Even if he’s unconscious, tell him you love him, ask him to forgive you for anything you may have ever done to trouble him. Tell him you forgive him for anything he might have ever done to upset you, and then tell him you’ll always remember him.”

And that’s what I did.

Dad and I held each other for a long while, and then I left the room and allowed my brother some privacy to do the same.

Later that night, after the other members of my family had gone home, I joined my dad for a very intense and private conversation.

I said, “Dad, you’ve never asked me what I think happens when a person dies.”

“I’d like to know what you think about that, Kenny,” he responded. “Because I’ve begun to see my brothers and sister and they’re reaching out to me.”

My dad had no religious beliefs, but I had some. So I said, “Dad, I don’t know this for sure, but I believe when a person passes, there is another plane that presents itself. In that place are all the people you have known and loved.”

As I began to describe this, he started to cry. Then he turned toward me and told me he was ready.

I asked him if I could record the rest of our exchange on my phone so I could always have it to watch when I missed him. He said okay, and this is what transpired:

Ken: “Dad, you know that what’s going to be next is going to be beautiful and your vision’s going to be back and you’re going to be a young man again.”

Dad: “I’m ready for that, Kenny.”

Ken: “And you know we all love you, and you’ve always loved us.”

Dad: “I know it, Kenny.”

Ken: “So, what you’ll need to do is let go and not worry about anything because everything is going to be looked after. All we need is for you to be relaxed and calm and just drift off into the white light. Can you do that, Dad?”

Dad: “Absolutely.”

Ken: “I love you, Pops.”

Dad: “I love you, Kenny.”

My father died peacefully that night. With help from all of us, he went out on his own two feet.

Ultimately, even with all his frustration and anger, my dad died a good death. At the end, his pain was minimal. His mind was calm. He found a way to think about leaving his body as not being frightening. And although he had been blind for years, at the very end, he began to describe beautiful waterfalls, flowers, birds and castles.

When my time comes, I hope that my wife Maddy will kiss me goodbye and at least one of my kids—maybe even both—will be there to lovingly guide me out of my body.

Complete Article HERE!

Yellowknife teacher’s final lesson

— How to live a good death

Maureen Tonge at a Kundalini Yoga Retreat in October 2019 on the Greek island of Karpathos.

Maureen Tonge’s death from cancer at age 52 offers friends and family a window on how to live and die well

By Joanne Stassen

Maureen Tonge’s living room looks out over the houseboats on Yellowknife Bay. She’s sitting in a comfy chair by the window, wrapped in a cozy blanket.

“I’m in the end stages of my life,” she says matter-of-factly. “Yep. I’m dying.”

It’s Sept. 16. Three weeks from now, Maureen will die at home, with her husband Robert Charpentier, her sisters and her parents, by her side.

The way she wanted it.

But on this day, with the warm autumn sun lighting up her face, she wants to talk about dying, while she still has the strength and memory.

Tonge has taught at École Sir John Franklin High School in Yellowknife since 1992.

In the last decade she’s shared her Kundalini Yoga practice with people in the North and around the world.

Her family and friends say she’s taught them how to live a good life, and now, to die a good death.

‘I would prove them differently’

Tonge was diagnosed with glioblastoma multiforme in February 2019.

Doctors gave her four months and said she wasn’t likely to see the end of 2019.

Those giving the prognosis had no idea who I was … so I would prove them differently.
– Maureen Tonge

But Tonge wasn’t giving up that easily.

“I indicated to everyone who would listen that I was not my diagnosis nor my prognosis,” she told CBC North Trail’s End host Lawrence Nayally at the end of 2019.

Tonge went through chemotherapy, but also followed her own less conventional path, working with a naturopath, and with other healers. At diagnosis, the tumour was bigger than a golf ball, but a bit smaller than an egg. Ten months later it was more like a quarter of a marshmallow.

“Those giving the prognosis had no idea who I was,” she said.  “So I would prove them differently.”

Welcoming death

By June this year Tonge begins to feel pressure between her eyes, jitters and dizziness. A scan shows the tumour has grown aggressively.

By mid-September trips to the bathroom require a supportive arm. She has trouble keeping track of conversations.

“I’m pretty low functioning now,” she says. “It has been a bit of a struggle to wrap my head around the fact that has changed so dramatically.”

But the transition from fighting death, to accepting it, has become easier.

