NEARING DEATH EMOTIONAL CHANGES
Months to weeks before death the patient may begin to withdraw. They are beginning to separate physically and emotionally from their loved ones. Caregivers may feel helpless and begin their own grieving.
We are never ready to give up holding the physical body. The realization of that day causes each of us to look within ourselves, and evaluate our lives together and apart. It is a time of preparation.
The patient may sleep more, or spend time with their eyes closed or staring into space. They may appear more irritable or lash out at loved ones. This is a normal reaction to fears and loss. It is a time of anger about unfulfilled hopes and dreams.
Expressing emotions at this time is difficult. Just being close, holding a hand and saying, “I’m here for you” is all that is needed during periods of silence.
As the body is preparing to separate from this world, so is the mind. At times when the eyes are closed or the faraway staring occurs, the patient may be getting a glimpse of their journey into another world, the world of soul and spirit. People of all countries and religions tell us about this special place.
The patient may appear confused and speak in rambling speech and symbols. They talk of going home, planning a journey or getting in line. They converse with others we cannot see. They reach out for people and things we cannot feel.
Helpful Things You Can Do
We cannot enter this other world, but we can share by listening to everything they say. The hospice team may be able to help you understand this near-death awareness the patient is experiencing. The team will also help you understand how this is different from hallucinations, a condition that occurs infrequently due to medications and is usually frightening and may include visions of bugs or feelings of persecution.
This is a precious time to share with the dying person as you watch for clues: Does the rambling speech have a message? Does their vision bring a smile or look of wonder? Does the body seem to relax? Do they speak of beauty and light?
Gentle statements or questions may let the dying know that you realize what is happening. They will feel that you understand and that you are giving them permission to tell you about this other world. “What do you see?” “Are you seeing someone who has gone on?” “What does it feel like?” “Is it beautiful, peaceful?” “Did they tell you anything?”
Allow yourself to be open to their reality. If they seem frightened, reassure them, ask them about their experience and help them explore their feelings related to it.
Do not try to “reason with them” or talk them out of their experience.
Call your loved one by their name and gently remind them of who you are if they are confused.