If you’re thinking about becoming a hospice volunteer, I encourage you with all my heart to take the training and try it.

Most people who are drawn to become hospice volunteers, but don’t follow through, are afraid it will be depressing. My experience of working with the dying for nine years was anything but depressing. If it had been, I’m sure I wouldn’t have stayed so long. When you meet a hospice patient, you know he is dying. This is completely different from finding out that a friend or family member is dying. With a hospice patient, you don’t experience the shock because you didn’t know him when he was healthy.

At the hospice where I worked, you were not allowed to become a hospice volunteer until one year after you had experienced a close, personal death. I thought this was a very healthy policy. If you’re actively grieving, you don’t want to re-live your own grief by being with others who are dying. However, this is when many people are drawn to become volunteers. Give yourself some time. Trust yourself to know when it’s right for you.

My patients and I laughed and had fun and were sometimes irreverent. And at the same time, we did very important work–we made gifts to say goodbye, we wrote good-bye letters to loved ones, we even wrote funerals and obituaries. We did meaningful activities. Sometimes I helped them find hobbies to divert their attention from pain. If I didn’t feel that we were accomplishing something that was meaningful to them, or that they weren’t in some way benefitting by my being with them, then I did not want to waste their precious time.

I wrote The Last Gifts: Creative Ways to Be with the Dying because I don’t want anyone to die alone, and yet even in our affluent society, it happens every day. I also wrote the book, and continue this blog, because I don’t want you to miss this inspiring, intimate, and life-changing opportunity when it comes up for you. If you engage with someone who is dying, rather than pull away, you will learn immeasurably about yourself. The dying will teach you how to live. For me it wasn’t depressing, it was a sacred privilege. It was awe-inspiring!

A friend of mine, Bonnie Connor (www.reverendconnor.com), had plaster casts made of her parent’s hands. It’s a beautiful pose, with her father’s hand placed over her mother’s. Her parents were married for fifty-two years–when her father had just turned sixteen, and her mother had just turned seventeen. When Bonnie’s mother died, this was an invaluable keepsake for her father. When Bonnie’s father died a few years ago, this became a familiar, comforting keepsake for Bonnie.

I remember studying my own parent’s hands when I was a child. I must have spent hours gazing at the colors the diamonds in my mother’s wedding ring reflected. Those diamonds were magical. And I heard the story over and over about how this ring was a Christmas present years after they’d been married. They’d eloped during the Great Depression and there was no money for rings at the time. I spent many hours watching my mother paint her fingernails the reddest red imaginable with Revlon polish. Her hands seemed so glamorous and exotic to me as I watched her smoke a cigarette or drink a coke out of a bottle. I remember her slightly enlarged joints from the beginnings of arthritis, and the permanent indention on the middle finger of her right hand where the pen rested when she wrote in her perfect teacher’s cursive script.

Thinking of my mother’s hands brings back hundreds of memories of all the activities I watched them do during her lifetime. I cannot wash dishes without thinking of my mother, and instead of this being a dreaded chore, it’s a little place of respite where I spend a moment of comfort with my mother. I can only imagine the memories Bonnie must have every time she looks at the casts of her parent’s hands.

Professional artists, such as http://www.lifecasting.net/home_page.html, can make casts for you. This is who made Bonnie’s parent’s casts. There are also recipes, instructions, and even a youtube video on the web if you want to do it yourself.

Hands inspire memories. A cast of your parent’s hands can be a personal, comforting, and unique keepsake.

When a person is dying and confined to his home, or his bed, he will probably need help keeping in touch with family and friends. As a caregiver, there are several things you can do to help him. You may need to help him organize his address book, or program his speed dial. You might ask if he wants a supply of greeting cards and stamps. If he wants to send cards or letters, you may need to set him up with a lap desk, or prop pillows in his lap (and behind his back) and use a hard surface (like a clipboard or a large book) for him to write on. Or you may need to let him dictate the note while you write for him.

As a caregiver, you could set up Skype or help him with FaceTime if he wants to visit face-to-face remotely. You might help him with Facebook to reach a lot of people with a single post, or help him set up CarePages to reach everyone he wants to send a medical update to, and also reach out for help if he needs it.