“It’s not been a struggle to wrap my head around the fact that I am dying. Dying is an inevitable part of living. I’m welcoming it.”

Teaching about life, and death

Maureen’s sister-in-law, Kathleen Charpentier has been helping with Maureen’s care and says hearing that gives her a lot of comfort.

“We live in a culture that is death-phobic and grief illiterate,” she says. “We often make the demand of dying people to live, and I think that’s a very hard demand.”

Eleven days before her death, Maureen’s condo is quiet, but there is still laughter, and a fridge full of food from friends. Hundreds of people have been posting on Maureen’s Facebook, sending messages of love and appreciation.

Maureen’s twin, Kirsten Tonge, has come from British Columbia, and soon her parents and two other sisters will be there, thanks to a special exemption from the territory’s chief public health officer.

Kirsten describes their relationship as “halves of the same whole” and remembers cuddling up with Maureen on the gurney, when they got the news that the tumours were growing again.

Their bond goes back to the womb, but Kirsten says she’s not sure she will ever understand the grace and gratitude her twin shows in the face of death.

“Earlier this month she said to me ‘I’m healing you know … it’s not the end.'”

Kirsten believes Maureen was talking about spiritual and emotional healing of trauma from her childhood.

“You know she had some deep wounds to her spirit, and emotionally. And she’s been able to truly dig deep and use the resources she’s built, and heal herself with the love and support of so many people.”

Former student Cailey Mercredi is there to give Maureen a massage.

“She’s taught me papier mâché mask-making and then Kundalini yoga,” Mercredi said. “To say she’s taught me about love would be an understatement.”

She added that being part of Tonge’s journey toward death will stay with her forever.

“Vulnerability and the trust there, is what brings us closer as human beings. This is how we make connections and how we build community.”

It’s just hard. Knowing I’m saying good-bye, and a part of me feeling entirely ready. And another part of me, not.
– Maureen Tonge

Tonge says she can’t say how she got to a place of peace about her death, but that it has been a process, something she’s been building toward through her life.Having people around her has been essential.

“I’m so grateful that I have family here but also friends that are like family. Connections have always been really important to me.”

For her sister-in-law Kathleen, sharing in Tonge’s last days is a gift.

“I think when you share your death, you are teaching others,” Charpentier says. “I think it’s important. Because we’re all going to be there someday.”

‘There is zero fear’

Tonge says she doesn’t know what happens after death, but she’s not afraid.

“Absolutely not,” she said. “There is zero fear. I know that we are composed of energy. And I don’t believe energy can be created or destroyed.”

She does feel sadness and it wells to the surface when she thinks about the ones she’s leaving behind.

“It’s just hard,” she says, between tears. “Knowing I’m saying good-bye, and a part of me feeling entirely ready. And another part of me, not.”

Two things bring Tonge comfort: Having no regrets, and the hope she has for her family and friends. It’s an echo of what her students of art and yoga have always heard from her: “I just hope that they are able to tap into their richest opportunities, and take full advantage of that.”

Kirsten Tonge says losing her twin will be the “the most difficult loss.”

“She has taught me that this time is only one of many … it’s not the final chapter,” she said.

“She may be gone in the physical sense … but I know without a doubt that her love will always be with me, and my love will always be with her.”

Complete Article HERE!

Social Isolation a Threat to Hospice Patients During COVID-19

By Holly Vossel

The threat of COVID-19 has forced many providers to keep high-risk seriously and terminally ill patients isolated to limit the virus’s exposure and spread. As families become disconnected from loved ones approaching the end of life, hospice providers have sought new ways to offer mental health support during the pandemic.

Social isolation during the coronavirus emergency has substantially impacted the hospice population, as well as seniors in general. Research has identified significant links between social isolation and increased risk of early mortality among older and seriously ill patients.

According to a recent report from health insurance marketplace company GoHealth, the pandemic has been driving a mental health decline among isolated aging populations as they practice social distancing from family and friends. In a nationwide study of 1,000 Medicare beneficiaries, 25% percent reported a decline in their mental wellness since the pandemic’s onset, and more than 90% felt lonelier now than before it began.

“Social isolation from friends, families and even their hospice providers visits, has impacted the mental health of hospice patients,” said Shelley Cartwright, executive director of Illinois-based Apex Hospice and Palliative Care. “Social isolation contributes to a decline in mental health. Depression, anxiety, and delirium in those who are terminally ill are frequent and currently most likely under-diagnosed as hospice frontline personnel are not being allowed to make in-person visits as frequently as they normally would as patients, families, hospitals and skilled nursing facilities are in COVID-19 precautions.”

