Author: This moment Matters

The simple answer to that is “Yes”.

You are allowed to transport a deceased person yourself.

So, from your home to the funeral service or from hospital or hospice to home or place of rest.

Many engage the services of a funeral provider for transporting their loved one but it’s not a legal requirement.

What is a legal requirement is that the body is covered – that might be in cloth or in a coffin.

You may wish to notify the local police of your intended journey but there is no requirement to do so.

Your car does not need to be registered to carry the coffin to the crematorium or burial grounds.

Many years ago, during my time in children’s hospice, a family who were known well to the hospice team, found themselves doing just this when their teenage son, M, died in hospital. To this family, the hospice was an extension of their family and their wish was for him to rest and be cared for here until the funeral.

Just a few hours after M’s death he was wrapped in a comforting sheet and gently placed into the boot of their estate car by the hospital staff and driven for more than an hour to hospice.

They drove in, parked up and we greeted and welcomed them back with the hugs that any loving family would offer at a time of shock and intense grief.

I remember, so well, their moment of arrival. The sense of loss that can only be imagined by another parent whose child has died intertwined with such deep love and affection.

I was on shift and assigned and entrusted, with another member of the team, to carefully bring M inside and settle him into the Rainbow Room.

A few years later M’s parents fondly reminisced about that very special time with M in their car (as opposed to a strangers car or hearse) and the following week spent at the hospice with his siblings where they could sit with him whenever they wished, day or night and other family members and friends stopped by for a visit, for lunch, for support.

Transporting your person yourself may not be possible or a choice you would personally make but it’s reassuring that we do have that choice.

The only caveat is anyone wanting to move a body out of England and Wales (including to Scotland) must have authority from a Coroner.

Nancy xx

Anticipatory medicines.

What are they, what do they do and who are they for?

Anticipatory medicines are prescribed in advance to people who are receiving palliative care and approaching end of life.

Not everyone will be prescribed them and not everyone will need them (even if they have been prescribed them).

These medications will be kept at the home of the person who they have been prescribed for or within the facility they are being cared for so they are ready for immediate use.

Ok, so what are they for?

Anticipatory medicines are a way of ensuring a person has access to relief should they experience any distressing symptoms during any stage of their illness and, particularly, in the active stages of dying.

To reiterate – they are “just in case” medications. They may not be needed at all.

The most commonly prescribed anticipatory

medicines are:

Morphine – to help control pain and breathlessness.

Midazolam – to help control restlessness.

Levomepromazine / Haloperidol – to help control sickness.

Glycopyrronium – to help control secretions.

All are usually injectables or administered via a syringe driver by a medical professional.

Ultimately, they are put in place to help relieve suffering.

Some people find they are a comfort to have at hand.

Others are afraid and resistant.

There’s one thing I feel I need to make absolutely clear.

Anticipatory medications DO NOT hasten death.

So please try not to be afraid of them when they are offered.

What’s important to me, as a doula, is to have had these important discussions with the person and their family ahead of time, ahead of their intended use so they can make an informed decision and we are all absolutely clear on the person’s wishes regarding these medications. This can all be documented in an Advance Decision or, as it is sometimes known, ADRT.

I prefer not to assume, particularly regarding anxiety or agitation that medication is immediately required and that other avenues of physical. emotional, psychological and spiritual comfort have been explored first.

I have talked a little about secretions before (secretions don’t necessarily equate to suffering) but I will write a more specific post about this as it requires one all of it’s own.

However, if there is any doubt, the aim to minimise suffering for the person must take precedence.

I hope this is helpful.

Nancy xx

Denial can be fleeting, a guest (welcome or not) that stays for a while before retreating or a constant companion.

It can present itself whilst grieving, when given a terminal diagnosis or following a trauma.

But here’s the thing.

Denial is not the failure it is portrayed to be.

This is a quote by Elizabeth Kubler-Ross

“Denial helps us to pace our feelings of grief. There is a grace in denial. It is nature’s way of letting in only as much as we can handle.”

