Responding to the Needs of the Dying

Psychological Needs

Everyone needs these, not just those sick or dying

Understanding - openhearted listening - let go of self- be the other person

Freedom - holding on versus letting go (may be assisted by any of the following)

• having permission to die from family and friends
  
• gaining reassurance that survivors will be OK
  
• receiving help with unfinished business (physical and mental)
  
• finding meaning in life and death, making sense of suffering
  
• aspiring to a positive direction - eg. to complete "one noble act", to die in grace, to be the best one can be, to die without regrets
  
• faith in their spiritual path, their God / universal love / Buddha / etc.
  
• strong altruistic attitude which concentrates on other people and forgets self

Acceptance -

• moods & downs are natural, the patient feels safe to express them
  
• repressed emotions - anger, grief, jealousy, guilt etc. are all due to causes and conditions too complex to blame on any specific thing or person
  
• cultivate a non-judgemental attitude
  
• remember inherent perfect Buddha nature or pure goodness (God-likeness) of the person

Respect-

• to feel special not damned or a failure, concentrate on positive virtues not faults
  
• acknowledge their courage which can inspire others, family and friends
  
• celebrate their good deeds - what will live on after they are dead

Love-

• built on the fore-mentioned, from empathy and true compassion
  
• sharing laughter makes hearts light and free
  
• compassionate touch - the nonsexual intimacy of unity with another human being or animal
  
• bonding with eye contact, with touch or laughter, beyond mortality, beyond words, heart to heart in universal oneness

Spiritual Needs

• Illness produces an awareness of death, which brings up spiritual issues to work through. Important: Not what one does but the way it's done - the how! How much one has harmed others - regret is growth, encourage an appreciation for what they have learned. Keep a non-judgemental attitude.
  
• How much one has loved others - remind them of what they have given others, reflected in the love others have for them.
  
• How much one can let go - offer acceptance, support, validation, love
  
• How well one can go forward into the unknown - support the individual's spiritual faith and/or altruistic outlook to develop confidence and peace of mind

How to Help the Dying Find Meaning and Peace of Mind

• Be honest - admit your feelings - be yourself (It's not who you are but how you are!)
  
• Listen & share meaning of life
  
• Cultivate a big perspective not limited to this situation
  
• Non-judgemental attitude - allow people to find and express their own meaning of life, acknowledge the fundamental goodness of our nature
  
• Validate positive attitudes, statements and memories
  
• Offer unconditional love & compassion which creates an atmosphere of trust and peace
  
• No one wants to be rescued with someone else's beliefs
  
• Don't try to convert but do try to help the person get in touch with their own strengths of faith & spirituality- inspiring poetry, music, memories, quotes
  
• Remember other person is just like me & wants happiness, wants to avoid suffering
  
• Put yourself in the dying person's place & check your perceptions of their needs with them
  
• Don't make assumptions and rein in your expectations with awareness and reason
  
• Cultivate equanimity (not pity)- we are equal to them not better than them, don't be righteous
  
• Develop compassion - the wish for everyone to be free of suffering, including family and staff
  
• Develop love - the wish for the highest & best happiness for the them and love yourself
  
• True compassion and love creates an atmosphere of peace that supports and inspires; which at deepest level helps the dying to heal themselves spiritually and even sometimes physically.
  
• Rejoice with the dying in their positive attitudes, efforts and accomplishments; it lifts everyone's spirits and gives strength
  
• Remember gratitude pacifies a troubled heart and rejoice in your own attitudes, efforts and deeds; it renews your spirit!
  
• Dedicate the experience, one's efforts, the results without judgement to the highest good, as extensive as possible

Essential Support (psychological and spiritual) for the Death Process

LISTEN and ACKNOWLEDGE WITHOUT JUDGEMENT WHAT IS SHARED

FOCUS ON THE POSITIVE and ENCOURAGE REJOICING, which lifts the mind and increases one's spiritual strength (Acknowledge "regrets" as lessons learned but discourage guilt which is destructive.)

SUPPORT 'LETTING GO' or SEPARATION and GIVING UP EVERYTHING (even "unfinished business" This assistance and the next two are used whether the person is conscious or unconscious.)

CORROBORATE FAITH, DEVOTION and CONFIDENCE (remind them of their faith, spiritual teachers, particular meditation practices. Put their religious pictures, statues etc in their view; their meditation beads or rosary in their hands.)

ENCOURAGE UNIVERSAL LOVE and the ALTRUISTIC ASPIRATION to serve others and continue one's spiritual practice through death and the after-life or heaven.

© Amitabha Hospice Service Trust 2000 - 2011