The Moment of Death: Creating Sacred Space at This Time
photo by Christine Stroud
Anticipating the moment of death for your loved one can induce feelings of anxiety and dread, and much of this fear comes from unknowing.
I want to share some information and offer suggestions on how to set the stage for honoring your loved one when they breathe their last breath and the following hours after they have died. By anticipating this moment and creating small rituals at this time, you can draw on these memories as you slowly integrate this loss into your life. Fostering a sense of love and respect and awe at this time helps to keep us grounded in this sacred event.
And by grounded, I don't mean that the goal is to not fall to your knees with despair–that may happen. Anything can happen emotionally when your loved one dies: grief, surprise, relief, awe, anger, happiness, fear. I sobbed unexpectedly while bathing a patient’s body with a wife who gently rubbed lavender lotion on her deceased husband's feet while weeping and whispering prayers of gratitude and Buddhist mantras. I flung myself on top of my mom when she died as though that might keep her here. We just do not know what will come out at this time.
By grounded in this sacred event, I mean zooming out a bit and breathing into your despair while loving and creating ritual at this painful time. My recommendation: have fluffy tissues ready and some friends on speed-dial. When we honor our loved one at the moment of death and afterward, we can draw on this thoughtful time to buoy us as our grief unfolds.
How Will I Know When My Loved One Has Died?
If you have been sitting next to your loved one in their final hours, you will know when they have died. They will likely have some final respirations which will slow and then stop. Sometimes it takes several minutes (even twenty minutes) to take these final breaths and sometimes another breath or two may come after what you thought was the final breath. But you will know. You may not believe they have died, but you will see the stark difference between living and breathing to not living and not breathing. You can feel their radial pulse during the dying process and afterward. You can place your hand on their chest to feel their heartbeat during the process and after they have died. You can call the hospice team to come out and confirm your loved one has died. (This generally elicits a barrage of “business” questions and can swiftly take you out of the reverence of the moment.)
Again, you may not believe that your loved one has died. I have listened to many heartbeats for a second and third time because family members are incredulous that their loved one is actually dead. Shock and surprise and disbelief are usual suspects at this time, no matter how long your loved one has been sick.
Pause.
I recommend pausing when your loved one has died. Feel whatever feelings arise. All are welcome: grief, sadness, despair, hope, relief, happiness, exhaustion. Be present to whatever you are feeling.
If you can, take in the AWE of the moment of death. Revel in the honor of bearing witness to this sacred event.
Note the time of death.
Turn off any machinery, like oxygen concentrators and suction machines.
Remove oxygen and any tubing.
Let the body be still.
I personally feel like the body should be left alone and allowed to settle into this new state of non-being for at least thirty minutes. You can talk to and sit with and touch your loved one, whatever feels right to you. Important note: the longer the body is still, it does begin to stiffen and will be more difficult to dress or bathe. If the head of the bed was upright, you may want to lower it in the next hour.
Invite friends or family to be with you at this time, especially if you do not want to be alone. You will likely have to outright ask them to come because people often don’t want to intrude at this time. Call on those who will be supporting you down the road. It is difficult to describe this time after the death to anyone; they are simply there to bear witness to your pain and provide emotional support. You may need the support when the funeral home takes your loved one away as this is jarring for most.
Bathe your loved one or freshen them up.
You can wash your loved one’s body from head to toe or simply freshen them up with a washcloth, a hairbrush, and an oral swab. It is actually quite difficult to move your loved one after they have died no matter their weight. If this task seems monumental, you can ask the hospice team to come by and assist. Or you can leave your loved one in whatever position they are in and wash their face and hands and brush their hair. You may not need to change their brief at all, and you do not have to do that if you do not want to.
This time is sacred–it is the last time you will be with your loved one’s physical body. Talk to your loved one and be with them in whatever way you need to be with them.
Dress your loved one.
You can keep them in whatever they have on or you can dress them in a favorite shirt or pajamas, or you can dress them from head to toe. I have helped many families dress their loved one with socks, shoes, belt, blazer, hat, glasses–the whole shebang. If we set a briefcase in their hand, they would have looked like they were ready to make a deal. Note: to easily get a shirt on, you can cut the back from the bottom to the top and slide it over their shoulders.
Items and objects of importance:
You can place a flower on their chest, a rosary in their hand, a holy book nearby, pictures and candles at their bedside. Create a setting that feels ritualistic. Place a blanket or quilt over their body, keeping the face exposed. This blanket will be one of the last items to touch your loved one and will likely be a forever reminder for you.
