CHAPTER 3

Pastoral Care for the Dying Person

The person who spiritually cares for the dying person and her family will be the appropriate one to conduct the funeral service for her, irrespective of their position in the hierarchy of the religious group, and will offer pastoral care following the service.

Where the dying person does not profess a Christian or other faith, there may be a person who gives compassionate and friendly support to the dying person who is willing to be the one to lead the celebration of her life. These secular celebrants will need to have had training and practice, and feel confident in their own ability to lead the common act of thanksgiving and grieving of the group, but with these qualities will do an excellent job.

What follows in this section are some practical suggestions about how to care in a pastoral way for the individual whose life is coming to an end. But first, a consideration about whether the person is dying.

Is the Person Dying? How Long Will It Take?

The judgment call on whether or not the person is dying is a subjective one. I recall being present in an intensive care unit where a patient was hooked up to several life support devices, including one that assisted him to breathe. The family members were called in to say their last goodbyes, and as chaplain I was called on to pray for the person and to give him God’s blessing for his final journey on earth. This I did and went on my way to await the buzz of my pager, which would summon me to the ward after he had passed away. It never came. The patient, a man in his seventies, resumed breathing on his own and was discharged the next day to the joy of his loving family members. Skilled doctors, nurses, and palliative care workers are often right when they say that the patient is dying, but not always; the patient is often the best judge, and it is good to listen and take note when the dying person says that his time has come.

The same problem is apparent when one asks the question “How long has he got? How long will she live?” It is difficult for those who have medical and palliative care skills to tell, and though some are experienced and often close in their estimate of days or weeks, others may be way off. Life goes on for the family of those who are dying, and it is extraordinarily helpful to have some idea of when their loved one will pass away. Employers are asking family members to tell them when they will be back to work; friends are pressuring them to let them know when they can go on that promised holiday together; there is daycare to organize; and a need to catch up on neglected work around the house and yard. All the loved one of the dying person is able to say is “The doctor says it will be around…days or weeks; she also says it may be a whole lot longer (or shorter). I’m sorry, but I’m simply unable to make firm plans to be with you in the near future.”

If the dying person does not die as soon as is anticipated, which often happens, then the caregiver may encourage the family to cut back their intense presence at the bedside and be good to themselves. Part of the encouragement the caregiver gives should include the options of taking sufficient time to have nutritious meals, going home to rest and sleep at night, and taking time for a shower or relaxing bath in the morning. If nursing staff have already mentioned this to the supporting family and friends, then the role of the caregiver should be to reinforce the suggestions of the staff and draw attention to members of the family who are looking very tired or exhausted.

However, at the end of the day, the loved one’s family members will make their own decisions about time spent at the bedside, and you will continue to support them in their presence, whether it is good for their physical and mental health or not. It is good to continue prayers for strength of the family and prayers for those who cannot be at the bedside of the dying person because of ill health or work commitments.

It is also useful to stress the reality that some family members will miss the time of death and that if they do, they will not have cared less for their loved one in his eyes or in God’s eyes.

What Is Going on with the Dying Person and Their Family?

For many of those who are dying, the primary feeling is that of fear, though this is often not expressed. “There is the fear of change, fear of losing our separate self and all we seem to possess, and fear of the unchartered territory we’re entering.”1 There is the loss of family, friendships, and participation in the communities that have sustained her over the years. The dying person no longer has the roles she had in her active life: membership in a health club, one of a group that met regularly at the coffee shop, cherished grandmother to youngsters with whom she read bedtime stories and treated to ice cream against the express direction of their mother.

And there is the fear of moving into the uncharted territory that follows the end of this life, fear of a future that she cannot possibly anticipate. The person who is pastorally with the dying person need not deal specifically with these fears unless asked, but needs to be aware of them. She needs also to be aware of the fears and other feelings that are present in the family members who are around the one who is dying. There may be the permanent loss of a supportive and encouraging loved one, and the need to re-balance the family or friendship circle. On the other hand, there may be the relief that suffering and emotional struggle that has drained the family is coming to an end, and that forgiveness has been given or received.

Every death situation is different, and every dying person is unique; the challenge for the pastoral caregiver (worship leader in a pastoral role) is to evaluate the emotional and practical needs of both the dying person and her family and respond with compassion.