Hospices have struggled to find a balance between technology and the human touch while offering telehealth visits and online virtual support. With families often connected only virtually in the last moments of life, disenfranchised grief has added to concerns of ramping up mental health support.

“Dying is inherently lonely and isolating and made worse when people are actually removed from their loved ones,” said Christopher Kerr, CEO and chief medical officer of Hospice & Palliative Care Buffalo in New York. “It’s ultimately a closing of a life, not just a medical phenomena, and that life is defined by relationships. The pandemic has taken a difficult situation and made it multiple times worse. It’s in moments of crisis and need that we need to connect ourselves to those people that give our life meaning. The opposite happened that when we most needed to be reconnected to those we love, we were removed.”

The sweeping effects of isolation has drawn heightened focus from hospice providers on the need for greater communication and deeper integration of psychiatric care. Research from 2018 projected that the number of seniors with mental health conditions will triple over the next three decades. An estimated 5 to 8 million aging Americans currently suffer from mental illness. Providers have been working on improving hospice access for these patients.

With facilities and hospitals limiting interactions, social isolation has exacerbated mental health concerns as hospices face barriers to reaching patients during the pandemic. One strategy being employed is increased collaboration with referring facilities, psychiatric disciplines and primary physicians as hospice work to support isolated patients and their families.

“We believe that no one should have to face serious illness or death alone,” Carla Davis, CEO of Heart of Hospice, told Hospice News. “Holistic, person-centered care delivered by hospice care teams plays a critical role in protecting and improving the mental health of vulnerable populations who would otherwise be left in isolation. The more we are able to work diligently alongside our facility partners to continue providing quality care, the better equipped we will be to prevent negative mental health outcomes in individuals facing serious mental illnesses.”

As COVID-19 cases and fatalities continue to climb, so does growing concern among hospice providers over the effects of isolation on the quality and experience of end-of-life care.

“Patients, even though imminent, often fight death until they are at peace and have said their good-byes or receive permission from their family to ‘let go,’” Cartwright told Hospice News. “Quality end-of-life experience and death for patients and their families is, and will be, jeopardized with the continued isolation of dying patients from their families.”

Complete Article HERE!

At 31, I have just weeks to live. Here’s what I want to pass on

Now that there’s no longer any way to treat my cancer, I’ve been reflecting on what I want others to know about life and death

‘I have come to see growing old as a privilege. Nobody should lament getting one year older, another grey hair or a wrinkle. Be pleased that you’ve made it.’

By

At the beginning of April I wrote a piece for the Guardian. If you haven’t read it, the headline pretty much sums it up: “Terminal cancer means I won’t see the other side of lockdown”. Given the pandemic and the announcement of shielding for vulnerable people, I thought I wouldn’t be able to live out my last few months in the way I’d imagined. It seemed like I would be stuck alone, with no light at the end of the tunnel, and without the comfort of friends or family.

Five months on, I’m still here, but much has changed. Thankfully, the experience wasn’t as bleak as you might think. During the first few weeks of lockdown I found I was floating nicely through the time by staying occupied and upbeat. In many ways, you can’t beat the liberation of being able to wake up when you feel like it, having few plans set in stone and being able to do whatever you want with the time you have.

Over the past couple of months, though, my energy levels have dropped, and I have started doing less. I look drastically different. I have lost a lot of weight. A 20-minute coughing fit is now part of my morning routine while my chest tries to settle itself. It’s nothing that some steroids, morphine, an iced drink to settle my throat and time spent dry-heaving in front of a bucket won’t eventually sort out, but it can get really distressing – like an intrinsic panic response.

At points I was really struggling. The loneliness of Covid was making me miserable, and I needed company. But my sister came to the rescue at just the right moment. She moved back into our shared flat at the end of June. It made a huge difference, and I don’t know where I would be without her. After months of isolation, having a family member close by changed everything.

At the same time, out of the blue, I was told I was finally suitable for a drug trial that had been dangled in front of me for more than a year. The oncologists made it very clear that this would not be a “magic bullet”, and the goal would be to extend life by a few months. The aim of the treatment would be to stop the cancer stealing all the nutrients and energy my body needs.

