What I've Learned Sitting at the Bedside

There is something sacred about sitting at the bedside. Time seems to move differently there. It's slower, softer, more intentional. In those moments, the usual rush of the world fades, and what matters most comes into focus. Over the years, I’ve come to see that it isn’t always the big declarations or grand gestures that hold the most weight at the end of life. It’s the little things: a hand hold, a shared smile, the sound of familiar laughter. It’s the conversations left unfinished, the comfort found in quiet presence, and even the healing gift of humor when the heaviness feels too much to bear.

I am often asked, “What should I do? What should I say?” when someone they love is nearing the end of life. These questions come from a place of care, but also uncertainty. None of us are taught how to walk with another through dying. The truth is, there is no perfect script, no right or wrong words. But there are small, deeply human ways of showing up. Little things matter. Unfinished conversations can hold more weight than we realize. Silence and presence can speak louder than words. And sometimes, a gentle laugh and a shared bit of humor is the very thing that keeps us grounded.

This blog is my reflection on those questions I hear so often, and the simple truths I’ve witnessed again and again when being present at the bedside.

Presence Speaks Louder Than Words

One of the most common things I hear from families and individuals is, "I don't know what to say." It's a worry that often weighs heavier than it needs to. the truth is, there are no perfect words when someone you love is nearing the end of their life. Words may feel small or uncertain, but love isn't measured in sentences. It's measured in presence and showing up.

Not only do I get this question often, but in reality, we were never trained or taught how to be comfortable with death nor how to be there for someone we love as we witness their passing. All of this is new and it's difficult to manage if you have never sat bedside for someone who is passing. By difficult, I mean in the sense of dealing with grief while still trying to be there for the one you love or someone who is passing.

Sometimes, the greatest gift you can offer is not what you say, but that you are there. Nothing more and nothing less. If this is all you can do, then that's more than enough.

I know just sitting around doesn't seem like you are doing much but trust me you are. Think about it. Was there ever a time in your life you were truly scared or going through something difficult? If you had someone to accompany you through it, would it have made a difference? Knowing you weren't alone. Even if they never said anything to you. Presence is the comfort of knowing you are not alone.

Silence, though it may feel uncomfortable at first, becomes sacred at the end of life. It allows space for peace, reflection, and for unspoken love to move freely between hearts. Even without words, your loved one feels you.

Sometimes all you can do is the simple, small things. A quiet hand resting in theirs to let them know you are there. That they are not alone. Simply breathing in rhythm beside them can speak more loudly than any carefully chosen phrase. Breathing patterns change at end of life. Their breathing becomes shallow, sometimes rapid and loud. It has been proven that tempo match of their breathing pattern can help bring labored breathing down. Start by breathing at their speed and slow it down. Go even slower. Think meditative breathing.

If you are someone who can't sit in silence but doesn't know what to say, that's okay too. the smallest of gestures go a long way. Softly brush their hair back from their face, massage their hands, whisper kind words, read to them, say "I love you." All of that carries comfort without the pressure to speak, even in quiet rooms.

And even when it seems they cannot respond, remember this: HEARING is the last sense to go.

Simply being there is often the greatest gift you can offer. You don't need a script, a perfect speech, or clever words. Just being there is enough. It is in those simple, attentive moments that your love is most deeply felt.

While presence is the foundation, it often shows itself in all the small gestures. The little things we do that ripple outward in ways we may not fully see. It is in these small acts, these tender "slices of pie," where the depth of our care becomes visible.

The Little Things Matter

Presence becomes tangible in the small, quiet acts we offer to those we love. It isn't always grand gestures or elaborate displays of care that claim a greater love. Often, it's the simplest actions. The ones we might barely notice that carry the most meaning.

At the end of life, loved ones often want to care for their loved ones the way they always have. Offering food or drinks, helping them sit up, or providing the comforts they have always given. but the reality can be different in this state, and sometimes, those gestures can do more harm than good.

Depending on how alert someone is, normal eating and drinking may no longer be possible. It can be upsetting, confusing, or even feel like failure when families realize that giving a full glass of water or feeding as they always have may be unsafe. Too much fluid can create a risk for aspiration, and they must give only tiny amounts in careful, measured ways.

So, what can you do?

Even in these moments, there are meaningful, gentle acts that can provide comfort. You can moisten the mouth with small glycerin swabs. You can reposition them from the current side they are lying on in bed to help alleviate pressure. Pressure sores can occur due to decreased mobility. Place pillows under their back if you lay them on their side. Elevate their legs with rolled up blankets. Adjust their bed to make it more comfortable. Think cozy. These are all powerful gestures of care. they seem small, but in truth, they are profound.