A Positive Presence with the Dying Person

There are some general guidelines to follow when you are with those who are dying, and a key one is to not let the fact of the upcoming death of the person dominate your approach to the conversation. If you have been asked to see this dying person and have never been a part of his life before, there will be a getting-to-know-you period, and during this time, you will explore his family and friendship circle; his interests; the books he enjoys; the movies he has been to see; whether he is a gardener or a stamp collector. This is not the time to resort to platitudes such as, “Well, you have had a good long life anyway...your family and friends will never forget you...be strong…I know you can be.” Focus on giving the person the dignity he deserves, and this means encouraging him to live his life as fully as he can in spite of his limited life­span. So you don’t talk about how he was a skilled carpenter, but how he is a great carpenter; not how he had such fun with his grandchildren, but how he is having so much fun making the Lego models with them even though he is in hospice.

Life did not change with the diagnosis; life goes on, with the only difference being that there is a finite, approaching, and certain end point. More than this, the enforced time in bed or the time with reduced mobility gives the dying person the opportunity to do a whole lot of reminiscing, and you can be the one to encourage him to look back over his life and get him to talk over those times and those situations that were significant and meaningful. It is likely that during the review he will talk about those times when he struggled and overcame some tough situations.

A significant question might be, “How did you deal with a challenge such as this?” It could be a challenge in a work situation, or in a relationship, or with a fraternal group, and this may be a way of preparing the person for dealing with the challenging struggle that lies ahead as he dies. There will be weakness and discomfort as he deals with medical treatment, but you can encourage him to live life to the fullest extent that his pain and limited mobility allow.

The one difference would be the way in which you concern yourself with her life of faith. You will want to know if faith for her is a living, vital experience or something that was left behind in Sunday school many years ago. If the dying person is a fellow church member or an individual who is a member of the faith community where you minister, then the “getting to know you” will already be done, and you will bring to the bedside many weeks or months of relating to her. She is not essentially different because she has received the diagnosis that her life will end in a specific period of time, so begin by picking up from where you left off the last time you met. Chat about family members; talk about knitting or hockey or cooking; or discuss whatever interest it is that you share. Ask about the food and how she is finding the hospital experience; relate to your family member, church member, or friend in the same way that you always did. The fact that she is dying hasn’t changed her as a person, just given her the certainty of an experience that awaits each one of us, the fact that we all will die.

Talk, but more importantly, listen to what is on his mind. Give the person the time to say what he wants to say; it is often helpful to directly refrain from talking, leaving a clear pool of silence, so that he is able to talk into it—whatever is on his mind. And who knows what that might be? It could be his physical discomfort, difficulty with breathing, or the fact that he is lying on the same spot in the bed and feels sore. It could be that he is worried about a family member who will be left without support when he dies. It could be he is worried about his cat and how she is faring without him. The agenda is that of the dying person and not yours. Respect their concerns above all else.

What the dying person will appreciate as she talks is your undivided attention. It is very easy to let your attention stray and consider the get well cards on the notice board, the petunias in the flower vase, or (especially) your watch. What the person will value above all else is your careful listening to what she shares with you, so give clear signs that you are listening. A forward, positive posture will do this as will nods of the head. Deliberate eye contact will signal your full attention as will verbal indications that you have heard what they have been telling you, e.g., gentle “er” and “um” sounds on one level and some unobtrusive rephrasing of what you have heard on another. For example, after a long description of treatment that has been physically gruelling or emotionally challenging, a remark like “Well, Edith, you certainly sound as if you have been having a dreadful time” will dovetail in with the feeling component of Edith’s experience and will be appreciated.

Be aware of physical clues shown by someone who is unable or unwilling to put something into words. Continual movement of arms and legs may indicate considerable discomfort related to the physical condition of the person or it may indicate that they are anxious to contact the nurse and get her to bring a bedpan. Above all, be aware of the person’s need to rest or sleep. Watch the person’s eyes; if they close, stop talking for a while.

If you are visiting with a friend or fellow family member, be sure that you do not stray from the agenda of the person you are visiting to your own agenda unless she asks you to do so. While I was bedridden for two months in hospital following a bike accident, I had a couple of church members come to visit me. They talked to each other across the bed for 45 minutes about their own ailments, enjoying the visit immensely, but treating me as a bystander. I spent the last half hour hoping that they would go away. And this reminds me that a short visit is usually better than a long one, and it is good to check in to see how the person is feeling about you being there. Some comment like “You are probably feeling like some rest now” will facilitate a move toward a prayer and the end of the visit. If the person is anxious that you stay, she will probably not be shy in saying, “I wish you would stay a little longer” or ask you a question about a family member or mutual friend to prevent you leaving.

