Individuals diagnosed with life threatening diseases often experience significant personal distress, as they may face daunting medical interventions without certainty that these treatments will lead to a cure for their particular condition. For many patients, there may come a time when disease reaches a threshold point where the medical focus shifts from treating the disease to a focus on making the patient as comfortable as possible. In either of these cases, individuals may feel called to begin coming to terms with the inevitability of their death. Turning oneʼs thoughts in this direction may elicit a host of deep feelings including disappointment, anger, sadness, hopelessness, shame and grief among others. End of life guidance may assist individuals in reflecting on their current circumstances as a means of coming to terms with the end of life in ways that nurture peace in the face of the unknown.
My role in offering end of life guidance is to listen carefully, empathically and respectfully as individuals share their journey through this stage of their lives. It is not my place to offer ready made answers to questions about how to find meaning in the face of death. Rather my role is to mindfully walk with those who are facing the nearness of death so that they can find their own authentic path of coming to terms with the end of life.
Depending on an individualʼs medical condition, personal understanding of death, religious/spiritual orientation and specific wishes regarding support, end of life guidance can include life review, mindfulness practices, prayer, guided imagery, listening to music, forgiveness rituals with family members and/or friends, and other practices to encourage acceptance and the value of their life. End of life guidance might also involve referrals and/or collaboration with other professionals (clergy, physicians, psychologists, clinical social workers, hospice workers, or others). End of life guidance can include family members and friends of the one who is facing death. Depending on the wishes of the individual and family members, end of life guidance might involve home visits (possibly to nursing homes and assisted living facilities) but not hospital visits where care would be exclusive to the medical team and hospice workers.
The approach I take in end of life guidance work does not make mental health diagnoses. The end of life guidance I offer is not psychotherapy. My intention in end of life guidance is to co-create with those seeking my help a safe, loving and caring space so that death is less fearful for the dying and their families. I view individuals who seek end of life guidance not as patients, but as participants.