Resources

  • Grief Resources & Videos

    These videos will inspire you start to get a new understanding of death and the different ways people begin to plan their final days. Hear from doctors and patients about their lives and peaceful transitions.

  • Children's Grief

    The booklet below, A Way Through, has been created from talks I’ve given to doctors and other professionals. Over the years, I have seen how it is all too easy to overlook children’s grief as we deal with our own. Yet including them is important. This booklet can help.

  • FAQ/Case Studies

    A list of questions I hear and honest answers. Of course, if you have a question but can’t find the answer on the FAQ, please reach out so I can answer you .

Grief-Resources

The Daily Iowan interviewed Mary Kay and other Death Doulas about their work in Iowa City: https://dailyiowan.com/2024/12/03/death-doulas-dying-done-differently/

Grief Resources & Videos

Children’s Grief

All children are unique.  As such, they will respond differently to loss.  What’s most important is to have adults who allow them to grieve.  Kids grieve in doses. They may shift from play to sadness quickly. Depending on their age, they may show little response. Letting them witness how others respond is one way of helping them. It’s okay to cry as long as you explain that you are sad. Reassurance about their safety is key. For more detailed guidance.  Download my ebook,  A Way Through.

A-Way_Through-Cover

FAQ/Case Studies

  • Dying isn’t a painful process. I believe it’s a gentle transition to another dimension. Being able to talk about it helps us prepare for it and formulate our beliefs about it.

  • Talking to others about dying is important. Find at least one person you trust who you can share your hope for how you die. Many people don’t want to be alone. Others want someone to hold their hand and play music. Each death is unique. Only you know what you want.

  • Many of us fear making others feel uncomfortable or emotional. It can help to frame a discussion by starting with, “What if…” Then, it’s hypothetical and less anxiety-producing. Try it.

  • Yes. Having been with many people who have been close to death or have had a health crisis, I began hearing these stories all the time. Most don’t tell others about their NDE for fear of being judged. “They’ll think I’m crazy,” is often what prevents these amazing stories from being shared.

  • Kids haven’t learned the social taboos about death yet. They are so open and honest that they will talk about things that make adults surprised or uncomfortable. Instead of being resistant to their stories, we should respond with curiosity. “Really? Tell me more.”

  • You may notice when you’re becoming more frail. You eat less and have less energy. You may also begin withdrawing from others. If this illness is being monitored by your doctor, s/he should be able to help guide you if you ask. Many patients don’t ask, so their doctor doesn’t give them good information to help. Palliative care teams can fill this gap. Don’t hesitate to ask for a palliative care consult. Hospice can become involved when you have six months or less to live. No one knows the exact date, but most patients know when they’re close to death.

  • When a person is dying, they begin to lose the ability to manage their secretions. They can’t cough or clear their throat. So, the saliva that gathers in the mouth slides down the throat and begins to collect there. As the person breathes, they cause a “rattle” when air passes over these secretions. Turning them on their side can help. Most who have a death rattle show no discomfort and are comatose.

  • Breathing is the best indicator of death. Once a person dies, they may have one or two final breaths. There can be long pauses in between these breaths. It often surprises those who haven’t been with a dying person so I encourage them to wait for at least three to five minutes with no breath before declaring death. Then, you will notice the face begin to turn a pale yellow as the blood has stopped circulating. It can be a beautiful process but very emotional.

  • Advanced Directives are a legal document that tells medical staff what you want and what you don’t want. The most important first step is deciding who you want to advocate for you if you can’t do this for yourself. This person is called your Durable Power of Attorney for Health Care (DPOAHC).

Dignity Therapy

Thanks to Max Harvey Chochinov, MD, Dignity Therapy became a real thing in 2005.  It’s a way of helping those who are dying to prepare for the end of their life.  No one teaches us how to do that.  So, Dr. Chochinov has provided some guidelines.  Through his research, Chochinov has proven that we need to claim our legacy as a way of looking back on our lives and thereby find peace. 

As a chaplain, I used Dignity Therapy regularly to help calm those who were facing their death.  It gave them a way of focusing all that anxiety about the unknown.  And it’s been proven to improve a person’s well-being simply by asking a few questions:

1)  What are you most proud of?

2)  How do you most hope to be remembered?

3)  When did you feel most alive?

4)  Is there anything you still wish to say to your loved ones?

5)  What are your pearls of wisdom about life?

The answers to these questions are written down so that the person can bequeath this “generativity document” to loved ones.  It’s a way of passing on our legacy. 

Dignity therapy: a novel psychotherapeutic intervention for patients near the end of life

Harvey Max Chochinov 1, Thomas Hack, Thomas Hassard, Linda J Kristjanson, Susan McClement, Mike Harlos (J Clin Oncol, 2005 Aug 20;23(24):5520-5.

Abstract

Purpose: This study examined a novel intervention, dignity therapy, designed to address psychosocial and existential distress among terminally ill patients. Dignity therapy invites patients to discuss issues that matter most or that they would most want remembered. Sessions are transcribed and edited, with a returned final version that they can bequeath to a friend or family member. The objective of this study was to establish the feasibility of dignity therapy and determine its impact on various measures of psychosocial and existential distress.

Patients and methods: Terminally ill inpatients and those receiving home-based palliative care services in Winnipeg, Canada, and Perth, Australia, were asked to complete pre- and post-intervention measures of sense of dignity, depression, suffering, and hopelessness; sense of purpose, sense of meaning, desire for death, will to live, and suicidality; and a post-intervention satisfaction survey.

Results: Ninety-one percent of participants reported being satisfied with dignity therapy; 76% reported a heightened sense of dignity; 68% reported an increased sense of purpose; 67% reported a heightened sense of meaning; 47% reported an increased will to live; and 81% reported that it had been or would be of help to their family. Post-intervention measures of suffering showed significant improvement (P = .023) and reduced depressive symptoms (P = .05). Finding dignity therapy helpful to their family correlated with life feeling more meaningful (r = 0.480; P = .000) and having a sense of purpose (r = 0.562; P = .000), accompanied by a lessened sense of suffering (r = 0.327; P = .001) and increased will to live (r = 0.387; P = .000).

Conclusion: Dignity therapy shows promise as a novel therapeutic intervention for suffering and distress at the end of life.