Maybe you want to make your small gestures more personable. You can dip the glycerin swabs in their favorite drink. I once dipped swabs into a woman's favorite wine! It doesn't have to be just water. Maybe you want to give them some ice cream. I highly advise just a small portion. The tip of a spoon. Let it melt and make sure you see them actively swallow. There's no need to rush, let them enjoy it slowly. Savor it.

There are many ways to make your presence and care personable. You can play their favorite music while you gently massage their hands. Read their favorite book. Sing to them. Play an instrument if you know how. Brush their hair. Grooming is huge! Some individuals are passing for days and weeks. Help them feel clean. Clean their fingernails. The list can go on, but these small acts make all the difference.

I often tell families that these "slices of pie", these tiny, attentive moments are powerful. In these acts of love, words are not needed. They show love, presence, and attention in ways that words cannot always capture. These small gestures often open the space for connection and for unspoken understanding.

Unfinished Conversations

While small gestures and quiet presence can bring immense comfort, there are times when they aren't quite enough for some. Sometimes, families feel a need to go a step further. To speak the words that have lingered, to clear the air, to express feelings that have never been shared. It's in these moments that unfinished conversations become important. It offers a way to release what's been weighing on the heart. To give closure, peace, and forgiveness.

At the end of life, there are often conversations that haven't been fully spoken. Words left hanging, feelings not expressed, or apologies never given. These unfinished conversations can weigh heavily on both the person nearing the end of life and their loved ones.

I have witnessed this in real time. Somebody is passing. They are on their second week. The family keeps asking, "what's keeping them here?" At this point, I have seen and heard the family dynamics. No judgement. I state to them if there are any unresolved issues. I ask if maybe there is forgiveness that has not been given. Or maybe they are a relative who is estranged, and they need to make their peace. Whatever the case may be, the person figures it out. They go into the room to share a moment of closure. And the next day, or even the same night, the person passes.

I don't say these things to put fear into you. The fear, that if you make peace, you will lose the one you love. But they are deserving of closure and peace in these final moments. Everyone is.

I often remind families it is never too late to speak from the heart. Saying your peace, expressing gratitude, love, or even asking forgiveness can bring relief, understanding, and closure. A simple "I'm sorry," "Thank you," or "I love you" can carry more weight than we often realize. Even sharing a cherished memory or a story from the past can create a bridge between hearts.

Unfinished conversations aren't about perfect timing because the best time to speak your truth is now. Before the person is gone.

these conversations are about honesty, courage, and connection. Even small acknowledgment of lingering feelings can lighten the emotional toll of regret later.

Sometimes, the best words to be spoken are the ones you don't think about. they come from the heart. To tell someone how much they matter, how much they are loved, and a simple sorry is the key to setting someone pass with peace.

Presence plays a vital role here as well. Just simply sitting and being there, allows difficult words to surface naturally.

Maybe, your relationship is in good standing and through their life you've given them words of affirmation. If silence still makes you feel uncomfortable, talk to them as you normally would.

Let them know how the outside world is doing. Let them know about how Timmy won his first baseball game yesterday. Or tell them you finally got that promotion. Talk to them about whatever. It doesn't have to be an inspiring conversation; it can just be simple and casual. Your voice is providing the comfort as well as your presence.

By addressing forgiveness, gratitude, and heartfelt truths; unfinished conversations can become one of the most profound gifts we give to each other at end of life. They allow us to leave the room with a sense of peace, knowing that love and truth have been spoken, and received, whether in words or simply in shared presence.

Humor is Key

My favorite thing to do while sitting bedside is a life review with loved ones. Here we gather around the person passing, or maybe elsewhere, and I start the conversation about asking each to tell me about their favorite memory with their loved one. This opens up a conversation that is filled with laughter. Each sharing a memory that is meaningful to them. One will share. then the next will bounce a memory they had similar to that. Until the conversation is just flowing naturally. This is where I get to witness pure love. A love that has expanded beyond the individual. A piece of their love that has been given to each individual. It's my favorite thing about what I do.

To see and experience a love that has been around for ages is breathtaking. It's not an everyday love that you witness. And it's something I cannot put words to if I am being honest.

Even in the most serious, sacred moments at the bedside, humor has a quiet, powerful place. Laughter can be a lifeline — a gentle reminder that life, even at its end, is still alive with joy, connection, and shared humanity. A chuckle over a remembered story, a playful comment, or a lighthearted observation can release tension, ease anxiety, and open hearts in ways words alone often cannot.

