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  READ MORE: As a hospice nurse, my experiences have led me to believe in an afterlife. The moments I’ve shared have reinforced this belief.
  

As an oncology nurse, a 44-year-old patient called Madeline profoundly altered my understanding of death.

She had gallbladder
cancer
One day she fractured her hip. She was taken to the hospital with her sister by her side. A few days later, a clot moved from Madeline’s hip to her lungs, reducing blood flow throughout her body.

When she expressed gratitude to her doctor for everything that had been done, it became evident that Madeline understood something the medical team hadn’t realized just yet—she wasn’t going to make it through this ordeal.

One evening after she woke up from a nap, she exclaimed, “Call my sister! I’m transitioning!”

She expressed it with so much enthusiasm, like someone stepping into an unfamiliar land for the very first time, eager for a fresh and exciting escapade.

Her experience was truly what I’ve begun to refer to as a ‘
good death
.’ She was not only unafraid but even enthusiastic about experiencing it.

Could you envision this? She had the ability to perceive and experience things that many of us cannot, and just observing her journey through it was remarkable.
altered my perspective on death
.

Not everybody goes through what Madeline experienced finally, and I felt awful working in conventional hospital nursing because we didn’t have sufficient time with our patients.

Therefore, despite having minimal practical rationale, I followed my instincts and entered the field of hospice nursing. After doing so, I noticed distinct trends across numerous patients which alleviated my anxieties surrounding death and transformed how I choose to lead my daily existence.

No matter what someone’s cultural origin or spiritual beliefs may be, there are four universal statements that terminally ill individuals often make towards the end:

There isn’t any end. I’m heading home.

Regardless of whether they converse with deceased loved ones or held such beliefs throughout their lives, they appear to know that they are going back to a place that feels familiar and doesn’t necessitate having a physical form anymore.

There’s always a purpose behind every occurrence.

I’ve heard numerous terminally ill patients say they finally grasp the reason behind some of their harshest experiences.

They experience a moment of clarity regarding the insights gained from their past learnings and realize how these occurrences were crucial and beneficial for their development and transformation.

This experience can be seen as a form of ‘life review,’ accompanied by an unexpected surge of insight that may have escaped them for much of their existence. This bestows upon them great solace, as they no longer perceive themselves as being punished or believe that their suffering occurred haphazardly.

There is no judgment.

Often, they come to understand that the errors made in life stem from being human, leading them to experience an emerging sense of forgiveness — both towards themselves and others.

It is said that there’s no accountability or penalty after we die. Rather, every action they took was for the sake of learning, and what endures is only love.

We are all interconnected through one infinitely loving force.

Those who were previously biased or held grudges frequently end up realizing that we share a common bond—people from various backgrounds, faiths, and nations alike. This realization fosters a profound sense of unity not only among humans but also with all forms of life ranging from creatures to plants, down to even the smallest particles.

It’s a deep spiritual journey that can often astonish those close to them, significantly smoothing the path from living to passing away.

Besides these four statements commonly made towards the end of life, there are also
other phenomena
That are extremely prevalent among those who are terminally ill.

They experience a surge of energy.

This phenomenon is frequently referred to as an “end-of-life rally.” Despite being unresponsive for extended periods—weeks without speech or movement—they may suddenly come alive momentarily with unexpected energy, both physical and mental, to bid farewell and convey their affection before passing away shortly thereafter.

They determine the date and time of their death.

I’ve encountered numerous individuals who held back from letting go until after waiting for a certain event. These events could be anything like their personal birthdays, wedding anniversaries, or the birth of a grandchild.

For instance, I know of a woman who remained in critical condition for ten days before passing away just four hours past midnight on her 100th birthday.

Those who are nearing the end frequently hold on until a significant person can come see them to bid farewell, or they linger seeking approval to depart due to concerns about abandoning those dear to them.

In such situations, it might be beneficial for them to hear a soft “I love you and will miss you, but it’s alright for you to move on. I don’t wish for you to endure more suffering.”

Occasionally, they wait till a beloved person exits the space.

This process can be distressing for those remaining, yet hospice nurses are thoroughly familiar with this occurrence. Consequently, they ready the family and friends for such an eventuality. The departing might wish to shield us from enduring the anguish of seeing them take their last breath, potentially viewing it as their ultimate gesture of care.

Even when the person nearing death is in a sleep-like coma, this occurs. Somehow, they can still tell whether we exit the room or not.

They discuss encounters with the deceased—even when they are awake, not only when they are sleeping.

Studies have revealed that up to 72 percent of those passing away speak about communicating with relatives and friends who have previously passed on.

Some individuals may disregard such experiences as mere illusions, yet it could be equally plausible to consider them encounters with deceased entities. Numerous loved ones and acquaintances find solace in this belief and view it as proof that our essence endures even after death, merely transforming into another state.

Regardless of whether you think the deceased are contacting the ‘other world,’ the most appropriate action is to acknowledge their experience.

I once met a terminally ill woman called Helen who mentioned that her deceased spouse would be joining her over the weekend to go dancing, so she required an outfit for the occasion.

His niece discovered an exquisite gown inside the wardrobe, alongside shiny red leather footwear which she positioned in Helen’s bedroom so she would spot them daily. Helen passed away peacefully over that weekend.

Following numerous encounters with terminally ill patients, I started living each day like an entire existence unto itself. Since this could potentially be my final day, I aim to embrace every moment completely and derive joy from even the tiniest, loveliest instances that cross my path.

I search for ways to provide the utmost service to others, whether it involves something as basic as giving a smile to an unfamiliar person or simply holding a door open for them.

I follow my internal compass, much like when I moved from working on a general hospital ward to caring for patients in their final days at a hospice facility where I discovered my genuine passion. Similarly, this intuition guided me when I departed from hospice nursing to establish the Doulagivers Institute, enabling me to teach not only professional caregivers but also families how to more effectively navigate and cope with end-of-life situations.

I aim to avoid judging both myself and others, viewing life much like those nearing the end do—seeing each experience as a lesson that helps us grow into better individuals. I recognize the interconnectedness of all living things and seek the divine in every aspect around me.

I also emphasize gratitude daily, yet what I appreciate the most are the numerous patients who revealed to me that there is indeed beauty in passing away. These individuals demonstrated that both our existence and departure form an unbroken, holy journey we all embark upon together.

“The Good Death: A Handbook for Helping Your Dear Ones Through Their Final Days” by


Suzanne B. O’Brien is published by Little, Brown Spark on March 18.

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