When a person enters palliative care, they understand that death is just around the corner.
Chaplains have the grave responsibility of spiritually guiding dying patients through their final moments, listening to their concerns and fears.
While each person’s final moments are different, chaplains and palliative care nurses have said most people approach their death with “radical acceptance.”
People who are actively dying also often have a new sense of clarity about the universe and may even have a temporary burst of energy or sudden moments of clarity if they have dementia.
The last words patients usually say to their families are to tell them they love them, wish they had spent less time working, and assure them that everything will be okay.
Chaplains told DailyMail.com that people who are in the midst of dying want to be surrounded by their loved ones and pets. Their final words are often words of love and pleas for forgiveness, as well as expressions of regret, such as having worked too hard.
The Reverend Catherine Duncan has helped guide thousands of patients and their families to death’s door.
It’s hard work, and no one knows it better than the Reverend Catherine Duncan, who has helped guide thousands of patients and their families to death’s door.
She told DailyMail.com: ‘In palliative care, when it’s something planned and you’re with someone in their final hours, it’s called active dying.
“I would say that most of the time with most people there is peace, there is acceptance, they work through whatever layers they need to in order to accept death.”
‘People usually mention what they need to forgive, what they need to let go of, if they have any regrets.
‘And a great lesson would be to realize that they spent a lot of their lives focused on the outside world.
“They spent their lives focusing on money, having a nice house, a car and all the external trappings, only to realize that it’s not about that, it’s about the love in the heart.”
Even before becoming a hospice chaplain, Rev. Duncan witnessed her mother-in-law’s peaceful death. She described a room bathed in light and a Zen atmosphere.
She said: “She literally told me, ‘I’m ready and I’m not afraid. ‘ And there was a light in and around her. It was just beautiful.”
According to comments from several palliative care chaplains, her mother-in-law’s perspective is not unique. Most people who die in palliative care share that sense of peaceful acceptance.
Palliative care nurse Annemarie Switchulis said people often fear their final moments will feel like suffocation.
Often, the job of a chaplain or palliative care nurse is to ease the fears of a dying patient.
Annemarie Switchulis, a nurse who has held the hands of hundreds of dying patients, said the first thing they often express is fear that their final moments will feel like they are suffocating.
Usually, they are assured that no, death does not feel like suffocation. People who have had near-death experiences have compared the peaceful transition from life to the last breath to unplugging a computer.
They also tend to want to be surrounded by their loved ones and even their pets so that the environment is as pleasant as possible.
She said: ‘It’s always something you hear when you have a lot of kids: ‘Please look after each other. Please don’t worry about me. I’ll be OK. Tell me you’ll be OK.’
‘And those are the last words most people want to hear.
‘I usually ask my family members to say, “Tell him that everything is going to be okay. Tell him the most important things that have been given to you.”
He added: “We usually have a lot of discussions about how they want to be remembered – what does their legacy mean to them?
‘Because most of them don’t want to be remembered for being sick or for how they were that day.
‘It seems like a lot of people want to talk about religion and forgiveness, talk about the regrets they have and what they’d like to do to make sure they tell everyone they’re sorry and that they love them.’
The final days are often marked by heightened spirituality and a desire to be closer to a higher power. Neal Shah, chief executive of CareYaya, a healthcare technology company specializing in senior care, said people are also showing a “desire for connection” with loved ones and faith.
Neal Shah, chief executive of CareYaya, a healthcare technology company specializing in senior care, said people are also showing a “desire for connection” with loved ones and faith.
He added: “Some express regret, while others find peace or tranquility. These responses are deeply personal and conditioned by individual experiences.”
Many are reconnecting with religious traditions that they may have abandoned in adulthood. A nonpracticing Catholic, for example, will likely ask his chaplain to pray with him.
The chaplain, acting as a combination minister and therapist, analyzes the patient’s chosen belief system in advance and uses it to help him feel more at ease about his impending death.
Zackary Price, a chaplain from Georgia, compared his job to that of the Greek underworld ferryman Charon, who ferried the dead across the River Styx. But in his mind, life doesn’t end with death.
He said: ‘It’s actually very, very gratifying because, for me, death is not the opposite of life.
“The opposite of death is birth. It’s like the first law of thermonuclear dynamics in physics: energy is neither created nor destroyed. It simply changes form.”
Like Reverend Duncan, who wrote about her near-death experience in her upcoming book Everyday Awakening, Reverend Price also had a near-death experience.
The incident occurred when he was 12 years old. His mother was taking him and his sister to school. His mother, who was drunk at the time, suffered minor cuts and bruises, as did his sister.
Price, however, suffered lacerations to his liver and colon, fractured vertebrae, two collapsed lungs and fell into a coma. His heart went into cardiac arrest shortly after arriving at the hospital and he died.
Zackary Price, a Georgia-based chaplain, compared his work to that of the Greek underworld ferryman Charon, who ferried the deceased across the River Styx.
His exposure to the mysteries of the universe in that experience transformed him, setting him on a path to study theology and become an ordained minister.
He said he felt “intimately connected and part of everything that was going on around me. Essentially, I was everything that was happening.”
Her study of Western and Eastern religious traditions has shaped the way she thinks about death and what she tries to convey to her patients. And simply holding someone’s hand in their final hours can be enough.
Rev. Price said, “There’s something called the ministry of presence, which is very common in end-of-life care. It’s about being a steady, grounded, steady presence as they go through this transition, letting them know, without saying a word, that everything is OK.”