A Ritual to Bless
You can request a hospice chaplain to come and give a final blessing. Chaplains have a stunning way of reading the room and honoring your loved one and all gathered humans.
You can perform your own ritual or blessing. This may feel contrived if you are not used to doing this, but just go with it. Again, these are your final opportunities to honor your loved one and create some memories that may assist in softening your grief down the road.
Light a candle (make sure oxygen is off)
Read from a holy book
Read a piece of poetry
Toast with sparkling cider or champagne or your loved one’s favorite drink. I have seen tequila shots at 10:00 a.m. and the full bar open at 3:00 a.m. with Vivaldi blasting in the background.
Bless their body with essential oils. Place a small amount on your hands, bless their forehead or bless each part of their body with it.
Music
I helped a family dress their mother after she died. Their mother had chosen this gorgeous floral dress three days before her death. One daughter brought in some whiskey. She saluted me with a glass: “Mom’s favorite drink.” She turned on Vivaldi’s Concerto Number Two in D Minor. “Let me guess, Mom’s favorite song?” Indeed.
For the next thirty minutes we bathed their mom, brushed her hair, dressed her from head to toe with intense classical music thundering in the background. We sweated, we laughed, they cried…When we finished, their mother looked spectacular. The daughters toasted to their mom and kept Vivaldi blaring as I quietly exited the home.
I love how the classical music brought a sense of ritual and intensity to what we were doing. It gave that moment sacredness, honor, and beautiful memories that will come flooding back when that music is played, a lovely way to integrate this loss into their life long after their mom died.
And it doesn’t have to be classical music to elevate these moments to sacred. I have memories of Elvis lulling a patient to his death. I’ve seen the family procession/dance party to the funeral home minivan while Mick Jagger couldn’t get no satisfaction, and I listened with reverence and awe while women priestesses/goddesses chanted at the bedside of their Zen sister.
Music has a way of softening, intensifying, purifying, and preserving these moments.
Open a window if that feels right.
I was trained to open the window, and I always feel a sense of relief when I do this. It allows the spirit an opportunity to leave. Definitely not grounded in science, just a hunch, but do what feels right to you.
Call Hospice.
You will be told to call hospice when your loved one has died, and they will likely offer a visit at this time. As soon as you call them, they will begin to ask you some death business questions. Would you like a visit? What time did he die? Which funeral home? Do you have any medications that need to be disposed of? This call can definitely take you out of the reverence of the moment, so you can wait to call them. Hospice has to be the one to call the funeral home, so you will need to call hospice when you are ready for this.
Funeral Home
The funeral home will generally pull up in a minivan. After your surprise wears off that not all minivans contain small children, dogs, and soccer balls, take a breath. You can assist the funeral home folks as they place your loved one’s body on the gurney, but generally they do this alone. They usually zip up the body bag and whisk your loved one out of the home, but you can request to make this more slow and reverent. You can ask to keep your loved one’s face exposed until just before they go into the minivan. You can be part of this moment or not at all. Again, I have seen the range of quick and no frills to a dance party from the house to the van. Up to you. It can be jarring.
An Empty Bed
It can feel confusing to wander back into the house with an empty hospital bed after you have spent hours, weeks, months, or years caring for your loved one. Feel the feels: the relief, the sadness, the grief, the confusion. Again, all emotions are welcome. Everyone handles this time differently: sobbing on the couch, going directly to bed, taking the first shower in days, tidying up, watching TV, working, eating a pint of ice cream, journaling.
Compassion Satisfaction
Because most humans can lean toward the negative spiral of regret and guilt, I recommend leaning into compassion satisfaction, which is reveling in the positive contributions you made to your loved one’s death.
Focus only on the good in this moment. Your presence, the thoughtful way you tended to them, your advocacy, and participating in one of the most difficult and most sacred times in your life and your loved one’s life. Well done.
The End
Your heart is shattered, no doubt about it. Grief will be the next unfolding. The moment of your loved one’s death will live in your body for ever more and you can contribute to your own healing by honoring or ritualizing this moment. Each thoughtful move you make when your loved one has died, may help to soften the jagged edges of your grief.
Most humans in America are shielded from death. In the hospital, they whisk the bodies away on a gurney that makes it look like it is just a gurney. Nursing homes are the same. We don't want to be reminded that this is our fate. And yet …
The diagnosis for our death is our birth (a quote from an unremembered source). When we can lean into this truth, it can shift our perspective on our life.
If you can breathe a bit and bring a sense of curiosity and reverence to the moment of death, it may possibly soften the intensity and offer a sense of peace as you tend to your loved one in their final moments and they exit this physical earth saturated in love and honor.
Blessings.