Nancy xx

Some people glide into the next year without any thought for the date and others celebrate with wild abandon.

And, of course, there is everything in-between.

There may be no miracles that happen as the calendar year turns from 2022 to 2023 – you are still you and your life doesn’t suddenly change, however, there is a subtle mental shift.

As we drift over the seconds of midnight whether you are awake or asleep, conscious of it or not, you will have one final 2022 outbreath and take your first inbreath of 2023.

New resolutions or intentions aren’t necessary, and yet, ceremony and ritual can bring resolution, comfort and hope for this shift in time.

Since ancient times, the use of flame has been an important feature of many spiritual ceremonies whether of religious origin or not.

However, you don’t need to have any spiritual or religious leaning to feel the comfort of a candle lighting ceremony.

It’s amazing how candlelight can transform a space. How it can offer up space for reflection with it’s comforting glow.

If you wish, take time to honour those who will not be arriving into 2023 with a candle lighting ritual.

You may wish, on the approach to midnight, to light a candle and spend a moment in time with a memory of those you said goodbye to.

For those grieving and suffering.

For all the losses that you have experienced or that have touched you.

And also honour, those special times.

The times that lit you up.

The times of personal joy.

And of collective joy.

Be present with whatever comes up for you.

If a loved one has died this year please know there is no pressure or expectation to wish away all that 2022 held for it is likely to hold some very special memories amongst the painful ones.

Let us live where we need to be, and hold on to those memories that help us through difficult times.

A heart-centred prayer to whisper to yourself and into the breeze as the moments of 2023 unfold.

"May I experience prosperity of the heart to provide enough propensity to love my way forward.
May I practice the art of living wider so I don't get lost in the expectancy of tomorrow.
May I be called deeper into my heart so I can touch the softness of untarnished love.
Through the thoroughness of my heart may I feel safe to experience it all.
May my moments of stillness always bring me back to myself no matter how far from home I feel."

I hope this loving prayer from my heart to yours touches just where it is most needed.
Nancy xx

Amidst stormy skies.

Simultaneously feeling relieved and disappointed when your person comes through a serious, potentially life threatening infection or exacerbation.

As an end of life doula and death educator I am here to not only share with you how beautiful death can be but also how difficult it can be.

It is only when we talk about these difficulties that we can best support ourselves and others and help each of us feel less alone.

I get to witness a lot of intense moments.

Some have this idealist view of dying and what it might look like or be like for yourself or supporting someone at the end of life and that includes those new to end of life care.

It can indeed be everything you ever wished for.

The truth is that, no matter how well prepared we are and how well we are supported there can still be suffering.

Today I will not be talking about the suffering of the person dying but the suffering of the main carer.

For some death can happen suddenly and unexpectedly.

It can happen after a short illness.

For others death comes at the end of a long, progressive and often difficult illness.

Here’s the thing – if you have been caring for someone over months and years of a progressive illness such as MND, dementia, COPD, some cancers, advanced heart disease, parkinson’s etc it takes a toll on your wellbeing.

Not least your mental wellbeing.

Along that journey of long-term caring, witnessing your person’s health deteriorate there are likely to be particularly challenging times when they present with a serious infection, an exacerbation or a relapse that is life-threatening.

You shift into survival mode, your adrenaline and cortisol levels rise. You switch up. You are on high alert.

Your whole being subconsciously preparing for the intensity of grief.

Day and night.

Sometimes with people coming and going.

GP’s, hospice, hired carers.

You wonder if this is it.

If this is the end.

Is your person dying?

And nobody can give you a definitive answer.

It might last for a few hours, a few days or a few weeks.

And then, slowly, day by day, your person’s health stabilises.

Their infection, exacerbation, relapse starts to pass.

And this is where you may experience the paradox, the duality of feeling relieved that your person didn’t die whilst also feeling disappointed.