A Conversation Where There Is Little Response

If the dying person is so sick that he is not able to keep a conversation going or if he speaks weakly or hesitatingly, don’t assume that there is no point in continuing the visit. Hearing is the last sense to go when a life is coming to an end, so if necessary, carry on a one-sided conversation, and don’t be afraid to hold his hand. You are there because you care for that person, and your physical presence is the most important thing. So stay around, even if you get little response. Don’t be afraid to speak of your love or friendship, for the words that arise from deep relationship and caring will be words the dying person longs to hear.

If there is little response to the questions you put to the dying person and you are in the room with other family members, there is a tendency to talk about them in the third person as if they are not present at all. “Mal is sure looking pale today. Did you talk to the nurse? I think he is going down.” Mal may not be communicating much; Mal may not be able to speak at all; but he may be taking in every word. It is a good and sensitive practice to treat the patient, whether he is able to speak or not, as if he can hear the conversation and include him even when there is no verbal response. If there is a need for a family discussion, make sure that this is done outside the room, preferably in a lounge or conference area.

Talking to the Dying Person about the Service

It is a huge gift to the clergy person/worship leader if the dying person is willing to share her thoughts about the rite that will mark the end of her life. Support the dying person if she raises the subject and explain how it will help, not just you, but the whole family. My experience is that you seize the moment to talk about the funeral, memorial, or celebration, even if it is most inconvenient for yourself. The opportunity may not come again.

If at all possible, have the person include one or more family members in the conversation and explain to the person who is dying that the family members left behind are the ones who will be reminded of her and will be feeling their loss deeply. Briefly range over the whole area of the service:

Where would the person like the service/celebration to be held?

Whom would she prefer to give talks (eulogies)—family members, friends, or persons from her workplace? And give the caution that more speakers and longer eulogies would not be better; quite the reverse.

Whom would she choose to be involved as readers of scripture or other readings?

What items symbolizing her life or photographs would she like on the communion table, or would she like a video of her life to be made? If so, whom would she like to create it, and what place might it have in the service/celebration?

What music would she like played, including popular and inspirational songs, and what hymns would she like sung? (If you feel that one or more of the choices would be difficult for the congregation to manage, be up front about it. It will save you from a tough solo on the day. An alternative is to contact a competent soloist known to the dying person or her faith community.)

What scripture readings or secular readings are especially meaningful for the dying person, and does she have any thoughts about the theme of the meditation? One typical approach is “You were always so involved with young persons in your life—teaching school, involved in the activities of your own children, and helping with the summer church camp. You were one of the best teachers and guides of young people that I know. I wonder if I could use ‘Jesus the Teacher’ as a theme for your service?”

The subject of the interment service could usefully be raised. What will be the service content and where will it be held? This is an opportunity to encourage the person to tell the family that she wants to have a service at the graveside and that the service should be on the same day as the funeral/celebration.

It is also a time to remind the dying person that it is the family who will be arranging and be present at the service and that their needs will be sought out and heeded in the arrangements.

Prayer with the Dying Person

If the person is a person of faith and you are the representative of the faith community, questions about prayer arise: “Should I pray?” “When do I pray?” and “If I pray, what do I say?” The answer to the first question is a simple one: Ask! If the person is not comfortable with prayer on this occasion, ask at another time, and if it is clear that prayer is not going to be a positive experience, a gentle “God bless!” or “Peace be with you!” as you go out of the room is enough. Some people will expect your visit to begin and end with prayer. Most will want you to pray at the end of the time spent together.

Where persons have no formal faith, you can still ask if they would like a prayer and you will be surprised how many will say, “Yes, please!” But it is important not to impose prayer on those who don’t want prayer. References to God and the Holy One should be used with caution.

However, if no prayer is offered at the end of a visit, it will be helpful to summarize the key points in the way you would do in a prayer but with no ascription to God, i.e., no thanks to the Higher Power and no blessing or offering of peace.

Having made sure that prayer is in order, ask the person if she would like to pray with you. The person may have issues to bring before God that you have no idea existed, and the invitation to pray gives her an opportunity to put any concern that has been troubling her, any anxiety about a family member or friend, into words before someone who will not share it with another living soul.

I remember wondering whether to visit Jack, who came to church at Christmas and Easter only and was seriously ill in the local hospital. There was no indication that he was dying, so I struggled with the need to make the visit: it was out of my way; it would mean that I would be home late for dinner. I rationalized I could easily leave it until next week. The problem was the nagging conviction that I must go, and so I made the diversion. After a good conversation, I asked Jack if he would like to join me in prayer, and he was keen to do so. It turned out that he had a confession to make, a need to get off his chest a happening from years back that still haunted him. I listened to his words, assured him of God’s pardon, and was aware of the sense of peace that permeated that place. I was soon on my way home. Jack died that evening.

