Death Rites and the Dying Person
This page is a companion to the in person, 60 to 90 minute, workshop 'Death Rites and the Dying Person'. it is not for credentialing an actual Death Doula, and does not give CEU's for bodyworkers. This information has been reduced down to the timeframe given from a 1 day, full 8 hour class to 60 to 90 minutes. It is only to inform a lay person about the importance of death work, gives *some* information on what happens during active death and how to help the dying person in a basic way. It also focuses on the ritual aspects of death and doing our best to fulfil the wishes of the dying person.
What is End of Life Care?
Words from the dying
“Don't try and give me advice. Don't go all sympathetic and say you poor thing. I feel desperate enough as it is without others' desperation”.
"The worst thing is when people say 'try to stay positive'. I am such a positive
person but I have had my moments, I have been on the floor sobbing. and that is VALID and okay"
"Give me the space to feel what I am feeling"
"Obviously I am dying so their may not be solutions to my rant- just be there"
"take your lead from the person it's happening to"
"Do not pressure me to forgive or forget because I am dying- we can talk about it, but once i give an answer- THATS IT unless I bring the subject up myself"
Why is death so...
Uncomfortable to the living?
It 'reminds us of our own mortality'- that may be true but we have to get over that in order to help the dying person
We took death out of the home and stopped learning about death and dying
Why does it seem like our best efforts to help people in grief/loss/end of life backfire?
We don’t get down into the nitty-gritty with it anymore. The only time we may see a dead body is for the 45 seconds we spend looking at one in an open casket. Very few touch that body.
Pain relief and the associated side effects - these impact the experience of the dying person- do they want to be fully conscious and yet in pain? Do they want to be completely out of it? Do they want their pain levels down but still aware of their surroundings? Sometimes a happy medium is not possible and we MUST not hide the truth from the dying person. Remember when they enter ACTIVE DEATH they usually become unresponsive. this doesn't mean they cannot experience, but YOU just wont know it.
What happens to the body when it is in active death? Active death starts 36 hours or less before death- though it can be a full week ahead of death.
In most people who are dying, the body’s normal systems start to operate more slowly.
The heart beats slower, or with less force
The brain and the other organs receive less oxygen
Hormone production slows
Digestion slows or stops - They will want to eat less and should not be forced- since their digestion is slowed or stopped, eating and drinking can become extremely painful
Breathing slows- sometimes with LONG pauses (pattern known as Cheyne-Stokes)
Some ‘Switch’ does happen in the body during active dying.
Cells no longer divide and renew- instead they start to fail. Often adding extra fluid to the body from their decay.
This fluid (and other bodily fluids) pools in arms, legs and lungs
Skin discoloration happens – resembles bruising
Bedsore DO happen if the dying person was not moved enough and with regeneration of cells no longer happening they WILL NOT heal
Skin becomes cool and can be DRY or Clammy
Breathing “rattles” - extra fluid build up causes this.
Fingers and toes may turn blue or light gray
Some people have a burst of energy in the 24 hours before they die, sitting up and talking normally for a short period.
Music - what , if any, music does the dying person want? if they know they WANT music but cannot pin it down ask questions like- what kind of mood do you want to set? what do you want to feel? is there any way you want visitors to feel etc.
Artwork - are the specific artworks the dying person wants in the room? paintings, statues, fiber arts etc.
Clothing - is there something the dying person want to die in and is that also what they want their body buried/cremated/composted etc in or is there another out (or nothing) for that?
Ritual items- are there rituals items they want in the room and what happens to those after death?
Visitors - do they want visitors? Only certain people or anyone? How do they want those visitors to behave when they enter the sacred space?
Sacred Space - speaking of sacred space- how does the dying person want that to happen? a full on circle where doorways are cut to allow people in and out? What does it LOOK like both astrally and mundanely as in what does the cast circle look like and how do they want the physical space decorated?
Ritual form - What ritual form do they want? Basic call the divine and that is it? full on circle with elements, ancestors, certain deities, which tradition, path, or? do they wish they ritual to follow?
Guided journey - do they want a guided journey? and if so do they want that to happen to ease pain and discomfort, to be what they are actually doing during the last hour of death to lead them to where to want to go? Wheat do they want to experience? Who do they wish to meet?
After death rituals and wishes. -What do they want to happen to their body- wrapped? clothing? Who does this? wake? funeral? cremated etc. What do they want the LIVING to do?
Legacy projects - legacy projects can be started by the dying person to leave something behind so that it is easier for future generations to remember or get to know them. It can also be started by family members before, during or after the dying person has crossed over. There are no rules here. Some choose NOT to do a legacy project for a myriad of reasons. There are no wrong answers.
Examples of some legacy projects are:
MP3 or recorded songs with special meaning or sung by family, the dying person or friends.
Scrapbook of Accomplishments
Acts of Kindness given to family members to do in the dying person name
Helping a certain population
As you can see there are endless options on what a legacy project can be.
What happens near the end
•They may see the people that have passed before them when they are dying or in active death.
•They may reach out to these people as they die. This is normal.
The dying may talk about needing theirs shoes or a map or a train is coming.. or needing to get somewhere. These are all metaphors for the transition- death
•Some people say this is just the limbic system going nuts or lack of oxygen causing hallucinations.
•Others say this is proof of the souls existence after death.
Neither side can prove or disprove this. I say its doesn't matter. it doesn't matter why they happen- it just matters that they DO happen
Having a conversation with the dying person while they are still lucid (if possible) about how they want this kind of situation handled would be best- but if that is not possible then the family must talk amongst themselves and figure out how they want to deal with this, so there is no confrontation in the dying space.
Remember that what you are trying to do is give a good death and if you dismiss what the dying person is experiencing then you are missing an opportunity to meet the dying person where THEY are.
•Witness to death have said that they recognized the phenomenon that were happening as signs that death was near even when the experts said differently.
•Many times people confuse hallucinations and visions. They are different. hallucinations are frightening and anxiety producing without any context to the life the dying person lived.
Visions are images/seeing which did have a context and brought great comfort.
A vigil is starts when the dying person has entered into active death. During the planning stage we would have determined exactly what the dying person and the family wanted the vigil to be and you need to do your best to facilitate that while remain flexible to new ideas and situations that arise. What a vigil is, what it looks like and what happens is completely unique to each dying person and family. It is a beautiful way to recognize this momentous occurrence and to make it feel important, comforting and sacred.
Some examples of the types of things that happen during a vigil are:
Play the music (if any) that was planned
Rearrange the room in accordance to the plan
Songs or prayers can be sung
Adjusting the lighting
Incense is burnt
Candles are lit
Holding the dying person is encouraged as long as it is comfortable for them
Scented oils can be used in the manner that was prescribed.
Many times the dying person has selected a guided meditation to be used to walk them through to the other side. Even if they are not responsive, this guided journey is still done
This is also the time to make sure those people coming into the sacred space leave their grocery lists and gossip outside the space. a small sign asking people to pause and realize they are about to enter into a room where something deep is happening or a chair sat just outside the room for contemplation before entering the room is appropriate. a vigil can take many forms. that is why it is important to have planning sessions with your dying person so things go as well as they can.
not all dying people want a vigil.
The solace of being seen and heard and acknowledged..
brings comfort even in the face of deep suffering.