Peace and Reconciliation at the End of Life

Some patients identify a need for some type of reconciliation; others feel there is a barrier standing in their way from having a peaceful death. Others need certain circumstances to die peacefully, like choosing the time to die or choosing who needs to be present.

When a dying person realizes what he or she needs, they may become concerned or feel a sense of urgency that might result in agitation. When a person can express himself or herself, requests are easier to understand. Requests that are vague or indirect, however, may be ignored or missed all together, leaving a sense of frustration, anxiety and, at times, agitation. If the awareness of a need comes late in the dying process, a person may actually delay dying in an attempt to settle the issue.

Need for reconciliation is probably the most important theme identified and is often very necessary in order for a person to feel complete and die peacefully. Underlying issues tend to revolve around reconciliation of relationships, including relationships with other people or a supreme being or themselves. Some people feel that an aspect of their behavior has been morally or ethically inconsistent with their values or standards. This affects the relationship with ‘self’, because intense sadness or feeling of guilt can prevent feelings of peace.

One way to discover a need for reconciliation is to encourage a mental inventory of accomplishments or disappointments with an exploration of tasks not completed or opportunities missed. This exercise can be done orally or in writing.

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