Parting: A Handbook for Spiritual Care Near the End of Life (Paperback)

Chapter One

Doug was an active, happy man spending his retirement years instructing others in golf. For a time, he brushed off the nagging pain in his lower back, thinking he had wrenched his muscles with a golf swing. But the pain intensified, and Doug learned that he had a malignant tumor on his spine. From a full life, he abruptly entered the process of dying. It took only a few weeks for him to die.

During that brief time, Doug chose to enter an inpatient hospice (a facility and program that is wholly devoted to helping people die in comfort and with dignity). He also immersed himself and his feelings in another of his lifelong pleasures: art. Doug's family brought him art supplies, admired his work, and even attached a little penlight to a baseball cap so that he could sketch through sleepless nights without disturbing others on his hospice ward. They collected his artworks, framed and displayed them near his bed, and listened as he told them about his drawings.

Doug wrote in his journal almost daily about the care of his nurses, the camaraderie with his doctors, and the visits from family members. His niece gave him a foot massage and pedicure when she came to visit. His sister reminisced and laughed with him about times past. He voiced his worries about his adult son and asked his sister to look after him. As he grew weaker, his sketches became less detailed. Then, as his life drew to a close, the sketches were only a few stark lines, the journal entries a few words.

Doug's dying wasn't all creativity and companionship. He suffered terrible pain, dark days when he felt despondent, restless nights he thought would never end. But, surrounded with his artworks and people he loved, he died with his work finished, with dignity and acceptance.

What would we give to have such peace surround the death of one we love? Of course, sometimes it is out of our reach. We have no control over sudden death, for example, and mean-spirited relatives can make a person's last days and hours more difficult than they ought to be. The dying may suffer from dementia and be unable to converse or even recognize family members. But it is possible, more often than people think, for death to be a spiritual blessing to those who are leaving as well as those who are left behind. Peace and meaning can light the way.

Offering Spiritual Companionship

When you sign on to be a spiritual companion, you enter a two-way street. You invite intimacy, and you share from your own soul. You are a source of strength, but you look to the dying person for inspiration and moments of strength as well.

You open the window for peace to surround the one who is dying, and you feel its breeze on your face.

You look for truth, for the expression of candid and deep feelings ranging from agony and anger to joy and acceptance, and find you must bare your feelings also.

Both of you will grow. You will care for one another. And you both will find tears to be a healing release and closeness of body, mind, and spirit to be a shelter from the cold night of pain and grief.

The journey of spiritual companionship at the end of life begins now. Set out on the path today, while there are still time and energy to devote to the road ahead. The person who receives a life-threatening diagnosis needs your spiritual companionship from the first moment onward.

One physician says that the best way to improve spiritual care for the dying is to improve it for the living. All too often, the day-to-day business of life gets in the way of the inner life. Death clears the calendar; it uncrowds life so that spiritual needs come to the forefront. It is painful to face mortality alone, and most persons who are dying will welcome your support and presence.

If distance separates you from your loved one who is going to die, and you will not be able to travel both now and later, seriously consider going now. You can have a memorial service later, in your own hometown, but you will never regret the time you spend with this loved one who is still alive, still breathing, thinking, loving, questioning, finding a way.

Itineraries: Stops on Spiritual Journeys

Where might a spiritual journey take you and your companion? What is the destination you seek together? Is this a journey you even want to contemplate taking?

Death calls forth the most intense of human emotions, both for the one who is dying and for the spiritual companion. It compels the travelers to search out every spiritual tool they have ever collected, to cry out to their higher power for help, to tap into every coping mechanism and source of strength they have ever used before. Death often presents nothing short of a spiritual crisis, both for the one who is dying and for the companion. The very act of admitting that death is the unavoidable destination of the journey requires facing an acutely painful reality.

