TRANSITIONAL GUIDANCE AND SUPPORT

Compassionate Companionship Care

Phase 3: Pre-Actively Dying to Last Breath and After

During the pre and active dying phases, Cindie is open to visiting anytime night or day seven days a week, because she believes that every patient and their loved ones deserve and need compassionate accompaniment, support and guidance throughout these final transitions.

Pre-active dying often begins about two or three weeks before the last breath. Active dying is the final stage and may last for 3 days. Once a patient is pre-actively dying, it’s best to schedule daily visits with Cindie. The timing can vary each day, depending on your needs and Cindie’s availability.

After the patient has taken their last breath, Cindie will be available for on-going support of the primary loved one/caregiver. By this time, you will have developed a trusting relationship with Cindie that offers continuity and connection born of a shared experience. Cindie’s strength, comfort and understanding of grief will be very important to your healing process, as you respond to your losses and adjust to the many changes.

This phase is focused on:

• Compassionate accompaniment
• Sitting bedside
• Attuning to the patient with full presence
• Attending to the patient’s needs
• Tracking the changes
• Facilitating sacred experiences that will become precious memories for all who are present
• Emotional support of the loved ones

These are some of the ways that Cindie can help a patient who is pre or actively dying:

• Sit bedside with the patient, providing compassionate companionship.
• Keenly observe patient for subtle and non-subtle signs of transition.
• Keep the family informed of any changes in whatever ways or frequency they would like.
• Help adjust the patient’s physical positioning when there is noticeable discomfort and/or suggest interventions for comfort.
• Offer water, moisten mouth with sponges, make adjustments to the lighting in the room, play music if appropriate.
• Talk gently and reassuringly to the patient.
• Hold hand if appropriate.
• Offer Gentle Touch.
• Offer energy work.
• Offer prayers. 
• Help the loved ones understand what the patient is going through, what they need and how to meet the patient where they are at, in order to honor the patient’s personal wishes, especially if their end of life values and wishes are different from their loved one’s.
• Offer ideas to help the loved ones communicate with and express their love to the patient in this phase.
• Understand, observe, and intuit special needs of the patient and their loved ones and coordinate resolutions.
• Honor the loved ones who are supporting the patient at the end of life. Meet them where they are at and offer support for what they need.
• Guide and support the family to express their grief.
• Help reduce the loved one’s anxiety, which will help the patient too.
• Take turns sitting vigil (sitting beside 24/7 with a patient when the patient is actively dying).
• Arrange vigil schedule as needed.
• Guide the most peaceful transition possible for the patient.
• Sit with the deceased body and coordinate the removal.
• Call doctor or nurse and wait until they come to confirm death.
• Call mortuary and facilitate removal of body.
• Sit with the body after last breath until the mortuary arrives, for the loved ones who can’t bear to do it.
• If on hospice, assist with washing the body at home, if that is wanted.
• Clear the room of medical supplies.
• Offer a clearing ceremony.
• Attend the memorial.

These are some of the benefits you will experience when working with Cindie in this phase:

• Peace of mind, knowing the patient has a compassionate companion during the final stages of dying.
• Increased physical and emotional support for loved ones during the final stages of dying.
• Some reprieve for the loved one from the on-going patient care.
• More peace and less stress for the patient and their loved ones in the final stages of dying.
• Consistent on-going compassionate support after last breath, at a time when you are vulnerable and need to be connected with someone you trust.
• After the last breath, grief and emotional support for the loved ones, as you respond to your loss and adjust to all the changes.

For Phase 3 of Compassionate Companionship Care when a patient is in the pre-active or active dying phase and you are seeking transitional guidance and support, it’s ideal for Cindie to visit daily. These visits can be scheduled the day before. The timing and frequency will depend on your needs and Cindie’s availability. In this phase Cindie is open to scheduling a visit anytime 24/7.  

After the patient’s last breath, Cindie offers continuity, grief support, and help with logistics. A mutually agreeable schedule can be arranged at that time.

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