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Preparing for Peaceful Death

Hospice carers have extensive experience of assisting people with life limiting illnesses to prepare for death and to achieve closure and acceptance in the final stages of life. The following chart shows the key landmarks that most people need to pass through in order to achieve a calm closure.

LANDMARKS	ACTIONS
Sense of completion with worldly affairs	Transfer of fiscal, legal and formal social responsibilities.
Sense of completion in relationships with community	Closure of multiple social relationships (employment, commerce, organizational, congregational). Components include: expressions of regret, expressions of forgiveness, acceptance of gratitude and appreciation. Leave taking, the saying of goodbye.
Sense of meaning about ones' individual life	Life review. The telling of "one's stories". Transmission of knowledge and wisdom.
Experienced love of self	Self-acknowledgment. Self-forgiveness.
Experienced love of others	Acceptance of worthiness.
Sense of completion in relationships with family and friends	Reconciliation, fullness of communication and closure in each of one's important relationships. Component tasks include: expressions of regret, expressions of forgiveness and acceptance, expressions of gratitude and appreciation, acceptance of gratitude and appreciation, expressions of affection. Leave-taking; the saying of goodbye.
Acceptance of the finality of life - of one's existence as an individual	Acknowledgment of the totality of personal loss represented by one's dying and experience of personal pain of existential loss. Expression of the depth of personal tragedy that dying represents. Decathexis (emotional withdrawal) from worldly affairs and cathexis (emotional connection) with an enduring construct. Acceptance of dependency.
Sense of a new self (personhood) beyond personal loss	Developing self-awareness in the present.
Sense of meaning about life in general	Achieving a sense of awe Recognition of a transcendent realm Developing/achieving a sense of comfort with chaos.
Surrender to the transcendent, to the unknown - "letting go"	In pursuit of this landmark, the doer and "taskwork" are one. Here, little remains of the ego except the volition to surrender.

Reference:
Byock I., The Nature of Suffering and the Nature of Opportunity at the End of Life
Clinics in Geriatric Medicine, Vol.12, No.2, pp 237-251, May 1996.