But I was not in the same good shape I had been in at the beginning of other treatments; I was extremely short of breath, unable to exercise and felt lethargic. And after pinning my hopes on the idea of a drug trial for so long, it took just over a week for it to batter me. My days involved moving from my room to the sofa, feeling like I had flu and struggling with mental fog. Almost immediately I realised I just couldn’t do it. Life for me is about living, not just clocking up the years. And this drug made living almost impossible.

I realised I had to finally accept the inevitable: that there was no treatment. I thought this mindset would leave me feeling completely liberated. I was wrong. With nothing left to fight, it really was just a question of waiting. The battle became emotional and mental. It has forced me to reflect.

The first three decades of my life were pretty standard. Well, actually they were awesome, and everything was going pretty perfectly with regards to work, health, relationships and friends. I had plans for the future, too: learn some Spanish, see more of central America, and get a bit more out of it with some volunteering too.

Elliot with his sister at Lulworth Cove, Dorset.

I imagined settling down in my 30s or 40s with kids, a mortgage and so on. Or maybe I wouldn’t. Maybe my friends’ children would call me Uncle Elliot as their parents gathered in the kitchen looking slightly concerned about their single 45-year-old friend about to set off travelling around Mongolia. Either way, growing older with my mates and living my life to the full was always my ambition.

Of course, the second part of this storyline won’t be written now. It’s a shame I don’t get to see what happens. But everybody dies, and there will always be places and experiences missing from anyone’s life – the world has too much beauty and adventure for one person to see. I will miss marriage or children, blossoming careers and lives moving on. But I’m not alone in my life being cut short, and I think my time has been pretty good.

At this point I should say a word to my friends. Being this ill complicates all relationships. The rut I found myself in a few weeks back hasn’t lifted. I’ve definitely been “feeling the victim” a lot more than usual. My acceptance that my time and energy is now limited comes with the knowledge that I won’t be able to catch you all properly to give our relationships the time and appreciation they deserve. I get so many messages from you all, which often exceed the energy I have to reply. Where I am able to see people, I’d just say keeping me company and being positive is helpful. I want fun, laughter, happiness, joy. I think it’s very possible to have this kind of death – there is likely to be a shadow of sadness hanging over proceedings, but for the most part I want everyone relaxed and to be able to feel the love.

Because I know that that moment isn’t too far away. I haven’t asked for a specific prognosis, as I don’t believe there’s much to gain from doing so, but I think it’s a matter of weeks. Medicine has luckily turned this into quite a gentle process. That really does take a lot of the fear away. And I’m hoping impending death now grants me the licence to sound prematurely wise and overly grandiose. Because I’ve had time to think about the things that are really important to me, and I want to share what I’ve discovered.

First, the importance of gratitude. During my worst moments – the shock of cancer diagnosis, the mental lows and debilitating symptoms of chemotherapy – it was difficult to picture any future moments of joy, closeness or love. Even so, at those times I found comfort in remembering what I have: an amazing family, the friends I’ve made and times I’ve shared with them, the privilege of the life I’ve had.

Second, a life, if lived well, is long enough. This can mean different things to different people. It might mean travel. I’ve had the good fortune to be able do this, and can confirm that the world is a wonderful place full of moments of awe and amazement – soak up as much as you can. It may mean staying active, as much as possible – the human body is a wonderful thing. You only appreciate this when it starts to fail you. So when you find yourself slipping into autopilot, catch yourself, and take simple pleasure in movement, if you can. Look after your body because it’s the only one you have, and it’s bloody brilliant. Knowing that my life was going to be cut short has also changed my perspective on ageing. Most people assume they will live into old age. I have come to see growing old as a privilege. Nobody should lament getting one year older, another grey hair or a wrinkle. Instead, be pleased that you’ve made it. If you feel like you haven’t made the most of your last year, try to use your next one better.

Third, it’s important to let yourself be vulnerable and connect to others. We live in a society that prizes capability and independence, two things that cancer often slowly strips away from you. This was naturally a very difficult pill to swallow for a healthy, able late-twentysomething male, but having to allow myself to be vulnerable and accept help has given me the best two years of my life, which was pretty inconceivable at the time of diagnosis. Vulnerability has shown me what phenomenal people my sister and parents are – words can’t do justice to how much they have done for me. The same applies to my friends – what better way is there to spend two years than being surrounded regularly and closely by these people?