Ask him who he would like to visit, and help him schedule times for friends to come that won’t interfere with hospice or other medical care. Hospice patients sometimes have visits from up to six or seven different hospice disciplines, and sometimes these caregivers visit more than once a week. Or if the dying patient is in a nursing home, the schedule can be even tighter. You may need to schedule visits around the nurse, home health aide, chaplain, occupational therapist, speech therapist, physical therapist, social worker, and/or volunteer. You also need to take into consideration when his energy levels are up to a visit, and be ready to cancel the visits for him at the last minute if he says he doesn’t have the energy.

A person who is dying still has many social needs. Often, they become isolated because friends are uncomfortable visiting. This is why I wrote the book The Last Gifts, and why I’m writing this blog, to show people how to use activities as a catalyst to a deeper conversation.

Be kinder than you think you need to be–everyone is fighting their own battles. I saw this note on a break room refridgerator at a healing center. I loved this sign so much, I wanted to make t-shirts.

In our society, we don’t know when someone is grieving. They don’t wear black armbands. They might get a day, or two, or three off from work. Then they’re expected to go back, and be 100% productive. I can guarantee you, they are not.

I have friends who are grieving right now. I remind them frequently that grieving is the hardest work they’ll ever do. They do it 24 hours a day, even when they’re asleep. Their brains are tying to adjust, to make sense of the loss. I remind them to take their vitamins, get lots of rest, give themselves permission to do only what they feel like doing. I encourage them to take their own car and follow instead of driving with a friend. Going out to dinner, or a movie, or even a party may seem like a good idea at the time. But in a split second, it may become too overwhelming, and they may wish they were anywhere else. A person who is grieving may want a hug, and the minute they are embraced, they may feel claustrophobic. It’s a difficult time. Emotions can vary from moment to moment.

This saying also applies to people who are dying. Some people become short with their caregivers who are often the people they love the most. Stephen Levine says that the flu prepares us for death. I understand this. I know when I had the flu a couple of times, there was a point where I was suffering so much, that I pretty much felt willing to die. Of course, I wasn’t really dying so this was just a concept. If I had been dying I might have felt differently. I can’t know. But I do know that I was a bit short with my caregiver who was only trying to help. “No  I only want a coke and dry toast, not soup.” Couldn’t he see how sick I was? Couldn’t he read my mind? Of course not.

So I encourage you (and remind myself) Be kinder than you think you need to be–everyone is fighting their own battles.

In the past fews blogs, I’ve been writing about a good-bye letter from a dying parent to his or her child. In this blog, I’d like to expand that idea.

The good-bye letter could be from the dying person to a niece or nephew, a godchild, or any child who is special to him or her.

The good-bye letter could also be written to a spouse or partner. In writing this letter, I encourage you to write the most loving, sensual, thoughtful, intimate letter that you have in you. Don’t hold back. Tell the person what they mean to you and how you will always love them.

I also encourage people who are dying to write good-bye letters to their friends. Again, don’t hold back. Tell them how much you value their friendship and why. Talk about special memories, how they helped you through times of hardship, or how they provide  a mirror so you can see and understand yourself more clearly because of your friendship with them.

I recently read a novel about four women friends. At the beginning of the book, one of the women is dying. She has written a journal for each of her three friends. Throughout the rest of the book her friends are referring to their individual journals from her in an effort to cope with their loss. They also use the journals to find answers to major questions in their own lives through the words she’s written to them.

I love this idea of a journal. However, this is completely overwhelming to most people. I encourage you to start with the short instructions in the first blog in this series. The simplicity of this letter provides the receiver with a tangible memory of you, and a lasting memory of your love.

In the letter below, Paloma tells her daughter the three things that I believe are essential in a good-bye letter from a dying parent to a child. They want to know that they were loved, that you were proud of them, and they want to know something about your relationship, from your perspective. Paloma was religious and her letter reflects that. Your letter might not look anything like this, but it gives you an idea of where to start.

Dear Becky,

I am so honored that God chose me to be your mother. In our short time together, you taught me so much about love. There were so many things I wanted to teach you, and so many places I wanted to show you, but there wasn’t enough time.

I could never have thought to ask God for a child so sweet and kind to all living beings as you are. Even when you were very young, you were instinctively gentle with animals. You are a child of peace. When I was so sick, you brought ginger ale to calm my stomach, or you rubbed my feet to help me relax. You mothered me when my biggest wish in the world was to be able to mother you.

