The liminal space at end of life
Transitioning between worlds.
Sometimes, those who are dying offer us a glimpse into a world we cannot see.
My sister in law was dying. She had incurable cancer and when the call came, we knew it was time. We drove six hours to northern Ontario to see her, knowing it would be our final visit together. Despite more than 40 years as a Registered Nurse, many of those spent working in oncology, and seven years as a certified End-of-Life Doula, I found myself asking the same questions many people have when faced with the impending death of someone they love: What do I say? What can I do for her? How can we support her adult children?
We had visited Norma and her four children a few months earlier, but her condition had deteriorated dramatically. Her eldest daughter, Ashley, called, and said it was time to come. As we packed for the trip, I gathered my thoughts and shifted into what I call “Doula mode.”
When we arrived, we were greeted by Ashley, who had become her mother’s primary caregiver. After a brief visit, I offered to stay with Norma overnight. Ashley was exhausted beyond words, the kind of exhaustion that comes from loving someone through the hardest chapter of their life. I held her as she wept and gently said, “Go to bed. You’re off duty.”
The next few days were a gift. I had the privilege of spending one-on-one time with Norma during the quiet hours of the night. We sat together in the dimly lit living room as she drifted in and out of sleep. At one point she suddenly woke with a start. Her eyes opened wide. “Oh I am back,” she exclaimed. “Yes,“ I replied, holding her hand. “You are here at home. We’re in the living room.” She looked around and settled back on the pillow. Curious, I asked “Where were you?” She calmly responded clearly, “At a party.” I paused and asked, “Who was there?” She began naming family members who had already died; her husband, her parents and several other loved ones. After a pause I asked, “How was it?” She looked directly at me and said peacefully, “Really good.”
A foot in two worlds, the transition, the waiting room, the threshold between life and
death-these are all ways of describing what is often called liminal space.
If we are willing to look and listen, we can sometimes catch a glimpse of the world the dying
person is experiencing. It is a threshold where identities shift, routines dissolve and a new
reality begins to emerge.
Navigating the liminal space often means providing comfort and reassurance as a person
transitions between life and death. What has always stood out to me is the sense of peace.
Each time I have witnessed these experiences, the individual has appeared calm, comforted, and accepting. Rather than resisting what is happening, they seem to be moving toward it with trust.
In their book Final Gifts, Maggie Callanan and Patricia Kelley write, “People know they are dying. They attempt to share this information by using symbolic language to indicate preparation for a journey. Travel is a clear metaphor often used to describe this need to go forth…to die.”
Over the years, I have witnessed this phenomenon many times at the bedside as a nurse. While each experience is unique, the themes are remarkably similar. Some people speak about catching a train, packing a suitcase or preparing for a trip.
Grief expert David Kessler notes that many dying individuals report seeing deceased loved ones, particularly their mothers, and often speak of “going home” as death approaches.
Research suggests that deathbed visions may arise from a combination of neurochemical changes in the dying brain and profound psychological or spiritual processes that help individuals make sense of death. As the body begins to shut down, decreased oxygen levels and changes in brain function may create dreamlike states that offer comfort and reduce fear. Whether viewed through a medical, psychological, or spiritual lens, these experiences often appear to soften the boundary between life and death.
At the end of life there is much to learn if we are paying attention. The dying teach us that presence often matters more than words. Hearing is believed to be the last sense to fade, which is why gentle conversation, reassurance, and expressions of love remain important, even when someone appears unresponsive.
As death approaches, priorities shift. Status, wealth and accomplishments become less
important than meaningful relationships and human connection. Forgiveness becomes
important. Unfinished business seeks resolution. Love becomes the language that matters most.
Witnessing death reminds us of life’s fragility and unpredictability. It deepens our gratitude, expands our compassion, and often changes how we choose to live our own lives.
The final days of life can be emotionally intense. Tensions may fill the room. Decisions must be made while family members are exhausted, grieving and vulnerable. In these moments, one of the greatest gifts we can offer is simply our presence, to stay grounded in the moment, to observe without judgement, to listen, and to hold space. When we do, we may find ourselves participating in something profoundly sacred.
I deeply admire my sister-in-law’s courage. It reminded me that dying, like living, is acutely personal. When surrounded by love, compassion and acceptance, death can become not only a final chapter, but a profound teacher. Norma’s death was beautiful.
Have you ever witnessed a deathbed vision or experienced a meaningful moment while sitting with someone who was dying? I’d love to hear your thoughts.
Lets talk,
Jayne Dill RN, End of Life Doula, Grief Educator
londondeathdoula.ca