You see, at this point you are physically, emotionally and mentally exhausted.

You are experiencing overwhelm.

Coping with the rollercoaster ride of emotions that come with caring for someone with a progressive, terminal illness long-term.

Your body and mind struggles to switch off in the aftermath.

To catch up and process the circumstantial change.

The expectation of death and when it doesn’t happen you are left with the intensity of grief that now has nowhere to go..

You are wiped out.

Stretched out.

Spent.

And wondering how many more of these times of anticipated death you can bear.

Actually, no, you may well be feeling that you can’t bear any more at all.

This is suffering.

I hear you.

And I see your suffering.

And although there is sadly no magic wand that can change any of it what I can do is rally the troops to help you ride out the storm.

We can hold space for your suffering, provide somewhere soft for it all to land and hold you in a way that you wish to be held.

And, when you tell me that you wish your loved one had died I won’t judge you.

Even if you are judging yourself.

I know this comes from a place of utter despair and deep love.

With tender loving care

Nancy xx

Over the festive period people do not stop dying, the seriously ill don’t suddenly become well, their life shortening diagnosis does not suddenly become curative and the frail do not spontaneously become spritely. Although the merriment can put a little twinkle in their eyes.

Like many others I will still be on call and serving my community. My holiday rituals are in a constant state of change and adaption which allows for a more relaxed and flowing time.

And I expect, for some of you here, Christmas and New year celebrations may feel different this year but know that, however you spend it, the best rituals are the ones that adapt with us, allowing us to create intention and meaning without locking us into a way of being that no longer applies to our current reality.

It may be your first Christmas without a loved one.

It may be your last Christmas with a loved one.

It may have been reorganised due to ill health.

It may be your first Christmas with a new addition to your family.

It may be your first Christmas in your new home.

It may be your last Christmas in your home.

It may be your first Christmas without extended family.

It may be your first Christmas with very limited finances.

It may be your first Christmas with someone struggling with their mental health.

So take your holiday rituals and adapt them; infuse them with new meaning and appreciate them for what they truly are – reminders of love, of our humanity and of our need for connection.

“Love is what’s in the room with you at Christmas if you stop opening presents and listen.”

Attributed to a 7 year-old named Bobby

With tender hugs

Nancy xx

Grief doesn’t take a break over Christmas and any feelings of joy can feel forced or coerced. It’s not as simple as celebrating being alive yourself in this moment. Grief is complex. Having that empty place at the table can feel overwhelming. Whether this is your first festive period without them or your 50th the holidays can feel bittersweet so here are some suggestions if you are grieving or missing someone this time of year.

1. Write a Christmas/Solstice/New Year card to your departed beloved.

In the card write them a message.

The message can be as long or short as you wish – simply say what you’ve been wanting to say since they’ve not been physically with you in this life.

Write all the things you wished you had said and all the things you’ve been wanting to tell them since their death, departure or transition.

Share any news with them.

Recall special memories.

Tell them how much you love them.

Or, just write something simple such as “I love and miss you”

When you’ve finished, either put it up on display with all your other cards or, perhaps, on your bedside table or pop it in an envelope and keep it somewhere safe to read whenever you want to feel closer to them.

2, Light A Candle.

The idea behind this is to bring to mind a loved one who has died or someone who is struggling with a message for them.

Light the candle and leave it to glow.

Then as it goes out or is blown out the air carries your message to them.

If you feel that you yourself need the support right now it’s ok to send a message of support to yourself too.

3. Flames and smoke.

If you have a firepit or fireplace you may also wish to write down on a scrap piece of paper your grief, troubles, struggles or anything you wish to dissipate or be held.

Once you have written all you need scrunch the piece of paper up and toss it into the flames.

Allowing your words of suffering, as they transform to ashes, to smoke, to be held by the universe.

4. Maintain traditions.

Keeping the traditions that you shared, when your beloved was still here in physical form, going may help you feel just a little bit closer to them.

