Noble Dying: Active Dying · Noble Living, Noble Caring, Noble Dying

Awareness and Vigiling at the Bedside

By Andrea Sherman
In this article, Andrea Sherman discusses vigiling, or being present at the bedside during the final hours of a person's life.

Vigiling with those who are dying is being present at the bedside during the final hours of a person’s life. To sit vigil is to sit and keep compassionate awareness and a sacred invitation and privilege to share presence with a dying person, so that they are not alone, until the moment of death. Often we vigil in the last 24-36 hours of life, but it can be a longer or a shorter time. During that period, it’s important to be mindful and aware, to be a witness and companion with a compassionate, kind, and gentle presence.

It can include the acts of breathing with silent contemplation, praying, talking, sharing music, legacy, reflecting on a person’s life as well as performing rituals. A vigiler accompanies a person from life to death, while providing whatever is necessary to make the transition peaceful. We recognize that death is a sacred transition, and we, the living, are honored to be in its presence.

Awareness

As a person who vigils, your goals are to be a companion through death, through the bardo, through the transition between life and death. To bring your open awareness to the bedside, and leave any goals behind, but to be present for whatever arises.

Be open to the energies, dynamics, feelings, and person who is dying, as well as to the people who are in the room. It’s good to practice awareness—to bring your calm and abiding peace to the bedside as you care for the dying. A vigil may be quick, or it may take several days as the person’s body, speech and mind begin to shut down. Hearing is the last sense to leave the dying person. We pay attention and bring our wisdom and skillfulness to the bedside along with our gentleness, and that can even be through compassionate breathing, entrainment-breathing with, with loving kindness, while maintaining awareness that they can still hear.

It’s important not to be distracted by your thoughts and by your wandering mind. Rather, be attentive and adapt as you go through the vigiling process. Of course, the most important is meeting the needs of the person who is dying, being attentive and wakeful as you vigil.

This awareness is a skill you can develop through meditation, as you practice calm abiding and bring your attention to your breath when your mind wanders. This is the same practice that you can do at the bedside as you sit, breathe, and are open and aware to the person who is dying.

It’s said that awareness is the knowing quality of our mind, and this is important when you are vigiling with a person who is actively dying in the last few days or weeks of their life. A key element of this awareness is paying attention to when your mind is distracted while you are caring, while you are vigiling. Phakchok Rinpoche says that the more familiar we become with our awareness, the more we enter non-distraction. Distractions are everywhere in the room: sounds, the breath of the person in the bed, dynamics of those in the room, temperature, and room environment. Our minds are distracted by all of this.

So we practice awareness, we stay open to the person who is dying, we don’t close, though they may grasp your hand, moan, breathe heavily, we stay open to their journey and stay aware. We keep our focus and stay present. Using our senses to see, hear, smell, and touch. We do not become distracted  by our own strong emotions as someone is dying.

There can be a lot of stimuli. If death occurs in a hospital or institution, there can be many things that pull a dying person away from the act of dying. Part of vigiling is maintaining that calm space with our presence and actions. Awareness notices when we are distracted and brings our minds back into the knowing quality of our mind. We let go of our inner conversations, our emotions, our judgements, our flickering thoughts, and their distractions.

Artwork by Jayne Feinberg Stuecklen.

Sitting vigil is about being present and creating a supportive and compassionate experience. It is about being. You can meditate, pray and bring a calming presence by sitting quietly, and holding the space with meditation or prayers. Providing support, nurturing, and your time, and touch are part of your presence. Presence is an active state!

Generosity

Practice generosity: The starting point of generosity is simply opening ourselves to others. If you feel yourself absorbed in your own personal concerns, simply bring your attention back to the person who is dying. If they want to talk, then talk together or just sit together with the person who is dying.

A person who vigils can transform a frightening and often difficult time into a sacred time as you talk and listen, share silence, read inspirational texts, provide healing touch, use music, and create rituals.

Intimacy

Part of the vigiling process is intimacy. Intimacy with the person who is dying and intimacy with ourselves. We listen, listen, and listen as we vigil, we care. We remember to honor our cultural differences, cultural practices, and the surroundings in the room.

Environment

The environment at the bedside is important, and may include lights, fresh air, room temperature, smells, sounds, music, conversation and medical alerts and machines at the bedside. Your goal is to provide ease for the person who is dying, so that their dying is not filled with disturbing events. Peace is important. If needed, you may find it helpful to speak to the family or staff and calm any anxiety that may enter the room, reminding them that death needs calm, compassion, and respect.

The most important element of vigiling is knowing what gives meaning to the person who is dying and offering that. Sitting vigil with those who are dying brings our own relationship with uncertainty, death, and impermanence. We are also dying. Death teaches us to be alive.

Remember awareness is being present and it is not the same as sitting still. We bring our body, speech and mind to the bedside. We sit like a mountain, cultivating mindfulness. We tune in to the person. And we take care of ourselves.

Boundaries

Be aware and respect boundaries. This includes physical boundaries, (how close you sit or stand), spiritual boundaries (don’t impose your spiritual beliefs and practices on others) and emotional boundaries (keep your voice calm). Pay attention to any nuances, signals, intuitions, feelings that you may perceive. They may be subtle, but the more you vigil, the more you will become attuned to the person who is dying.

We are all engaged in taking care of each other. We are all engaged in compassionate care. We are interbeings.

Practice Kindness

Let your kindness into the room, practicing kindness and tenderness for the person who is going through the transition from life to death. You can sit, hold the person’s hand, ask them if they need anything, and if you know the practice of tonglen or sending and taking you can practice it at the bedside. Breathing in the person’s suffering and sending them ease and courage on their journey, your calm presence is very important. Stephen Levine said:

It is essential to remember that death is inevitable, everyone dies, though the time of death is uncertain. Providing comfort care to relive suffering includes physical comfort, mental and emotional needs, spiritual issues, and practical tasks. Care that soothes and care that conveys to the person that you are there for them. Holding hands, touch, gentle massage and music, and silence can be helpful.

Artwork by Jayne Feinberg Stuecklen.

You can assign a “doorkeeper” to help transition those from the outside space into the bedside/calm area. From time to time during the vigil step outside the bedside and refocus. You can ask friends and family who are far away to keep vigil through shared prayer.

As Phakchok Rinpoche has said:

Be conscious about what you do. Don’t be like a blind man; see what you are doing through the actions of your body, through your speech and most importantly through your mind. Be Mindful.

What Vigil Volunteers Do

  1. Bring a calm presence.
  2. Sit together, and provide companionship.
  3. Talk together and listen.
  4. Pray and share silence.
  5. Provide healing touch.
  6. Read inspirational texts or scriptures.
  7. Perform rituals.
  8. Play inspirational and soothing music.
  9. Listen and or create a life review or life stories.
  10. Support family members.

Self-Care While Vigiling

  1. Take care of your needs first so you can support others.
  2. Meditate beforehand.
  3. Be a compassionate and active listener.
  4. Use your intuition and provide support for the dying person’s belief system.
  5. Avoid burnout, stresses, emotional distress, and unrealistic expectations.
  6. Don’t vigil if you are sick or emotionally strained.
  7. Don’t vigil too many days in a row.
  8. Have a snack. Drink water. Silence your phone.
  9. Exercise. Work with your own energy, whatever it is today. Take a walk, wash your hands, get fresh air. 
  10. Wear comfortable shoes.
  11. Feel gratitude, for vigiling is a privilege and an honor to be invited into.

Further Resources

Please check out our new Noble Living, Noble Caring, Noble Dying resource center. This new page will allow you to easily explore these precious resources.