The prayer at the end of a visit should be in preparation throughout the visit. If there are worries about family members, friends, or a pet, these should find a place in the prayer. If there are anxieties about treatment or thanks for the attention of a doctor or particular nurses, then they should have a place in the prayer. If there is regret for actions in the past or fear for what comes after death, then this should also find a place in the prayer.

At the end of the prayer, there should be an affirmation of the love of God for the individual and the assurance that in time or beyond time God’s love is with him and will never leave him.

Sometimes, it is difficult to keep track of all the people and situations to be included in the prayer. My experience is simply to do your best and be ready for the moment in the car coming home when you realize that the person’s daughter wasn’t Brenda but Bertha or that you forgot to pray for Dr. Verana who had been particularly kind. It is not crucial to remember everyone, and if the dying person says, “We should have prayed for Grandma Hoskins,” just respond, “You are right. Well, let’s pray for her now… Caring Creator, be with Grandma and give her strength for this difficult time. Amen.”

A prayer might be offered like this:

Loving God,

we thank you for the time we have shared together.

It has been good to be here.

We thank you for those who are strength to Eva,

her well-loved husband, Paul,

and her children, Lisa and Jason.

We thank you for those who have looked after Eva.

Especially we remember Dr. Ranic and night nurse Julie, who talked with Eva when she was afraid and in pain.

Holy One, be a companion with Eva in the struggle that is hers now and in the journey beyond this life that lies ahead.

We pray in the name of Jesus, for whom dying was a faithful but tough experience. Amen.

Or when other family members are present:

Let’s join hands.

Holy One, you are with us all the time,

and in these times of sickness and frustration

you are with us, a loving and sustaining presence.

When Richard goes for tests and treatment, you go with him, and your limitless compassion is with Sally

(Richard’s wife) when she feels lonely and anxious.

Be with those family members (names) who are troubled because they cannot be here today, and with those friends (names) who long to see Richard but cannot do so because of work or family commitments.

In all the uncertainty Richard feels at this time, O God,

be the solid ground beneath his feet, and may he know your peace, the peace that lasts forever. Amen.

It is sometimes helpful to share in the Lord’s Prayer. It isn’t the words that are important, but the fact that it is a shared prayer and the “mantra” that links the person to the rest of the faith community.

Readings, Sacred and Secular

There will be times when it is appropriate to read some passages from the sacred writings of the faith group to which the person belongs. Again, it is both sensitive and appropriate to ask the person whether she wants you to read and whether she has a favourite passage. The place for the reading is usually before prayer is offered, and the passage should be chosen by the dying person or have relevance to the spiritual or practical needs in that situation.

Psalm 23 is a reading frequently requested and with good reason as it is well-known and speaks directly of God’s sustaining presence with those who are going through “the darkest valley.” I remember being with a man who was dying and in great pain. “Would you like me to read anything from the Bible?” I asked. “I would like you to sing Psalm 23 with me,” he replied. So I held his hand, and we sang Psalm 23, not very tunefully, but he told me he felt so much better at the end of it. Whether the three other patients in the room felt better I rather doubt! With older persons it may be more helpful to read this psalm of comfort from the King James version that they would have been taught as children.

There are several types of readings that may be helpful. There are readings that speak of a hope of life after death and a community of the saints, readings that speak of God’s presence when the dying person feels most alone, and readings that are especially relevant to women or to children. Some of the scripture passages that I have had requested or have read are:

In the darkest valley God is with you (Psalm 23)

Out of the depths (Psalm 130)

God the eternal presence (Psalm 139)

I lift up my eyes to the hills (Psalm 121)

God will wipe away the tears (Isaiah 25:6a, 7–9)

Come to me, all of you who are weary (Matthew 11:25–30)

Jesus blesses the little children (Mark 10:13–16)

I go to prepare a place for you (John 14:1–9)

God’s loving presence (Romans 8:31b–39)

The spiritual body (1 Corinthians 15:20–22, 51–58)

Eternal glory beyond all measure (2 Corinthians 4:13–18)

A new birth into a living hope (1 Peter 1:3–9)

A new heaven and a new earth (Revelation 21:1–7)

On the secular reading side, the readings in appendix 2 provide inspirational material that may be appropriate.

