Family Guidance In The Final Hours and After…

By Barbara Karnes, RN

Someone asked me about deathbed rituals. They wanted to know what to say and do when someone is in the moments before death and what to do before the funeral home arrives. Here are my suggestions:

In the hours to minutes before death, gather family and significant others. Encourage each person to spend some time alone with the person dying. This is the time to talk from the heart, to talk about the good and the challenging times, to speak of love and forgiveness. This is a private time.?

The person dying will be non responsive, breathing erratically, probably with their eyes partially open. I believe they can hear but are so removed from their body they can’t respond.

After everyone present has had the opportunity to say their private goodbye, gather everyone back into the room. This is vigil time. Explain to those present what will probably be happening, such as fish out of water breathing. They will likely frown or grimace before their last breath.

The lights can be on with their favorite music playing. They can hold their special person’s hand, lay beside them, have the dog or cat on the bed, reminisce, tell stories. This is “we are here with you as you make your special journey" time. It is also a time to support each other.

Breathing will get slower and slower. There will often be a frown, a grimace and sometimes a tear just before the last few long spaced out breaths occur.

Give everyone the opportunity to really comprehend that their special person is gone. Then suggest that you would like to tidy and have everyone come back and say another goodbye before you call the funeral home.

Clean and tidy the body. A bath is not necessary although it can be a beautiful gift the family can give, a hands on expression of love. Following the tidy, position the body with the head of the bed?slightly raised and encourage each person to return to say their final goodbyes.

When goodbyes have been said, call the funeral home. While waiting, reminisce with life stories. When the funeral home has taken the body, return to the room. Make the bed, even if it is a hospital bed, with clean sheets and put a memento upon the pillow. The memento can be a flower, their rosary if appropriate, or a stuffed animal. It can be anything you can find in the room to ease the pain of seeing an empty bed. Leave a small light on in the room when you leave.

Rooms have memories and you want to soften the memory that will be in that room from now on.

The goal of our supporting a family and significant others during and after the death is to create for all a sacred experience. They will carry that memory with them forever.

Something More… about Family Guidance In The Final Hours and After…

I go into further detail about deathbed care for the patient and family in my book The Final Act of Living, Reflections of a Longtime Hospice Nurse. You can get your copy here: Book