Fourth, do something for others. Against the backdrop of Covid-19, Black Lives Matter and the desperate attempts of migrants to cross the Channel, my thoughts really turned to those who have not had my privilege – whether that’s by virtue of socioeconomics, ethnicity or the country I was born in. I always try to remind myself of this.
Fifth, protect the planet – I can’t leave this off because it’s so important. I’ll be gone soon, but humanity will still be faced with the huge challenge of reducing carbon emissions and saving habitats from destruction. In my time here, I’ve been lucky enough to see some natural wonders and understand how precious they are. Hopefully future generations will be able to say the same. But it will take a massive collective effort.

If you asked me what I’d want to leave behind, it would be a new awareness of these things among my friends – and anyone who’ll listen, really. I was astonished by the number of people that responded to my article in April. I now find myself in a position where people are asking me how they can help or what they can do that would make me happy. Apart from the obvious – looking after each other once I’ve gone – I’m going to push for people to give, be that money or time. I’ve already had so many people ask which causes I recommend, and there are loads, but I’d say any that align with the values I’ve sketched out above would have my blessing. Among friends and family there is talk of setting up a small charity in my memory.

Despite some very low times, it’s worth repeating that the period since being diagnosed has been made not just bearable but actually fantastic. I’ve had new experiences that haven’t seemed tainted by cancer – and those experiences were, as always, much better shared. In a situation that is pretty new for most of my loved ones and friends (I am yet to meet anyone I grew up with who has had to deal with cancer or a similar chronic illness at my age), it has been amazing watching them all rise to the challenge. I’m not sure if it’s just that I know a high proportion of amazing people (possible) or if most human beings have this capacity for connecting and recognising what’s truly important (very likely).

After the gut-punch of cancer diagnosis, I’ve really struggled to define a purpose for my own life. I found in time this came naturally. Life is for enjoyment. Make of it what you can.

Complete Article HERE!

Tips for Talking with Someone Who is Dying

By: Glen R. Horst MDiv, DMin, BA

Knowing what to say to someone who is dying and when to say it can be difficult. The following tips may be useful at any point during a serious illness, but especially when the person is not expected to live more than a few weeks or days.

Tip # 1: Follow the dying person’s lead

It is normal to feel anxious when talking about dying with someone who is nearing end of life, especially if the person is someone you love. Some people handle this anxiety by being clear and blunt. Others say little or nothing about the situation for fear they may appear to be giving up hope. One way or another, we tend to try to protect each other at this difficult time.

If you feel it is urgent to talk about end of life with the person who is dying, you may be impatient with conversation about ordinary things. Humour and laughter may be distracting. On the other hand, if you find talking about dying embarrassing or awkward, you may be relieved that the topic doesn’t come up. In either case, what is most important is what the dying person needs. Ultimately, he or she will choose if, when and with whom to discuss dying. Listen for cues that the person is ready to talk about dying – for example, a passing comment about new symptoms, not being around for an upcoming event, being tired of being sick, or wanting to go home. When you think you hear such a cue, you might ask, “Do you want to say more about that?” or, “I’m not sure I know what you mean.” Then listen and ask more questions to make sure you understand.

Tip #2: If possible, be clear that you know the end is nearing

Some people who know they are dying avoid talking about it right up until the moment of death. It’s important to recognize that this is a valid choice and to respect it. More often, however, people who are dying feel respected and supported by openness and honesty in conversations. They may talk about symptoms such as pain, shortness of breath, or nausea. They may wonder what to expect when death is near. Rather than avoiding these concerns, acknowledge that they must be worrisome. You might say, “Tell me more about what you are experiencing,” or ask, “What do you think is happening?” You could add, “This would be important to discuss with your doctor. Can I help you make a list of questions for the doctor?”

Inviting the person to share information from the health care team can lead to open conversations about the progress of the illness and an opportunity to ask, “What do you now need most from me (from other friends and family members, from the health care team)?” If the person has difficulty answering this question, offer examples of the support you could provide – perhaps being present and listening, running errands for the family, or helping with housework.

When death is near, close friends and family members may want to be present. This is a tender time requiring balance between the needs of the family and the wishes of the person. Ask who the person would like to have visit and how many guests would be appropriate at one time. Keeping his or her wishes front and centre can provide a dying person with a sense of control at a very vulnerable time.