You may want to check out whether the dying person would like something read out of the newspaper or a passage from a favourite book. If the person is a sports fan, then a report of the previous evening’s football or hockey game might go down very well. Also, talking books with audio buds or headphones are a wonderful way of passing the night hours and require little assistance to set up and keep going. If the person has an iPod or similar device, there may be music or text that he would like to tune in to.

The Sacrament of Holy Communion (Eucharist)

During the two months I was in hospital following my cycling accident, I was visited by clergy of my own and several other denominations, and for the most part they were empathetic, sensitive, and friendly. It was four weeks into my hospital stay when a lay trainee chaplain asked the question “Have you received the sacrament of Holy Communion?” and I realized that this sacrament was something I had been missing. For many denominations it is only ordained clergy who are permitted to celebrate the eucharist, so I was hesitant and asked, “Can you celebrate with me?” “Sure,” she replied, and as we prayed and as I received bread and grape juice, I felt the challenge and the joy and the peace that come from this common act of the Christian church.

What different people receive as the eucharist varies enormously, but the sacrament is especially meaningful for those who are going through the valley of the shadow of death. For the dying person, taking the bread and wine is a way of being one with the faith community of which she is a part, but cannot physically join at the table. And more than this, it is a way of sensing that she is a part of that community of saints present and past who have unity in Jesus Christ. The dying person may remember parents or grandparents with whom she shared Holy Communion in time past and sense that before long she will once again know their presence.

There is usually space in the service to come humbly before God and confess those things that are on the communicant’s mind, believe that God hears what she says in the silence of her own heart, and receive an assurance of total forgiveness. This may be a significant time for the dying person (and for family members if they are with them). The dying communicant will have an opportunity to bring to God the deepest feelings that she has and the fears that are hers about the fact of death that lies just ahead. Again, she can do this believing that God hears her prayer and will give her strength for the days of dying and the time of death itself.

Both the communicant and the person celebrating will bring before God the family members who are supporting this person and the friends who have shown their care. There will be much gratitude here and hope that those who are giving help will receive the spiritual and physical help they need.

Participating in the eucharist will hopefully bring peace to the dying person, peace that passes all human understanding. This is the bridge time when human life is ending and another life is beginning, and in the experience of communion, the merging of humanity and new life in the spirit becomes a reality.

So, if you are a worship leader and are trained and ready to offer the eucharist, then this is something to consider for each dying person. As always, the key question to be asked is “Will celebrating the eucharist (or Holy Communion) be helpful to you?” If you are not prepared to do this, or if your denomination restricts the celebration of this sacrament to those who are ordained or commissioned, then you should ask the person if she would like to receive the bread and grape juice (or wine) and then arrange for a suitable ministry person from the denomination to come round and be the celebrant.

Remember to check that taking the bread and wine will be in accord with her treatment and nutrition plan. If the dying person is not able to ingest the elements, they may be touched gently to her lips. It will be good if the spouse or other family members were asked to join in the eucharistic celebration and, as long as this is fine with the dying person, then the invitation should be extended.

In some traditions, such as in those of the Roman Catholic Church, elements are set aside by the priest at the mass for serving to the dying person at home or in the hospital by a deacon, chaplain, or other authorized church celebrant. In this situation, the reserved elements should be used.

I cannot stress too strongly that celebration of the eucharist can open spirit­ual doors that is not possible any other way. It can be the place where “heaven” and earth momentarily meet. Most dying persons of faith will welcome the opportunity to celebrate. One word of caution: do not delay the invitation too long as it is better for the dying person to have a reasonable understanding of what is happening.

Permission to Die

Sometimes the person who is dying may hold out against all the odds, waiting for a family member significant to him to arrive before taking his last breath; and sometimes he is waiting for permission from family members to die. Or the dying person may be hanging on, worried about how the family members will be when he passes away, worried about how they will be able to manage without him. He is ready, his body is ready for the peace that comes with death, but he needs a word from a significant family member.

The more sensitive family members may be aware of this, but as pastoral caregiver you may also be the one to alert them to the need to say, “It’s okay to go now. We are going to miss you so much, but we are ready for God’s peace to enfold you. Just let go.” As pastoral caregiver, you will be ready to reinforce this in the prayers you offer.

