As a PSW (personal support worker) student or as an experienced PSW learning about palliative care and a palliative approach, you may feel anxious, apprehensive, or even fearful about the unknowns – what you might see, hear, or experience when providing care for a dying person. Know that these are common concerns for any person beginning a new practice, and that these are common feelings for any person who begins their education on caring for dying people.

First, let’s look at some of the common reasons why you may be feeling apprehensive about providing care for a dying person. Second, I invite you to participate in a guided reflection to explore and begin to resolve any personal fears and concerns about death and dying.

Society’s Fear of Dying and Death

North American society is primarily a death-denying society. While the news services report deaths of celebrities or deaths from tragedies, rarely is dying or death discussed openly or publicly as an experience or in terms of the process. Coupled with this is the belief that dying and death are to be avoided at all costs. We somehow forget that life is terminal, that we are all mortal, and that death is a natural part of life.

This is in sharp contrast to the way dying and death were understood and experienced historically. One hundred years ago, care of the dying was primarily the responsibility of the family. In that time, people grew up with an understanding of what dying and death looked like and what to expect as a person’s health declined.

Forward to the current century where the care of the dying has mostly shifted away from the family to professionals and is provided in care facilities such as hospitals, long-term care, and hospices. The result is that, as a population, we have lost the knowledge and confidence to provide care for a dying person. Without knowledge of what dying and death look like, it is common for people to be fearful about what they may see, hear, and experience when dying, or when caring for a dying person.

As a PSW, getting familiar with and becoming more comfortable with dying and death is one way to support yourself as you learn about and provide palliative care. The process includes exploring your experiences with dying and death, and recognizing your fears and concerns about providing care for a dying person. With knowledge and an understanding of the dying process and ways to support a person, your fears about providing palliative care may diminish.

The following reflective activity begins the process of helping you get familiar with, and more comfortable with dying and death by exploring your personal experiences.

Guided Reflection: Exploring Your Feelings About Dying and Death

Gather a writing tool – pen, pencil or marker, and something to write in. If you have a writing journal, you may want to use that.

Find yourself a safe, comfortable place where you can complete this activity. Set aside 10 to 30 minutes.

1. Prepare yourself by creating a safe space for the guided reflection. Use a grounding activity you already know, follow the steps shown in the Grounding Activity, shown below, or consider one of these activities.
2. Reflect on these questions and free-write your responses:
   • Describe your experiences with death and dying. For example, one of my first experiences of death was a dead leaf at the end of winter. Feel free to illustrate, use colours, shapes, and drawings as part of your narrative.
   • Consider one or two key experiences with dying or death:
     • Describe how you feel about these experiences and how you believe they have shaped your feelings about dying and death.
   • Consider your family and friends: Describe what you know about the ways they perceive dying and death?
     • In what ways do you believe that your feelings about dying, and death been shaped by the experiences of family and friends, and those around you?
   • Read through your reflections. Write to summarize your understanding of how you came to have these feelings about dying and death.
   • Post-Reflection: Consider whether your feelings about dying and death serve you well in your life or whether they restrict or hinder you. Be compassionate towards yourself as you consider which of the fears or concerns are valuable to you in your life.

Grounding Activity

Read through these instructions completely before beginning the grounding activity.

• Settle comfortably in your seat and close your eyes.
• Centre yourself by breathing deeply and slowly three to four times – in through the nose and out through the mouth.
• Say to yourself, “I am safe and calm. I am willing and ready to explore.” Change the language to suit your style. Repeat these phrases as many times as you need to, until you feel a sense of quiet, calm and trust within.
• Consciously “open” your mind. You can imagine opening a door and entering the space if that helps.
• Open your eyes and begin the Guided Reflection.
• After completing the guided reflection, consider taking a moment to take a few deep breaths, and consciously but softly “close” the door to exploration in your mind. Remind yourself you are safe, and calm.