The gathering of family and close friends becomes a quiet signal to all that death may be near. If the person wonders why you or others are present, explain that you want to be with him or her during this time. Follow the person’s lead in talking about what is happening as death approaches. Direct questions deserve simple, direct responses. Use your own words to say something like, “It seems that your journey on this earth is coming to an end.”

Ask the person if there is anyone he or she would like to talk to by phone, internet, or in person. This may include a visit from a religious leader in the person’s faith community, or the spiritual care provider in the hospital or hospice.

If you feel that you still have important things to say, consider the advice of Dr. Ira Byock, a palliative care physician and author of “Four Things That Matter Most.” According to Dr. Byock, the next four tips are things that dying people want to hear from their loved ones.

Tip #3: Deal with regrets by saying, “Please forgive me.”

There is no need to fuss over small injuries or insults. However, when you are preparing to say a final goodbye, you may be bothered by regrets about hurtful words or actions, or ways you may have disappointed the dying person. Deal with your regrets by saying something like, “I’ve been feeling sorry about something that happened between us. I know I had a part in it and I’d like to apologize for it.” After describing the issue or incident in simple terms, say, “Please forgive me.”

Whatever the response, you will know that you have done what you could to address a painful part of your relationship.

Tip #4: Free yourself of hard feelings by saying, “I forgive you.”

If you ask the person for forgiveness, you may be surprised that she or he wants your forgiveness too. Saying, “I forgive you” can clear the way for a deeper sharing of the remaining time. It can also give you a sense of peace following the person’s death.

Due to defensiveness, a lack of understanding, or some other reason, the person may not be ready to acknowledge the deep hurt in your relationship. You can still, however, forgive the person in your mind and heart. This involves letting go of your anger and any wish to punish the person for the hurt you experienced. One woman did this with an older male family member who had abused her as a child by whispering “I forgive you” in his ear shortly before his death. Since he was no longer able to respond, it was not possible to know the effect it had on him. However, for the woman it was an important step in freeing herself from her burden of pain and anger.

Tip #5: Appreciate the person’s legacy by saying, “Thank you.”

Expressing thanks for the positive ways the person has touched your life is a way of letting someone know of his or her lasting significance for you. It contributes to the person’s sense of dignity at the end of life.

Rabbi Harold Kushner writes: “I am convinced that it is not the fear of death, of our lives ending that haunts our sleep so much as the fear… that as far as the world is concerned, we might as well never have lived.” Dr. Harvey Chochinov’s research into dignity in the people who are dying supports this. You can support your loved one’s dignity with a sincere and specific “thank you.” It will let your loved one know that her or his living mattered.

Tip #6: “I love you” – Say it freely; say it often.

It is never too late to say, “I love you” in a relationship. If you are not in the habit of declaring your love for a person you call a “loved one,” take a risk and surprise her or him. It could take your relationship to another level.

Tip #7: Don’t wait until the last minute to say, “Goodbye”

When your loved one is nearing death, it is important to end each conversation in a way that will be okay if it is the last time you speak. Casual goodbyes like “See you around,” or “I’ve got to run, so bye for now,” may leave you wishing you had said something different. Your goodbyes don’t need to be mushy. Just say goodbye in a way that lets the person know that he or she will always be important to you.

If you are leaving for a longer time and unlikely to see the person again, your goodbye may be more emotional. You might acknowledge openly that you don’t know whether you’ll be with each other again. Say what needs to be said. Remind the person again of what he or she means to you. Saying goodbye in a satisfying way can prevent regrets after the person is gone.

Tip #8: Touch talks too.

When you talk with a person who is dying, you touch each other with your words. When words are no longer necessary or possible, you can still connect through touch. Placing your hand gently on the person’s hand, shoulder or head can be a tender way of saying, “I am here. You are not alone.”
Continue to talk to the person even when she or he is no longer able to respond to you. The dying person will sense your presence and hear your voice.

Complete Article HERE!

What Happens As We Are Dying?

The First And Last Things To Go

Knowing what happens when we’re dying can tell us how to console colleagues and loved ones as they lose their battle with COVID-19.

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As our mother lay dying, my sister and I sat on either side of her, holding her hand and whispering words of comfort until the hospital machine showed a flat line. Having heard that physicians often witness positive reactions in patients when loved ones speak to them in their final moments, we intuitively thought that perhaps she could hear us. No one knows for sure what happens as we die, but recent information from neuroscientists shows that our intuitions could be right. Knowing what happens when we’re dying can tell us how to console colleagues and loved ones as they lose their battle with COVID-19.