A Person of Little or No Faith

There will be times where the pastoral caregiver may be called on to help a dying person of little or no faith background, but one or more of their family members will have a connection with you, the pastoral caregiver. It could be a spouse of a good friend of a church member or it might be someone who was married in the church, or has a vague or perceived connection. Several times I have been asked to visit a dying person or to conduct a funeral where the request has come from someone who has told me, “My grandmother/father was married in your church.” And again, the request may come out of the blue from a family member who knows his loved one is dying, will be looking for someone (anyone) to lead a funeral service, and wants to get to know the celebrant/worship leader who will be doing it.

Many of the approaches and attitudes in the above sections are common to those with no faith or with some Christian or other faith, and a compassionate worship leader will be aware of the need for a positive and affirming attitude, the need to encourage open expression of fear and other feelings, and the need to follow the agenda of the person who is dying and not your own.

The answer, “No” to the question, “Do you want me to pray with you?” is a good indicator that the person being visited is not a person of faith, though this may not necessarily be the case. It is also useful to remember that if a prayer is not offered to “God” or “The Holy One,” it may be helpful to voice the same sentiments at the end of your visit in a calm and peaceful way. The person who is dying may appreciate that her family are with her at this time of weakness and despair, and what was originally a prayer offered to the Loving God may be reframed into a series of positive statements:

Let us all join hands around Eva’s bed.

We are thankful for this time we have shared together:

the talk, the laughter, the stories.

Paul, Lisa, and Jason, you have been strength to your wife, to your mother, in these tough times.

We are thankful for those who have looked after you, Eva.

We especially remember Dr. Ranic and night nurse Julie, who talked with you when you were afraid and in pain.

We realize that the next few days will be not be easy, but (you will be able to face the journey from this life knowing that) your close family members are with you every step of the way.

At the end of these statements the worship leader could put her hand on the brow of the dying person and say, “Peace be with you, Eva.” The family members would then speak, hug, and kiss their goodbyes.

Usually, it will not be helpful to read scripture with the one exception of Psalm 23. This may be called on because of family use in childhood or because, even with its references to God, it remains the testimony of one who is going through an exceptionally hard time and is ready to put his feelings into words. “I feel like that, too, and I would like that sense of assurance,” may be the spoken or unspoken response of the dying person hearing this piece of ancient scripture. This passage of scripture (and any others) would only be read with the dying person’s permission. A general question such as “Would you like me to read something to you?” may be a useful one to ask.

It will be helpful for the worship leader to have non-scripture readings ready to use. He might say, “I have found this reading very helpful,” offering one or two like the following:

You would know the secret of death,

but how shall you find it unless you seek

it in the heart of life?

The owl whose night-bound eyes are blind unto the day cannot unveil the mystery of light.

If you would indeed behold the spirit of death,

open your heart wide unto the body of life.

For life and death are one,

even as the river and the sea are one.

For what is it to die but to stand naked in the wind and to melt into the sun?

And what is it to cease breathing, but to free the breath from its restless tides, that it may rise and expand unencumbered?

Only when you drink from the river of silence

shall you indeed sing.

And when you have reached the mountaintop,

then you shall begin to climb.

And when the earth shall claim your limbs,

then shall you truly dance.

Kahlil Gibran 2

For a creative person, validating their attitude to life:

Thousands of years of history have passed...and during that time human beings have fought, killed, plundered, and wronged each other in every possible way. Of such stuff history is made.

But also during that time other human beings have quietly and patiently persevered...in the development of the arts, crafts, inventions, ideas, and programmes. From these millions of creative persons, most of them unnoticed and unknown in the upheavals of history, have come the good and lasting things in the sum of human culture.

Barbara G. Walker 3

For one who is aware of an indescribable source:

I was not aware of the moment when I first crossed the threshold of this life. What was the power that made me open out into this vast mystery like a bud in the forest at midnight! When in the morning I looked upon the light I felt in a moment that I was no stranger in their world, that the inscrutable without name and form had taken me in the arms in the form of my own mother. Even so, in death, the same unknown will appear as even known to me. And because I love this life, I know I shall love this death as well. The child cries out when from the right breast the mother takes it away, in the very next moment to find in the left one its consolation.

Rabindranath Tagore 4

A key factor here is for the worship leader to develop her own library of readings that she can call on to suit the situation. For those without a recognized faith, the books Earth Prayers from Around the World and Life Prayers from Around the World by Elizabeth Roberts and Elias Amidon have been found to be especially helpful by some. The ability to search the Internet enables worship leaders unlimited opportunities to find poems and readings that are appropriate for various situations and for the outlook of the person who is dying, but you have to have the determination to carry out this task.

