Saying goodbye concerns closure. Many family members are hesitant to approach closure because they are not comfortable with loss and feel that they need more time with the person. It is usually about their denial and not denial by the patient, but it can however be denial by both parties when end of life discussions have not previously taken place.
Caring for one another when cure is not longer possible, according to the Reverend Daniel H. Grossoehme, BCC, "becomes a matter of comfort; physical, emotional and spiritual." Most patients value honesty but the complex emotions experienced when death is approaching can be difficult for families to navigate. By asking the patient questions about what they need, others become a safe and accepting advocate for them. Quite often that involves allowing them to express anger and grief at the situation and their inability to control what is happening to them.
Additionally, it involves leaving family members’ needs and denial at the door and finding peace in being present at the patient’s final moments. This avoids feelings of guilt and regret long after the loss has occurred and facilitates movement through the grief process.
A helpful activity is to write a history and or record significant events from the past for posterity. This can help to pass the time and bring the patient closure by knowing they will be remembered.
Contributed by LeNae Peavey-Onstad, chaplain and Manager of Pastoral Services for Jordan Valley Medical Center and Pioneer Valley Hospital in Utah.