The spiritual "disease" of either the companion or the one who is dying can pose obstacles to spiritual companionship. Both travelers must rely primarily on their current level of spiritual maturity and familiar spiritual resources. The journey offers an unparalleled opportunity to expand their spiritual awareness and resources by trying new spiritual pathways together and consciously seeking spiritual adventure and awakenings. They will undoubtedly encounter rough spiritual terrain, and their road must go through these hard and painful places, not around.

What are some of the stops along the way they might anticipate on this spiritual journey? Their itinerary might include the following "spiritual moments":

Wholeness: The sense of being complete in oneself. A sense of basic inner integrity. Said one spiritual pilgrim, "I felt as though the battle had finally stopped. Floating there on the water I lacked nothing, thirsted for nothing, was dissatisfied with nothing about myself. It was a moment of absolute calm, a sense of profound fulfillment."

Belonging: The feeling of being at home, or at the proper place in time. A sense of participation in one's world, of connectedness to others and to one's environment.

Gratitude: An awareness of and receptivity toward the gifts that enrich one's life. Recognition of the presence of resources, experiences, relationships, and objects that have no connection to one's efforts. In a moment of gratitude, one spiritual wayfarer said, "My favorite thing is watching the sun rise on the bay in the morning. Sometimes I just sit there and say 'Thank you, God.' It's a beautiful gift."

Humility: The ability to love oneself in spite of oneself. Acceptance of limitations, awareness of capacities, respect for the mysterious aspects of oneself all are part of humility. One man reflected, "I'm a pretty average painter. But when I'm painting I don't have to think about how I measure up. And every now and then, something happens ... and I surprise myself."

Reverence: A sense of wonder and awe; of vastness, greatness, complexity; of being taken outside of oneself.

Perspective: Seeing deeply into things. An intuitive awareness of meanings. Insight or wisdom about oneself or one's life situation.

Trust: Moving into and with the current of an experience or a relationship. Surrendering control of outcomes and conditions. Depending on persons or forces outside the range of one's immediate control. One person said, "You really have to believe that people aren't going to let you go.... I was shaking and crying. But for one time I was able to trust somebody else."

Devotion: Commitment to care for someone/something. Experiencing the other (or an aspect of oneself) as a valued part of one's life. Devotion came to one man in the form of a dog: "I got her (a golden retriever) because through all these years of drugging-living out of cars, in the gutter, stealing, selling, all that-I never had one thing I took care of, except my habit. It's a start about being loyal to or responsible for something."

Release: The experience of being liberated, unburdened, or rescued from compulsive drives or anxieties. "I begin ... with all kinds of worries, stress, or frustration. And most of the time it just feels like I literally outrun them.... They are far behind me. I feel lighter."

These are only a few of the stops along the way of a journey of spiritual companionship. Your stops will be as individual as your itinerary, as interesting and replenishing as you make them.

Two Levels of Needs: Physical and Spiritual

Two issues loom large at the end of life: managing pain and having spiritual needs met. The medical team-doctors, nurses, and hospice and other caregivers-certainly will do what they can to ease pain with medical and physical means. There is much you can do as well. This handbook will suggest some simple methods that will help with your loved one's physical comfort. But professional end-of-life caregivers also have learned that attending to spiritual needs often brings relief from pain, or improves ability to cope with it.

As Manuel lay dying, he expressed deep anguish over years of alienation from Tony, his son. Manuel's pain had become unmanageable, and regrets tormented him. A sister managed to track Tony down. She found him eager to end the isolation from his father, but his situation made it impossible to come immediately. In the meantime Tony tape-recorded a message to his father, telling him that he loved him and wanted to let the past go. When Manuel heard the tape, he wept. Then he listened to it again and again. As it played, his pain diminished, and so Manuel found both physical and spiritual comfort from his son's words of reconciliation.

Body and soul are, we think, inseparable. Spiritual care is every bit as important as physical care at the end of life. You offer a gift to even consider spiritual companionship for the one who is dying. The voices of past experience assure you that gifts await you, as well. Let's begin!

(Continues...)