Hospice

Emotional and Spiritual Signs at the End-of-Life

  1. Giving away belongings and making funeral plans. Some people want to maintain control over their life, so they want to participate in making final decisions about their belongings or their person. How you can help: Although it is emotionally hard for families to talk about final arrangements, it is important to let your loved one do this if they want. Everyone, especially the dying, appreciate having their choices honored.
  2. Withdrawal. The person may seem unresponsive, withdrawn, in a comatose-like state. They are detaching. It is a typical end-of-life symptom. How you can help: Know that hearing remains. Speak in a normal voice. Identify yourself. Hold their hand. Say what you need to say. This helps them let go.
  3. Vision-like experiences. The person may say they have spoken to people who are already deceased. They may say they have been places or seen things not visible to you. This is not hallucination or a drug reaction. It is common. How you can help: Do not contradict, explain away, or discount this experience. Affirm them. If the experience frightens your loved one, reassure them it is common and natural: “Yes, these things happen.”
  4. Restlessness. Repetitive and restless tasks may indicate something unsolved or unfinished is preventing them from letting go. How you can help: Talk with your hospice chaplain. Help the person recall a favorite place or good experience. Read to them. Play soothing music. Give reassurance that it is okay to let go.
  5. Communication and permission. Your loved one may make statements or requests that seem out of character. They may be testing you to see if you are ready to go. They may want to be with a few select people. Maybe they only want one person. If you are not included, it does not mean you are not important or not loved. It means your task with the person is fulfilled. If you are selected, it may mean the person needs your affirmation, support, and permission to let go. How you can help: Let your loved one know you will be alright. Say whatever words of love and support you need to say. Give them permission.
  6. Saying goodbye. This is their final gift. How you can help: Listen. Hold them. Say whatever you need to say. It may be just, “I love you,” or recounting favorite memories you have shared. It may be an apology, or saying, “Thank you.” There is no need to hide your tears. Tears express your love and help you let go.

Remember, all these end-of-life signs and symptoms are common. Your loved one may be as unique during this time as they have always been, so they may show some of these signs and not others. Or they may be different altogether.

As the bereaved, it’s also important for the family caregiver to understand that grieving is unique. As such, your grief recovery process will differ from others.

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