Practicing Compassionate Presence at the Bedside
Being present at the bedside of those who are dying can be a deeply profound experience for everyone who is involved. It may be filled with an array of feelings, anguish, physical pain, and loss. In addition, it can also be a gateway to the spirit’s journey and a doorway to the mystery of death. Sometimes there are unresolved feelings, regrets and distress. Whatever there is, your goal is to provide ease and comfort for the person who is dying, and at times for the family and for friends.
Compassionate Presence Allows for Adaptation
One of the best practices is compassionate presence at the bedside. When we are present with our compassion, we see the humanity and suffering of another, and that helps us to engage in the present moment. We can then adapt and shift with the changing reality of the person that we are caring for. And we can maintain our own balance and our resilience, because when we take care of ourselves, we are better able to care for others.
To be a compassionate caregiver, first bring your whole self to your caring. Be mindful and aware. The discipline and attention of your awareness has a quality that is spacious and compassionate, warm and tender, and this can permeate the atmosphere at the bedside. When we are present, we are present to our precious human life, and to death, and to being wakeful like the Buddha.
Sometimes compassionate presence is referred to as consoling presence. This can take the form of sharing consoling silence, which can ease the loneliness of suffering and have a powerful effect on the person who is dying. Healing touch, tone of voice, an open and awakened heart, and practicing being rather than doing are all components of compassionate and consoling presence.
When you are present you can embody compassion, calmness, attentiveness, kindness, warmth, and discipline. As in your meditation practice, you can bring your clear, awake, awareness of your thoughts and of your feelings. Present moment awareness is rich, compassionate, and tender. There is a dignity in providing care and in receiving care.
Just before entering the room, you can do the PAUSE practice. Before entering the room, pause, take a moment, take a breath. Then quietly say the person’s name who is dying. It is very helpful to take a moment to catch your breath, and to ground yourself before you enter the room. Stop and be present. As you quietly enter, pay attention to the details in the room, the physical, emotional, social environment, the atmosphere.
Practice panoramic awareness, learn to “read” the room, to see what the
environment of the room is. Is there an uplifted or oppressive quality? What are the clues? Use your observation skills. Is the room orderly, clean, does it smell, what objects are in the room-are there religious objects, symbols, photographs or music, are the blinds open, or closed. It is a skill to bring your panoramic awareness to the bedside.
The space around a dying person can make them feel supported and held or it can create a feeling of messiness and chaos. You can add love, protection, healing, and comfort to the space. Make sure, that if needed, there are chairs nearby the person who is dying and that there is space to sit and to stand.
Along with panoramic awareness another practice at the bedside is deep listening. If the person who is dying is able to speak: listen and hear to the meaning beneath their words. Listen carefully, listen actively. Listen without judgement, with a warm and awakened heart.
Listen to others in the room, especially if family and friends are weeping, and grieving. If possible, you can direct them to take a few moments and to step outside of the room and catch their breath. If people are arguing and or angry, it’s also best for them to step outside of the room for a few moments, and have any needed discussions. We can guide others through our compassionate presence-our gentle kindness and calm.
Sometimes prayers, music, poetry and rituals can provide comfort and ease. You might want to create a small semicircle of people around the bed, and incorporate any symbols, traditions, prayers or blessings if appropriate. At the bedside, when listening maintain eye contact with the person in bed. You can communicate at eye level if possible and use a soft touch and embody a welcoming and warm presence. Sharing deep silence can also be therapeutic and healing.
Notice when you are not listening, when your mind is distracted or spaced out. Then, reconnect with the present moment over and over again. Just like in meditation. Quiet your mind. Remember that being present is not the same as sitting still. When we are present we connect with our awareness, with presence, with compassion. We connect with our body, our silence, our speech and our mind. We tune in!
Sitting at the bedside, I am you, you are I, we are present together. Interdependent. I am here for you, mindful, and aware.
Sometimes those that you are caring for may be in pain. Pain and suffering can be profoundly distressing. This is an important time for you to remain calm, to use a soothing voice and gestures, and to connect deeply with your own compassion and mercy and to be aware of the person who is suffering- to practice bodhicitta, with an awakened heart.
It’s vital for you as a caregiver to find a place of calm and rest in the middle of the dying process, to take time to restore and renew yourself. Leave the room if possible for a few moments. Look at the sky, become aware of your breath, drink a glass of water mindfully, have a snack. Take a walk, move your body, especially if you have been sitting a lot.
Rejuvenate, reenergize, rest. Then, you can reenter the room with renewed energy and bring your compassionate presence back into the room with you. As Phakchok Rinpoche says: “Remember, compassion does not drain you. What really drains you is when you try to practice compassion while being absorbed with yourself. Check for yourself.”
Offer your care, knowing that it may be met with anger or indifference or spiritual distress. If you yourself are uncomfortable, be open to your own areas of discomfort and distress. See your own limits with compassion. The only tool that you have is yourself. Bring your compassion to the bedside, and to yourself. Care deeply. Let any anger or confusion dissolve, let go.
It is possible that the person you are caring for at the bedside has confusion, and or dementia. If the person does not recognize you, don’t take it personally. See if you can help them comfortably to a state of peace and acceptance. No matter what, help and support them with your calm and soothing presence.
Let peace and clarity permeate to the bedside. Be in the open space together. Present. Remember it is a blessing, each act of caregiving. We enter the spiritual landscape of dying, with our compassionate presence and awakened heart, aware of life, and aware of death.