Your person has chosen to receive palliative care at home, and plans have been put in place for an Expected Death in the Home (EDITH).
The palliative care team has been involved and is monitoring pain and symptom management. Your Doula has been visiting regularly, talking with you about what to expect as time runs out.
Final goodbyes may be taking place through video calls, texts, phone calls, and perhaps short visits. You have done what you can to prepare. Your questions have been answered. Your fears have been diminished. You know that the end is near.
The Moment of Death
And then comes the moment. The breathing changes. There is an exhale that is not followed by another inhale. And then
Silence.
Stillness.
Profound finality.
To witness someone you love take their final breath can be intensely emotional and, for some, a sacred experience. You have been given the privilege of being present for this final stage of their life. You look at each other and wonder:
What do we do now?
As your Doula may have encouraged you, the first thing to do is nothing. Take a breath. Then take another. And then take one more.
You are bearing witness to an incredibly private and emotional moment. The finality can hit hard. Take the time you need to absorb what has happened. Be together.
There is no rush. There is no emergency.
What you do next is completely up to you and what feels right in that moment. There is no single “right” way to spend these moments. Do what feels comfortable and meaningful to you, while respecting the dignity of the person who has died.
Some will hold their hand. Crawl onto the bed beside them and hold them. Talk to them. Sing. Take a photo. Light a candle. Open a window. Bring the dog into the room and let them sit beside you. Make a cup of tea. Open a bottle of wine and raise a glass to your person.
Play their favourite music. Cry. Laugh. Tell stories. Pray. Remember. You have permission to honour your person however you see fit. It is an honour to be present with your person as they transition.
And we often don’t talk about the sense of relief you may feel, knowing that your person is no longer suffering. This, too, is very common. Relief does not mean you loved them any less. It may simply mean that you know their suffering has ended.
Next Steps
There is no need to hurry.
When you are ready, and if your Doula is not already there, you can call them for support and guidance through the next steps.
The palliative care team will also need to be notified according to the plan that has been established for the expected death. A physician or nurse practitioner will attend to confirm and formally pronounce the death and begin the necessary paperwork.
This is one of the reasons preparing for an expected death is so important. When the plans are in place ahead of time, you and your family don’t have to figure everything out in the middle of the moment.
Saying Goodbye
Eventually, the transport team will arrive. You may want to watch, or you may not. Both choices are okay. Your person will be placed on a stretcher and taken from the home. This can be another difficult moment because suddenly, you realize:
They will never be in this home again.
The chair will be empty.
Their things will still be there.
Their scent may still linger.
They will not walk through the door again.
You may want one final goodbye.
Take it.
There is no need to hurry this moment if the circumstances allow. Hold their hand. Kiss their forehead. Say the words you need to say. Or simply sit quietly and observe.
When they are gone, you may find yourself standing in the middle of your home wondering what comes next. Take another breath. Then take another.
You will begin to initiate the arrangements one step at a time—the phone calls, paperwork, notifications, and funeral arrangements. The practical things that may suddenly feel impossible.
You don’t have to do everything today.
In This Moment
Breathe. Grieve. You are not alone. There is no perfect death and no perfect goodbye.
There is only this moment.
And in this moment, you have permission to love your person, honour your person, and say goodbye in whatever way feels right for you. The important thing to remember is this:
You do not have to rush away from the moment.
The room that has held so much fear, anticipation, conversation, love, and caregiving can now simply be a place where you say goodbye.
There is time.
Breathe.
Be together.
Let the moment unfold.
Let’s talk.
Jayne Dill, RN, End-of-Life Doula, Grief Educator
London Death Doula
londondeathdoula.ca