Even in the most serious, sacred moments at the bedside, humor has a quiet, powerful place. Laughter can be a lifeline. It's a gentle reminder that life, even at its end, is still alive with joy, connection, and shared humanity. A chuckle over a remembered story, a playful comment, or a lighthearted observation can release tension, ease anxiety, and open hearts in ways words alone often cannot.

Families sometimes worry that laughing might seem inappropriate or disrespectful. In truth, humor is a gift. It reminds both the person nearing the end of life and those who care for them that love is multifaceted: it is tender, it is solemn, and it is joyous. Humor can coexist with grief, offering moments of relief and lightness when the heaviness feels overwhelming.

Laughter also carries a quiet reassurance. It can give the person passing a sense of peace. A feeling that those around them will be okay, that love continues, and that they are leaving a world where they are remembered and cherished.

How do I know this brings them peace? I've seen it for myself. In this field, we usen a body language scale (It's a specific scale called PAINAD, also used for advanced dementia) and vitals to monitor someone's comfort level. It's astonishing to see how a little change in the environment can go a long way.

Even small smiles, shared memories, or funny stories create connection and reinforce the sense of presence. These moments are not distractions; they are part of the tapestry of care and a reminder that we are fully alive in these precious, fleeting hours.

And while laughter is needed, it often leads naturally into the deeper stillness of presence and reflection. Which brings us to another quiet, essential form of communication: silence.

The Power of Silence

Silence holds a power that words often cannot capture. At the bedside, it can feel heavy at first. an empty room. Unspoken thoughts. It creates a stillness that seems almost sacred. Yet, it is withing this quiet that the deepest connection often emerges. Simply being present in silence allows both the person nearing death and their loved ones to breathe, reflect, and to be in the moment.

But silence extends beyond our presence. Sometimes, those nearing the end of life wait for the room to be quiet. For the hustle and bustle to fade before fully allowing themselves to rest.

Families may feel a need to fill the silence, fearing it is empty or unsettling. This silence is not absence; it is presence at its most profound. It is a language all on its own, one that communicates peace, acceptance, and grace of letting go.

The silence I speak about isn't the one I spoke of earlier. It's not you sitting at bedside with no words to speak. This silence is complete silence. where the person is left by themselves. Not negligence. But a moment of complete silence needed to make their final transition.

I've sat with families for countless of hours. Nightshift will come on and visit the person passing, during my hospice times, and the family would still be there. Come morning, they are still there and haven't gone home. I understand. They want to be there for the passing. But sometimes, the person won't pass with their families around. they wait until the room is silent.

I tell this to families, and it makes them fearful of leaving. I ask them to describe to me who the person was as a person. Were they a mother to 10? Were they always the one getting things in order? Did they always stick to their own terms? If the answer is yes, typically the person is not going until they are left alone.

I tell adult children, "Once a mother, always a mother." A mother never wants her children to experience her death. Someone who marches to their own beat will go on their own terms and typically those terms are to be left by themselves.

So, families leave. I stay behind while they grab lunch or go home. I comfort the dying and give them my blessing of forever peace. I leave. And soon I get a call that the person has passed.

Some families stay hesitant. I ask them if they have ever hosted a holiday get together. They typically say yes. I will ask them, when everyone leaves, how do they feel? I often get a returned smile. A simple understanding. This is the reassurance they needed.

The complete silence is another great gift. It's here where the mind and body can slip into a deep meditative state. Where they can turn inward and surrender to complete stillness. It is a profound pause, a time to let go, a threshold between life and what comes next.

Complete silence breaks the threshold.

Being present at the end of life is a gift. Both for those who are passing and for those who remain. It is in the small gestures, the unfinished conversations, the shared laughter, and the sacred silence that the deepest connections are formed. These moments teach us that love is not always about grand declarations or perfect words; it is about showing up, fully and authentically, in whatever way we can.

Presence, attention, and care create a space where forgiveness, gratitude, humor, and peace can exist. They allow families to leave the room with fewer regrets and more treasured memories. They remind us that even in the final hours, life is felt, love is shared, and every act, no matter how small, matters.

If this reflection resonates with you, I invite you to reach out. Whether you are planning for the future, seeking guidance for a loved one, or simply want to understand how to be present in these sacred moments, I am here to walk alongside you. Together, we can create a space where love, presence, and peace take center stage, allowing families to focus on what truly matters: connection, comfort, and the gift of being fully there for one another.

"Your presence it the most precious gift you can give to another human being"

-Marshall B. Rosenberg