End of Life

Addressing Mental And Emotional Issues

Complete end-of-life care includes helping the dying person manage any emotional or spiritual distress. Even those who are not spiritually minded may feel existential distress and question the meaning of life, their own or in general.

Depression, Anxiety, Fear

Someone nearing the end of life may feel anxious or depressed. Encouraging him or her to talk about feelings, either with a close friend, family member, or counselor, could be helpful. Some counselors specialize in talking about end-of-life issues.

If the depression or anxiety is severe, medicine might provide relief.

A dying person may also have specific fears and concerns. He or she may fear the unknown or worry about those who will be left behind. Some people are afraid of being alone at the very end.

Coping with Distress

There are several things you can try to help soothe a dying person’s emotional distress.

  • Be there. Don’t avoid spending time with someone who is dying. Sometimes friends and family members, and even health care providers, may visit less or withdraw emotionally before the person has actually passed. This can add greatly to a dying person’s sense of isolation. If this seems to be happening, discuss your concerns with those who may be unconsciously pulling away.
  • Offer reassurance. If the dying person is worried about who will take care of things, be present with them and listen to his or her concerns. Reassure him or her that you will help as best you can to take care of his or her personal affairs.
  • Make physical contact. Simple acts of physical contact -- holding hands, a touch, or a gentle massage -- can help a dying person feel connected to those he or she loves. Warm your hands first by rubbing them together or running them under warm water. A common misperception is that it will hurt a loved one who is dying to be touched. Watch for his or her reaction to your touch and proceed accordingly.
  • Respect visiting preferences. Schedule visits in accordance with the dying person’s preferences. Some people enjoy being surrounded by many visitors at once, creating a party-like atmosphere. Others may prefer quiet moments with just one or two people at a time.
  • Consider using music. Set a mood that is most comforting for the dying person. Experts suggest that when death is very near, music at low volume and soft lighting are soothing. Music can help improve mood, lessen pain, and relax a dying person. Music may also evoke memories those present can share.
  • Reduce noise. Keep distracting noises like televisions and radios to a minimum, unless the dying person requests them.

Discussing Relationships and Memories

Family and friends can talk to the dying person about the importance of their relationship. How has the dying person influenced your life? What does he or she mean to you? Family and friends who cannot be present can send a recording of what they would like to say or a letter to read out loud.

Sharing memories of good times is another way some people find peace near death. This can be comforting for everyone. Even if the dying person is unconscious, some experts think it is possible he or she might still be able to hear; take the opportunity to say how you feel or talk about fond memories.

Communication Tips

When you come into a dying person’s room, identify yourself and let the person know you’ve come to see him or her. Always talk to, not about, the person who is dying.

Ask someone to write down what is said at this time -- both by and to the dying person. In time, these words might serve as a comfort to family and friends. People who are looking for ways to help may welcome the chance to aid the family by writing down what is said.

There may come a time when a dying person who has been confused suddenly seems clear-minded. Take advantage of these moments, understanding that they may be only temporary and are not necessarily a sign that he or she is getting better.

Existential or Spiritual Issues

People nearing the end of life may have existential or spiritual needs as compelling as their physical concerns. These needs involve finding meaning in one’s life and ending disagreements with others, if possible. The dying person might find peace by resolving unsettled issues with friends or family. Visits from a social worker, counselor, or representative of their faith tradition may help this process.

Many find comfort in their faith. A dying person may welcome visits from someone in their religious community such as a minister, priest, rabbi, or Muslim cleric. Praying, talking with others of their faith, reading religious texts, or listening to religious music may also bring comfort.