The Last Thing To Go

In the last hours before an expected natural death, many people enter a period of unresponsiveness, during which they no longer respond to their external environment. Anecdotal reports from near-death experiences commonly include stories of the dying person hearing unusual noises or hearing themselves pronounced dead.

In a June 2020 groundbreaking study published in Scientific Reports, neuroscientists provided the first empirical evidence that some people can still hear while in an unresponsive state hours before dying. Using EEG indices, neuroscientists at the University of British Columbia measured the electrical activity in the brain from hospice patients at St. John’s Hospital when they were conscious and when they became unresponsive. A control group of young, healthy participants was also used. The researchers monitored brain responses to tones and found that the auditory systems of the dying patients responded similarly to the young, healthy control groups just hours from the end of life. They concluded that the dying brain responds to sound tones even during an unconscious state and that hearing is the last sense to go in the dying process.

The First Thing to Go

Many people who have had near-death experiences describe a sense of “awe” or “bliss” and a reluctance to come back into their bodies after being revived. I interviewed brain scientist Dr. Jill Bolte Taylor, who described having a strikingly similar awe experience during her stroke which she detailed in her book My Stroke Of Insight.

Jill Bolte Taylor: I was bouncing in and out of the consciousness of my right brain. The left brain had the hemorrhage, growing at an enormous rate over those four hours. By the time I got to the hospital, the hemorrhage was about the size of my fist in my left hemisphere. Over the course of the morning, I drifted into blissful euphoria, the consciousness of my right brain. And then I would come back online and attend to the details to get myself help. It was a movement in and out of being aware of external reality. I was completely conscious through the entire experience, but only at some point could I attend to detail in the external world, recognize that it existed, or even care.

Bryan Robinson: So the fear factor wasn’t there?

Taylor: I was very blessed. I had zero fear. I was there in blissful euphoria in the right brain. Or I was in the left brain, preoccupied with trying to figure out what I needed to do to orchestrate a rescue.

Robinson: How did the stroke change your outlook on life? Or did it?

Taylor: One hundred percent. It shifted me away from believing that I was the center of my world and that “me and mine” is what matters. That whole circuit—the consciousness of me as an individual—went offline. In the absence of the focus of my life being me, I shifted into a consciousness and awareness that I’m a part of a greater humanity. I’m more open, expansive, and flexible to possibilities—as opposed to “here’s what I want and these are the steps I’m going to take to get what I want.” I function inside of a hierarchy of people above me and below me and I’m climbing a ladder. So I shifted away from the linear way of looking at the world and my relationship to it. I live more open to the possibilities of what can be and what is the best match for me.

Robinson: Is it true that your training and professional and personal experience have led you to believe that the right brain or authentic self is the brain hemisphere that endures even at death?

Taylor: The authentic self is the part of us that I firmly believe shows up in the last five minutes of our lives. When we’re on our deathbed, the left brain begins to dissipate. We shift out of all the accumulation and the external world because it’s no longer valuable. What is valuable is who we are as human beings and what we did with our lives to help others. We all face it, and I think that is judgment day. But I don’t think it’s the judgment of something beyond us; it’s the judgment of ourselves. Those of us who are tangled up in the external judgment are not slowing down enough to reflect on the essence of who we are as human beings and what we could be in connection with one another.

Steps You Can Take

It’s important to be supportive, compassionate and understanding in cases where a coworker loses their battle with COVID-19. Don’t hesitate to reach out to other bereaved colleagues, share your concerns and be willing to listen. If you’re an employer, make sure HR personnel are well educated about the process of death and dying. If you are an employee in an organization where COVID-19 deaths haven’t been acknowledged or discussed, speak to someone in authority who can take steps to provide training for all employees. Appropriate information makes sure employees receive emotional support during the loss. Otherwise social isolation can cut employees off from help when they most need it.

Now that hearing is widely thought to be the last sense to go during the dying process and that a blissful experience might replace fear, this information might be helpful to bring comfort to family and friends in their final moments. Perhaps being present with comforting words in the last hours in person or virtually can console the dying as well as loved ones. According to Dr. Elizabeth Blundon, lead researcher in the Scientific Reports experiment, “This is consistent with the trope that hearing is one of the last senses to lose function when a person is dying and lends some credence to the advice that loved ones should keep talking to a dying relative as long as possible.”

Complete Article HERE!