Spiritual Guidance for Final End-of-Life Conversations: A Thread.

Every human is unique; every story is unique. What works for one person may not work for someone else.

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What I’m sharing is some gathered wisdom over the years of my rabbinate; some learned from wise souls who do this holy work daily, much from trial and error and sticking my foot in my mouth and apologizing and working to keep going,

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centering love and relationship and tenderness, always. I am no expert here, just a dad and a husband and rabbi and a friend and a son who is trying to love my way through death and grief and life and love.

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A. Never ever wait to tell someone you love them. Tell them. Frequently. Of course, tell them when they are dying. But if you make a practice of sharing love, it makes those final moments ever more tender, honest, and real.

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B. If you are fortunate enough to sit at someone’s bedside who is dying, sit, don’t stand. Make it easy for them to see you if they still have vision. Don’t tower over them but do your utmost to be face to face, on the same level.

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C. Touch is a gift, but ask for permission. Many of the people I’ve sat with who are dying share that people are often scared and don’t touch them when, in fact, many yearn to hold a hand, have their forehead or neck or feet rubbed.

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D. Keep the number of people you go with limited to a small group if possible. Dying is hard work and my experience has been that for the dying person, paying attention requires tremendous energy. Too many people in the room at any one time can be exhausting.

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E. Ask for forgiveness. Sometimes the dying person will grant it to you; sometimes they won’t. It is worth asking and trying to heal wounds while the person is alive, because trying to tell them once they’ve died is really tough.

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F1. Tell the dying person what they’ve meant to you. Be specific. Platitudes are for bumper stickers, not people. “You’ve been a tremendous friend to me all my life;

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F2. I’m especially grateful how you’ve helped me with my career, parent my children, and listen to my endless stories of trying to date.” Paint a picture with your words.

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G. Ask the dying for their wisdom. What do they wish for you? What guidance do they have? A dying person’s world gets smaller & smaller as the process of dying takes up more space. It is a gift to both of you to invite them into sharing their hopes and dreams for you.

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H. Keep the visit relatively brief. For most people, dying is hard work and physically exhausting. Our task is to have a sacred conversation, which is determined by the content of what we share, not the length of the dialogue.

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I1. 1.People who are dying have an entire range of emotions about their own death: Some people are really angry! Some are quietly resolved. Some are ready and death is a blessing, a relief from physical pain. Pay attention to the dying person’s experience and honor it.

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I2. You can’t fix it—you can’t make them not die. But you can sit with them and be present so they aren’t alone as they transition from life to death.

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J1. Just like birth, dying is messy. There can be blood, bodily fluids, breathing challenges. Do what work you need to do beforehand to not be freaked out by the messiness of death.

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J2. The person who is dying needs you to see them as a person—not as their illness or disease or tumor or diagnosis. They are a human person.

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K1. Come prepared. Bring tissues or a hankie. Tears are ok; this is likely a heart breaking and sad moment to say goodbye to a loved one. But hysteria and wailing at the deathbed are NOT ok because they turn the attention away from the person who is dying to you.

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K2. Believe me—I’m did my share of sobbing when my Ann Kaner-Roth (z"l), my BFF was dying: in the shower, with my husband and dear friends, randomly while driving. It needs to come out—just not at the side of the loved one who is dying.

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L1. It is ok to ask a few questions: Are you comfortable? Do you need anything? Are you in pain? How do you wish to be remembered?

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L2. But I would limit questions to four—both because I’m Jewish (Four Questions during the Passover Seder) and because any more it turns from a conversation into a didactic interview and starts to feel unnatural.

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M1. Ask the dying person if it is ok to offer a final wish, a prayer or a blessing. Some will lovingly receive traditional words of religious faith;

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M2. others may appreciate more general words of gratitude and hope that that the transition from life to death is gentle and surrounded by love. Hold the moment: You have the power to close this interaction with compassion and love—use your power.

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N. As you began with love, leave with love.

Make sure your final words together are words of love.

All My Love, Michael

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