I wanted to be there for every moment of your life. I wanted to be there to comfort you when times were hard and celebrate each of your accomplishments. I am so proud of you. You had to develop strength in your heart and find your own path so much earlier than most. I don’t understand why God separated us so early but He had a plan for each of us. What I most want you to remember all of your life is that God loves you. When you make mistakes, and part of being human is making mistakes, you simply have to ask His forgiveness. You are showered with His love every minute of your life.

I pray that you will have a long, happy life. Always, always, always know that you are loved. The love I feel for you transcends the thin veil between heaven and earth.

Love,

Mother

This letter was condensed from The Last Gifts. In the book, Paloma’s letter is about twice this long. She gives Becky some more advice, and writes quite beautifully about her wishes for Becky’s life. However, if she had chosen to stop where I stopped in this blog, she covers the three elements that I listed earlier.

I hope I’ve provided you with enough information over these six blogs so you’ll feel comfortable writing your letter.

Good-bye letters don’t have to be limited to parent and child. In the next blog, I’ll write about good-bye letters to others.

What do you most want to tell your child? Can you sum it up in one sentence? One paragraph? Is it about you, or him, or someone else? Is it clearing up a rumor or misperception that has followed you all of your life?

Bobby was 29 years old, lived in a nursing home because of the care he needed for his ALS (Lou Gehrig’s Disease), and rarely got to see his 6-year-old daughter, Kim.  I suggested that Bobby might want to write a letter to his daughter about special memories he had about her–how he felt the first time he saw her, her first words, sweet memories he had of her, etc.

The next time I visited, Bobby had typed twelve pages and he wanted me to read them. There was little about how he felt about this daughter or his experiences with her. It was a confession and I felt uneasy as I read about his sordid past. At first, in my mind, I judged it. After I thought about it for a while, I realized it was perfect. He knew that all Kim’s life she would hear only one side of the story and he needed to be able to tell his when she was older. “Yes, I treated your mother badly. Yes, I had an affair. And yes, I’m sorry for all this.”

Bobby requested that the letter be given to Kim when she was eighteen. Most dying parents choose a time that they want the letters to be given. I always recommend that children are not given the letter on their birthdays. Birthdays are happy occasions. No one can be happy and sad at the same time. It will be a significant event in their lives to receive this letter, and there will probably be some feelings of loss, even if the child was very young when their parent died. I encourage the dying parent to trust the person delivering the letter to know when it is the right time.

I also encourage parents, if at all possible, not to die with secrets to be revealed later in letters. Kim knew her dad had been unfaithful to her mom. Bobby’s letter was just one more chance to say “I’m sorry.” It feels unfair to have a secret revealed when the parent is not there to discuss any potential questions. I just wanted to mention that, but each parent has to make the best decision about what should go in a letter. You’ll do your best for your child–that’s why you’re writing the letter.

Next week in the final blog in this series,  I’ll give an example of a good-bye letter.

This week we’ll talk about the question How do you want them to remember you?

You might want to write about whatever is important in your life, that you want to be remembered for by your child. A couple of days ago, a friend whose mother died this year was telling me about her many talents. She knitted, played the piano, and cooked fabulous meals. She encouraged her children to express their feelings openly. She loved Christmas and spent days decorating the house every year. This was a woman who had six children and whose husband died when many of her children were still young. Even though she worked outside the home to support her family, she provided a rich, warm environment where her children felt safe and loved. As adults, they carry her values. But how many of the details of her life will he remember in ten years? In twenty?

What do you want your child to remember about you?

• That you served your country.
• That your favorite part of being a mother was picking the kids up after school and listening to their stories about their day.
• That your dream was to become a professional saxophone player, but you went to war instead.
• That you once hit a hole in one.

The memories can be profound, or just fun. It’s how you want to be remembered.

My own father died when I was 18, and mother died when I was 28. There are so many things I don’t remember about them now. I wished I’d asked them more about their lives before they met each other, but it didn’t seem important at the time–I thought they’d live forever, or at least much longer. And now it’s too late. So I encourage you, while you have a chance, to write a little about how you want your children to remember you. And someday, they may be able to tell their children about the qualities their grandparents passed on to them.

In keeping with our topic of the good-bye letter from parent to child (and keep in mind that I’m also talking about adult children), here is another suggestion.

Is there something you can say to help them cope after you’ve died?

You might reassure your child that you had a full, happy, long (or whatever is true for you) life.

