Saying Goodbye

This information has been written for the caregiver and patient. It gives some hints on ways a caregiver and patient can express what they're feeling to each other in the final stage of life, especially as death gets closer.

Saying goodbye is not easy, and often does not come naturally. It also may be hard to do because of the patient's health or because of the place where they are receiving care. Remember that every person's situation is different. No one can really predict what may happen at the end of life, how long the final stage of life will last, or when death will actually happen.

If able and if time allows, people often use this time to gather family to say goodbye. But, sometimes death happens quickly or a loved one is out of town or traveling. This can limit the time to say goodbye.

If they can be together, family may take turns with the patient, holding hands, sharing good memories, or just sitting quietly. Some caregivers and family members may feel the need to stay busy by making meals or doing chores and other activities around the house. This can also be a time to perform any religious or cultural rituals and other activities desired before death. It’s a chance for many families and friends to express their love and appreciation for each other. The key is to be reassuring and honest, and to speak from the heart.

Here are some hints that may help you in this difficult time.

• Try to plan ahead, but remember it's not really possible to predict when the last minutes or hours of life may happen.
• Understand and respect that each person has different needs and ways to express what they're feeling.
• Be open about knowing the end of life is approaching.
• Try to avoid topics and unpleasant memories that may cause hurt, stress, or pain.
• You don't have to be formal with goodbyes when taking a break from being together, or if a caregiver is leaving the room for any reason - just expressing your love is often recommended by hospice experts.
• Consider other types of communication for people who may be out of town or traveling, such as phone calls, video apps such as FaceTime or Skype, or other technology.
• For caregivers, know that many experts believe those who are unconscious or unresponsive may still be able to know you are present and can hear what you're saying.
• If you're having trouble managing your emotions, consider asking your clergy or health care provider for help or for a referral to a counselor or mental health specialist.