Another good question is “Is there something you would like me to read? A passage from a book or a magazine that is especially significant to you?” The response to this question may be surprising.

A Service of Saying Goodbye

Where a loved one has a diagnosis that suggests death will happen within days or weeks, it is possible to craft a service that is held in the home or hospital, includes many of the elements of the funeral/celebration, and has the dying person present. This is a true “goodbye” (God-be-with- you!) service.

In this situation, family members and good friends have the opportunity to publicly talk about the joy and wisdom that the dying person has brought to their lives, and the worship leader is able to offer a strong note of resurrection hope to her and to her family members and close friends. In the prayer of thanksgiving as well as the thanks given for aspects of the dying person’s life, there is an opportunity for her to voice her own thanks to God, especially for her family and friends, but also for areas of life that have given her especial joy and fulfillment.

The act of committal has a whole fresh impetus and meaning if the loved one is aware of her life being committed to the love of God for all eternity. And at this service, the sacrament of Holy Communion could naturally be offered to a person of faith.

Clearly the length and content of the service would have to be tailored to the strength or weakness of the dying loved one. And it should be noted that this service would in no way replace the one-on-one farewells of family and friends or a service after the person has died.

How Will We Live on after Death?

What will happen to our loved one after she dies? Where will she go? What will it be like? How will she live on? If these questions are not asked, you may be sure they will be on the minds of those around the bed of the dying person. The life that begins (or does not begin) when this one ends is of huge interest to the vast majority of people and becomes a major concern as life draws to an end.

There have been myriad forms of speculation, a raft of lurid near-death experiences told, but nobody has come back to give us the definitive answer. Do we live on? Will we have individual existence? Will we meet our loved ones and our not-so-loved ones again? These are good, relevant questions, and as a pastoral caregiver you will need to be ready with an answer at the bedside of the dying person and as you write the meditation.

Inevitably there will be mention of heaven, but what is this heaven like? Talk to a dozen people, and you will get a dozen different answers—everything from a shining city with golden paved streets to a tranquil fishing hole. And is heaven the most important aspect of what happens after we die? I like to start with the belief that no one is lost to God. As the old Jewish prayer puts it:

We remember those who have departed.

They have not died into the grave,

but into the love and eternity of God.

The love and eternity of God, who was our Creator, will have the last word with us. How we don’t know, in what location we can’t be sure, but the loving God in the end will see us through: In life, in death, God is with us.

There are some certainties as we think of how we will live on. We will continue in the memory of our loved ones and in the memories of those whom in our lives we have touched in many different ways. And among those who will remember us, it will be family members and friends who will remember us best of all. That is why the eulogy and the thanksgiving prayer in the memorial or funeral service are so important, because they model and inspire the remembering that will continue long after the service is over. When we celebrate the eucharist, we remember and are inspired by Jesus, whose life on earth ended 2,000 plus years ago. More than this, we will be remembered in the communities of which we have been a part and may be missed. We will be remembered in the church of which we have been a member, and the business, fraternal, and sports groups in which we had a significant place.

I was sent last year the CD of the memorial service for Ron, a “pillar of the church,” who helped and supported me when I was an intern and had died after a long illness. You could tell in the family and church stories during the service the faithfulness of this man, but also in the enthusiastic and spirited singing of the old, familiar hymns how much he meant to the faith community. I remembered how he always kept a sermon in the glove compartment of his car in case the Sunday morning worship leader failed to show. He will be remembered in his home church for many years. Eventually though, Ron’s faithfulness and his contribution to the faith community will fade from memory, and as the years go by, he will be remembered by fewer and fewer people. Shakespeare was right when he wrote “The good men do lives after them....” (Julius Caesar). And the following words (adapted) of St. John Chrysostom are true: “The person whom we lose is no longer in the place she was; she is now wherever we are.” This is true, but memory is not forever, and it is our mortality that puts limits on our remembering.

However, if the community lives and is effective, then the memory of Ron lives on in different ways. If the community cares for those in need in his church and cries out for justice for persons in the locality who are denied a fair wage, and writes in support of political prisoners, then in this just and merciful group the spirit of Ron lives on. Though his name might be forgotten, his influence is alive. The same community influence would hold true if the aim of the group was to protect the environment, or support persons released from jail, or give shelter to those in danger of being abused.