There might be healthy ways you can suggest to help them find solace. Because they will all be going through grief together, you might suggest they keep in touch with family. However, it’s important to point out that people grieve in different ways, and they should not judge each other on these differences. Some people are active grievers and must be “doing something.” So if your brother suddenly goes to the gym to work out for two hours every day, that may be his way of grieving. It may look like an escape from grief, but it may not be.

You might also suggest they get in touch with friends–your friends or theirs. It’s helpful to keep in touch with your friends, because if they have questions about you later, your friends may know the answers. It’s important for them not to pull away from their friends (probably their main support system) at this time. However, if their friends haven’t experienced the death of a parent, they can’t possibly understand what your child is experiencing. They can imagine it, and hopefully empathize, but to truly understand it, it has to be experienced.(I had a 60-year-old friend say this to me only last week. ” I haven’t been sympathetic enough to friends who have lost their parents. Until it happened to me, I didn’t really understand what they were going through.”)

You might suggest they reach out to their community (friends from work, neighbors,etc.), or to a spiritual community (depending on your family’s beliefs), or to God. Very often when someone dies, there is a period of time when the bereaved person is angry at God. You might even address this in your letter, saying it’s only natural.

This is a time for them to let themselves depend on others. This is a time to let themselves feel what they feel. If they try to stuff it down, it only comes back later.

Grief lasts longer than we expect, so it’s a good time to ask for support. I heard a story about a woman whose Mother died around the holidays. On the second year after her mother’s death, she sent a Christmas ornament with a note attached to each of her friends. The note simply read, “The anniversary of my mother’s death will be soon. Please call me for lunch or coffee.” I thought that was a great way to ask her community of friends to support her. She may have not been able to pick up the phone, but sending the small gift with a note was, in my mind, brilliant.

Asking for help at this time is not a weakness. In many other cultures, the bereaved are given support for much longer than here in the U.S. Here, it is common to get only three days off work if a family member dies, and then you are expected to return to work at 100%. With this being the cultural attitude, we accept this as normal. It isn’t.

And finally, as a parent you might want to encourage them to go to a grief support group. In a support group, often sponsored by hospices or churches, they will be with people they don’t know (which sometimes feels safer) who are going through a shared experience. Hearing their thoughts and feelings helps normalize the experience of grief. If they don’t feel like their grief is moving along normally, they can seek the help of a grief counselor, someone who is an expert in this area of therapy.

We’ll talk more about grief in future blogs.

Last week we looked at the importance of a good-bye letter from a dying parent, and how to write the basic letter. In my experience, by answering the questions in last week’s blog, you’ve written a perfect letter and you can stop there. These letters don’t need to be long, but some people like to write more, so I’m going to give some steps of how to do that.

Some other questions you might want to consider for writing a letter to your child:

• How do you feel about each child individually?
• What influence do you want to have on their futures?
• Is there something you can say to help them cope after you’ve died?
• How do you want them to remember you?
• What do you most want to tell your child?

I’ll cover the first two questions today.

How do you feel about each child individually?

If you have several children, try not to write the same letter to all of them. A good way to differentiate is to ask yourself how you feel about each child individually. What is special about this individual? What is special about your relationship? An easy way to start is with their birth order and then mention a special talent.

Barbara, my third-born child, you have always amazed me with your creative way of thinking. Where did that come from? Certainly not  from me, nor from your father. You are your own person. My hope for you is that you continue to let your creativity flow in whatever form that takes in your life. It makes you passionate about anything you pursue, whether you’re solving a complex problem or drawing a picture. I love being your mother.

Now if you write a sentence like “I love being your mother,” you probably need to put that in all of your children’s letters. Most siblings are going to want to see the other letters.

What influence do you want to have on their futures?

I encourage you to make this as general as possible. If you have specific goals for them and they don’t meet them, they may feel guilt when they read the letter. Below are a few lines from Paloma to her daughter in The Last Gifts: Creative Ways to Be with the Dying.

Here is all the advice I get to give you. Be your own person. This is how you do it. Don’t be hypnotized by society. Always do what feels right to you even if it’s not the norm. Listen to yourself for guidance. Second, always ask for what you need and want. You may not always get it, but you sure won’t get it if you don’t ask. Be fearless about this. I didn’t learn this lesson until I had cancer. And third, put some effort into being healthy. Try to eat some healthy food, have friends that you love, and balance work, play, and rest.