5. Alternatively do something completely different.

Not to forget or dismiss your grief but acknowledge that your life is different now that your person is no longer here. To usher in new experiences and make new memories.

6. Raise a glass to them at the table.

7. Take a memory walk.

Go for a walk in the place you enjoyed together. Breathe deeply. Smile if you can. And sense their presence alongside you.

8. Don’t feel you have to celebrate or participate at all.

Do what you need to withstand this difficult time even if that means declining invitations and feeling like a party pooper. It’s ok to spend this time just being peaceful with your own company and your own thoughts.

You can do these rituals for any occasion or for no reason at all.

It’s a little gift of connection to that someone, a continuing bond.

These small rituals can make you feel just that little bit closer to them.

Nancy xx

Winter Solstice is my day of celebration.

A celebration of this threshold in time.

It is one the most powerful times of the year as the earth pauses and shifts. In the surrounding days of the solstice we experience the power of this time of stillness and the shift of direction.

Where the light of the days slowly gets longer but we still reside in the embrace of winter.

Life is being drawn into the earth, without resistance, hunkering down, descending into the very heart of nature.

The breathing of the earth deepens and slows.

I am reminded that we too, in our mortal suits, are part of nature.

We are being called to follow suit.

To embrace the enriching aspects of winter’s darkness.

To pause, to sit in stillness in the darkness of this space.

To commune with nature.

To attune to it’s wisdom

To descend into the heart of ourselves.

Into our body.

Into rest.

Into stillness.

Notice the richness of the dark. How it invites us to cocoon ourselves and rest.

It is within the depths of the earth, this darkness and the depths of ourselves that transformation begins.

But first we need the quiet, the rest, the pause.

To dream and to feel.

I am also reminded that, as we all hunker down to commune with ourselves and nature, some will not arise from this deep rest.

They will rest eternally in the womb of the earth.

Offering up all that they have- their physical form, their breath, their soul to nourish all that live upon and within it.

Those who do not arise will birth new life.

With that in mind my wish for you is that you have the wherewithal to meet each moment, each cold winter breath, each other with love and care as life unfolds.

May you grow still enough to hear the subtle noises earth makes in preparing for the long sleep of winter, so that you yourself may grow calm and grounded deep within.

Listen and breathe

May you grow still enough to hear the stir of a single snowflake in the air, so that your inner silence may turn into hushed expectation.

Listen and breathe.

May you grow still enough to hear the soft beating of your heart, of the beautiful life within so that you find awe and worth at your very core.

Listen and breathe.

May you grow still enough to hear the soft beating of earth’s heart so that you may appreciate it’s very being for without it we are nothing.

Listen and breathe.

I want to take this moment to tell you how much I appreciate you all.

For being here, for reading my posts, for sharing moments of stillness with me, for sharing in this deep stuff of death, dying and grief – I thank you.

Sending solstice and festive love and hugs into the atmosphere for you all to take what you need.

Nancy xx

One of the most valuable assets we can bring with us as we accompany the dying, as we walk someone home is a sense of humility.

It requires not only our keys, phone and worries to be left at the door but also our ego.

Entering their space with a beginners mind.

Being present with curiosity.

No matter how many times we have been present at the bedside of someone dying we don’t know it all.

We can never know it all.

We cannot change the outcome.

As family, friends and doulas we are not there to fix or heal – as much as we wish we could.

We are there to provide a soft place for all that they are experiencing to land.

The love, the anguish, the grief, the joy, their truths, hopes and fears.

And we cannot assert our own value system over those of the person dying or their family.

Whether cultural, spiritual, familial, political or even emotional.

It is not for us to say how living, dying and death should or shouldn’t be done.

Our beliefs, behaviours, practices, and core values are not of importance here.

Only those of the dying.

People may make choices that we ourselves wouldn’t make and it is not for us to judge, correct, criticise, change or belittle that choice but to hear it and advocate for it.

To champion it.

To champion them.

With love as always

Nancy xx