Some would say that this is avoiding the issue: “We know that we will live on in the memory of our loved ones, but (answer the question) will we have a separate and self-conscious existence after we have died? Or is death the terminus of it all?” I have touched on this issue in chapter 2 “Biblical Roots,” but it is worth reinforcing with reference to Paul whom we meet in the Christian scriptures. If you had asked the apostle Paul the question about a conscious existence after death, there is no doubt he would have answered: “I have known the love of God through the work I have done and the relationships I have made. On the road to Damascus I realized I had to change my allegiance and follow Jesus; when in prison I was given the strength to witness to the jailor; when shipwrecked I found the strength to endure; when death was in prospect for me I was inspired to put fear behind me. What was the common denominator in all this? It was the active, practical love of God as we understand it in Jesus Christ, which knows no limits of time or space.”

Look again at the reading from Romans 8 at the end of chapter 2. The love of God that Paul writes about is not a time-limited love, nor is it a space-limited love, and this is a love we are able to take to heart. It won’t show us what “heaven” looks like, or confirm whether when we die we will see our loved ones who have died; it won’t tell us how it feels to be alive again, to be resurrected. But if we are held fast with God’s love how can it fail to work out?

This is my way of looking at how we live on after death, but you will have your own concepts. The important factor is that you are ready with a well thought out answer when someone says, “I’ve been wondering about heaven,” or “My grandma said she would be waiting for me when I die, will she?” or “I’m afraid of what happens when I die. What does happen?” These questions will come your way, so be ready!

On a more practical level, we have the ability to live on through our body parts donated to others after death.

Organ Donation

There is a long list of persons waiting for replacement organs and tissues. There is a huge demand for kidneys, livers, corneas, and lungs among others. Most provinces and states have a card that is given to those who have a driver’s licence issued or reissued on which they may give permission for these body parts to be used, if the person has an automobile accident for example.

In a situation where a person is dying, but has not filled in a donation card or expressed a wish to donate organs or tissues, the pastoral caregiver may have the opportunity to raise the subject. Both the dying person and the family may have views on the need for the card to be completed (or permission to be given in writing for donation), and the pastoral caregiver can act as a catalyst in making sure that if there is a wish for organs to be donated, this wish is carried out and that the document is signed and witnessed.

It is useful to talk to the medical professionals before the person dies about how the donation of tissues and organs may be facilitated in that institution. In a situation where a baby or a young person has died, the donation of organs and/or tissues may be seen as a direct way in which the person who has died lives on, and can be a powerful aid to the grieving process.

A good friend died recently, and a year after her death her spouse was visiting us and showed us a certificate and medal acknowledging the donation of corneas that had been given to restore good sight to a stranger. The corneas were the only useful parts of her body that could be harvested, but that they were transplanted into the eyes of another person was a factor that significantly aided the grieving process for family members left behind.

Self-Care for the Worship Leader in a Pastoral Role

Being with those who are dying is intense and demanding work. In her book Being with Dying, Joan Halifax reminds her readers that as caregivers we are called on to offer loving kindness not only to those with whom we work, but also to ourselves: “Just as a mother can care best for her child after her own needs have been met, it’s crucial that we recognize our own limits of compassion, in the same way (as in an airliner emergency) we’re instructed to place the oxygen mask on our own face before we try to help those around us.”5

This means that all the advice you give to family members about taking time to get enough to eat and sufficient sleep and time away from their loved one also applies equally to yourself. You need to pace yourself and to realize that there are others who are able to give care to the person who is dying, and to have the confidence that they will do a good job. You may also need a friend or colleague with whom you can talk out your options and concerns around the bereavement. Military authorities are now waking up to the fact of post-traumatic stress in soldiers and the need to take it seriously. It is a reminder that those who wait beside the bed of a dying person may be exposed to a traumatic situation and the stress that comes with dying and death.

This is also a time when it is crucial to adhere to our regimes of both physical and spiritual exercise, especially as it will seem that there is little time to be about both forms of personal renewal.

1 Excerpts from Being with Dying, by Joan Halifax, ©2008 by Joan Halifax. Reprinted by arrangement with The Permissions Company, Inc., on behalf of Shambhala Publications Inc., Boston, MA. www.shambhala.com.

2 From “On Death” by Kahlil Gibran (1883–1930). In the public domain.

3 “Thousands of Years of History” by Barbara Walker, from Life Prayers, Elizabeth Roberts (ed.) (Harperone, 1996).

4 Rabindranath Tagore (1861–1941). In the public domain.

5 Excerpts from Being with Dying, by Joan Halifax, ©2008 by Joan Halifax. Reprinted by arrangement with The Permissions Company, Inc., on behalf of Shambhala Publications Inc., Boston, MA. www.shambhala.com.