The dying process: Creating a personalized plan for your unique journey
By Terre Mirsch
Death, like birth, is a rite of passage that each one of us experiences. It is part of the natural order of life. While some deaths occur suddenly, for most it is a process of gradual decline, providing opportunity for preparation and planning. But while personal birth plans have become somewhat commonplace for those welcoming new life into the world, similar plans for how one would like to experience the dying process are less common.
Birth plans typically include personal preferences, hopes, and desires for labor and afterwards, usually consisting of where the birth will take place, preferred means of pain relief, who will attend the birth, and how that person (or those people) can provide support. Birth plans may also include other values that one feels strongly about wanting to be part of the birthing experience, providing a forum for discussion between the pregnant woman, coach, and physician or midwife. While unpredicted medical conditions may preclude some or all aspects of the plan or situations may arise where choices may not be possible, having a birth plan increases the likelihood that one will have the birthing experience desired.
Just like birth plans, preparing a personal death plan may facilitate a meaningful experience that is based on one’s preferences, hopes, and desires for the dying process. For caregivers, this plan provides opportunity for contemplation about your role and experience during the dying process and afterwards, while providing time to prepare and discuss your and your loved ones’ preferences with others.
Consider the following when preparing a personalized plan for yourself or your loved one:
- Where would you like the death to occur? While most people prefer to die at home, others may prefer an institutional setting such as a hospice inpatient unit, nursing home, or hospital.
- Who, if anyone, would you like to have present at the time of death? If your loved one is cared for outside of the home, be sure to inform the healthcare team if you would like to be present at the time of death. While the exact time of death is unpredictable, often there are signs and symptoms that death is approaching.
- Describe the ideal environmental conditions during the dying process. Do you prefer a calm, peaceful environment or one where people, engaged in activities or dialogue, surround you? Would you like music playing in the background or do you prefer quiet? If you would like music playing, what type of music do you prefer? Are there favorite readings or prayers that you would like shared? What are your feelings about scents or fragrances such as those used in aromatherapy? Or candles? Or flowers?
- Do you like to be touched or massaged? Or do you prefer a more “hands-off” approach, where touch is limited to essential aspects of care?
- What preferences do you have for the management of pain or other symptoms? For example, do you prefer that medications be provided to alleviate symptoms even if they may cause decreased wakefulness or alertness, or is it your preference to remain as alert as possible, even if it means experiencing some pain or other symptoms?
Also, consider preparing a personalized plan for your experience, as a caregiver, following the death:
- Do you want to spend time alone with your loved one following the death?
- Do you prefer that your loved one be bathed and dressed following the death? Do you want to be involved in these, or other, after-death activities?
- Or is it your personal, cultural, or religious preference that the body is left undisturbed for a period of time?
- Are there other specific rituals such as prayer, meditation, or music that are important to you and your family?
- Do you want to be present when the funeral home arrives?
- Would it be helpful to have family or friends with you for the hours or days following the loss of your loved one?
Sharing these and other preferences with family members, the hospice team, and other healthcare providers will assist those involved in facilitating an experience that is in keeping with you and your loved one’s values. As with birth plans, medical or other circumstances may, from time to time, get in the way of these hopes and desires. But, the more specific we are in our planning, the more meaningful the experience can be and the more confident we will feel in honoring our loved ones legacy.
Please share your experiences in caring for a loved one during the dying process. Did you and your loved one create a personalized plan for the journey? How did this plan prepare you and guide you through the process?