1. Notice the Subtle Changes

 Have I observed:

• Decreased appetite or interest in food

• Increased sleeping or longer periods of rest

• Less energy or difficulty engaging in conversation

• Reduced mobility or strength

• “Are these changes part of a natural decline rather than something to fix?”

2. Understand the Pattern of Decline

Have I noticed:• Recovery from illness or hospitalization is slower each time

• Treatments are helping less or causing more strain

• More frequent hospital visits or complications

Suggested reflection:

• “Are we seeing a gradual narrowing rather than a sudden change?”

3. Recognize When Treatment Is Shifting

Do I understand:

• If curative treatments are still effective or no longer working

• When the care team begins discussing comfort-focused care

Have I asked:

• “Are we still trying to cure this, or are we focusing on comfort now?”

4. Acknowledge the Emotional Response

Have I experienced:

• Shock, even though I knew this was coming

• A feeling of “this happened suddenly”

• The urge to ask, “What else can we do?”

Reminder:

• These reactions are normal and rooted in love, not lack of understanding

5. Know What the Body May Be Doing

Do I recognize:

• The body may be gradually slowing down• Eating and drinking less is often part of the process

• Increased sleep is natural, not harmful

Have I asked:

• “Is this a normal part of the dying process?”

6. Shift the Focus of Care

Have I considered:

• Moving from cure to comfort

• Prioritizing pain control and peace

• Supporting dignity and emotional presence

Suggested question:

• “What can we do to make this more comfortable and peaceful?”

7. Stay Connected to the Care Team

Do I know:

• Who to call with questions (nurse, hospice, physician)

• What changes to report

• What to expect in the coming days

Have I asked:

• “What should we expect next?”

8. Allow Space for Presence

Have I given myself permission to:

• Sit quietly without needing to fix anything• Hold a hand, speak gently, or simply be there

• Focus on connection rather than intervention

Reflection:

• “Being here may be the most important thing I can do.”

Understanding the dying journey doesn’t remove the pain of loss—but it can soften the

shock and help you move from panic to presence