When a loved is diagnosed with a terminal condition or is very near the end of life because of old age, things begin to change.  How we treat our loved one changes.  Their behavior toward us also changes.  This can be a difficult time.  This page provides information about what to expect during the dying process and provides a few points to keep in mind as you journey with your loved during this very important time.

The process of dying

As a person moves through the process of dying, a general pattern is usually observed.  This process is sometimes described in three phases, each of which is described here with a few suggestions on how you can best handle each phase:

1. Acute Crisis Phase: The person is told they are dying.
   
   It is common that the person will suffer denial and become very stressed upon hearing the news.  This is often the most stressful time in the process, as your loved is just beginning to process the reality that their life is almost at its end.  The dying patient needs your support at this time.  Do not feed their denial, but help them to accept the reality so they can make use of the precious time they have left.  They can still control what is left of their life, and they should be allowed to do so.
   
   
2. Chronic Living-Dying Phase: Medical Work
   
   It is important that your loved one receive as much medical help as is needed for his or her comfort and care.  At this time, shortly following the realization that death is coming soon, family and friends often focus on helping the person medically to the exclusion of proper spiritual or psychological care.  Keep in mind that your loved one may be scared, lonely, or may want to simply talk about their life with you.  Try to be there for them.
   
   
3. Dying Phase: Saying Goodbye
   
   This is the time in the last few days of life.  Now is the time to provide your loved one with opportunities to go to Confession, to receive Holy Communion, and to receive the Sacrament of Anointing of the Sick.  Keep in mind that the Anointing of the Sick can be repeated during the same illness, and do not hesitate to talk to a priest about it.  This will give your loved one a greater opportunity to make peace with God. Also remember that, even in these last moments, we need to treat them with the same respect we always gave them before they began the process of dying.  It is best to keep him or her as informed as possible with true, up-to-date information about their condition.  It is also important to keep them involved, as long as they are able to communicate, in the decisions about their affairs and treatment.

Nearing Death Awareness

It is also important at this time to listen to what your loved one has to say, even if it seems confused.  Often, people that are near death seem to have a specific knowledge about their coming death and, in some cases, can even control it.  For example, we sometimes hear of a dying grandfather hanging on until the last grandchild arrives at his bedside, only to have him pass away shortly thereafter.  This phenomenon is real and surprisingly common.

Those who experience this phenomenon, known as nearing death awareness, may also sometimes try to communicate something they have seen or experienced to us or make a request of us.  For example, a dying man once said “I need my ticket punched.”  At first, he was dismissed as confused.  But a nurse asked him what he meant and he clarified, “I’m going on a journey.” Whether anyone told him or not, he knew death was near.

It is also not uncommon for a dying person to describe visions or claim to see dead relatives.  For us Christians who believe in a real afterlife, this sort of near death experience should be encouraging. A dying person may make an important request in similar language that might sound confusing.  Whatever your belief, it is important to listen patiently and with an open mind.

Do's & Dont's

Do’s:

• Call a priest soon, well in advance of the person's death. The sooner the better.
• Ensure spiritual needs are met.
• Be honest with your loved one.  Treat them as you did before, not as if they were already gone.
• Keep them informed and involved in decisions that affect them.
• Listen, even if your loved one doesn’t make sense toward the end.

Don’ts:

• Wait until the last minute to call a priest.
• Focus solely on the medical needs following their diagnosis as terminal.  There are great spiritual and personal needs that must be met.
• Hide from them the fact that they are dying.
• Neglect your own grief, which may begin during this time.

Dirk Bouts, Resurrection, http://commons.wikimedia.org
Roger van der Weyden, Seven Sacraments, http://commons.wikimedia.org
Harvath, Dr. Sue.  Lecture on Grief Counseling (St Louis, MO: Kenrick-Glennon Seminary, recorded 12 November 2009).