Tuesday

Advice from an End-of-Life Care Chaplain

By Chaplain Alley Smith

You can always bring a sense of warmth and gentleness into sitting with someone who is dying or by acknowledging the fact that you’re going to die. It’s important to forget yourself and just be present.

Most of us have no idea when we are going to die. Yet, it’s interesting when individuals know death is going to happen or that it’s expected. Premonitions are captivating and very real. The whole process can cultivate tremendous awareness of the preciousness of life.

For the last several years, I’ve been sitting with dying people, doing funeral services, and even working on teams of removal (care) technicians. These are interesting points of view. On one hand, I’ve been a witness to death. On the other hand, I’ve opened my heart to vulnerable families. I’ve also picked up corpses and remains of the deceased. Part of the work entails preparing the bodies for refrigeration and cremation services. These experiences of working the charnel ground have shaped who I am.  The whole evolution has been sharp and penetrating, like a steel arrow to the heart. 

Many people ask me, how do you do it? How do you constantly work with death? I could not do it without generating bodhichitta, an awakened heart. Death, to me, is no different than birth. In the Buddhist tradition, we consider the notion of death as an opportunity to turn the mind toward dharma, the teachings of Buddha, and rebirth. Just like the Buddha has said, “Death is occurring every second, to every being-as long as they exist.” Everything and everyone is impermanent. 

What happens when you die is clearly the process of dissolution. Dissolution of the five elements: earth, water, fire, air and space consciousness that goes out in the human body. You can actually see these things happen. However, in my experience, the signs of dissolution are not in perfect order.

Being gentle and having an open heart is paramount. It’s also important to have a good sense of head and shoulders, dignity and respect in the presence of those who are dying or who have died. I cannot quite describe the tenderness I feel. I always practice Tonglen and offer the Four Immeasurable prayer. I find this helpful.  This may help the individual focus on the clear light at death.

Speaking of clear light, I’ve sat with several people who have seen light so-to-speak. They simply enter into the unknown at the time of death. I don’t believe this occurrence has anything to do with one’s spiritual preference or tradition. However, it’s visible and it’s there. People see it – a light when they are leaving consciousness.  It’s clear to me that they are going somewhere. No one really knows where. 

You can sometimes feel the consciousness, soul or spirit (whatever you prefer to call it) leave the body. It is a subtitle occurrence but if you pay attention, it’s clear. It happens like a candle flame blowing out. At that moment, I usually get a feeling of great spaciousness and freedom. Allowing people to die — giving them permission is important. Sometimes, folks hang on.  Sometimes they wait to die when people leave the room.  Sometimes, they hang on for a long time. Sometimes they wither in pain. Sometimes, there’s nothing but serenity.  It’s really a process only known to the dying person.

It is a precious gift to see someone born and be with someone when they die. Some people are terrified to be alone. Some people prefer to be alone. Each time this occurs, I know that the individual is returning home.  If I could offer one bit of advice about death and dying is this, learn to relax and become intimate with your mind in meditation now. Don’t wait.  When you are preparing to die, practice what is most familiar to you. And last but not least, always ask yourself if you can find the great gate of peace, joy, and compassion in your pain and suffering. When we practice following our breath in meditation – we are preparing for our final breath.

About Alley

Alley Smith is an ordained Buddhist Chaplain in the Shambhala Lineage. She serves at Brown University in Providence, Rhode Island as a Buddhist Minister of Religion. She is an experienced hospice and end of life care chaplain. Alley is a US military war veteran. During her career, Alley served with the military funeral honors Honor Guard. She specializes in end of life care, mortuary affairs and as a funeral clergy. Alley has been a student of Shambhala Buddhism and Zen since 1999.

Alley is the teacher for Making Friends with Death and Dying: Bereavement Support Group at Shambhala Online.