How a Vigil Plan Can Help You Shape Your Final Days

More and more people are training to become death (or end-of-life) doulas, and more families are hiring them to help maneuver through the process of death and dying. One key aspect of the services doulas provide is creating a “vigil plan.” We asked two doulas from a Portland collective, Deanna Hagy and Maryann Giunta, what a vigil plan is and how it works.

What is an End-of-Life Vigil Plan?

A vigil is the time when family and friends hold space for and tend to a person who is actively dying. A vigil plan is a document that outlines the specific ways a dying person wants to be engaged during this time when they can no longer speak for themselves. This flexible document is created while a person still has energy and is based on what normally brings them comfort. The elements of a vigil plan can be altered at any time.

A vigil plan lets visiting friends, family, and caregivers know how to interact with the dying person. The plan addresses the physical space around the bedside: things like music, lighting, scents, flowers, spiritual objects, and photo albums are just a few elements that are taken into account. These are things that engage the senses and that the person finds comforting. The plan can also address if and how the person wants to be touched.

What Are the Elements that Create the Best Vigil?

We had a client who was a practicing Buddhist. He had done a lot of the emotional work to prepare for his death. He was particularly struggling with how to handle the last visits from two family members. He was concerned that their time together would not be focused and meaningful, with opportunity for emotional movement and healing. His vigil plan spoke very clearly to the topics of conversation he was open to. His beloved shared this plan with people before they came to visit, so they could have time to process. Reports were shared with us that both of these final visits were emotionally very important and that the plan was critical in laying the foundation.

Can Those without a Doula Create a DIY Vigil Plan?

One simple way to make those last days and weeks meaningful is to ask your loved one to look around the room and choose something they see that has meaning to them. If you can, bring it to them to hold. Ask them why it’s on display. Where did they get it? Who gave it to them? Why do they like it? What was happening in their life when they got it? What lessons did they learn from this time, item, or person? How have those lessons been integrated into who they are now? These conversations may be worth recording or writing down to share with family and friends at a memorial or at a later time.

What are Ways to Create a Better Experience of Dying Away from Home?

For those in a hospital, hospice or care facility, ask a staff member to facilitate a phone or video call and consider recording the call. You can prompt a story with a question about some family history that perhaps you’ve heard before, for example, “Mom, why did Uncle Jimmy enlist in the Army?” You could also write them a letter expressing your gratitude and lessons learned. These ideas give your loved ones an opportunity to remember and ground themselves in the things they know and did well. Taking a walk down memory lane of a life well-lived can be emotionally healing.

Why is Conversation Such an Important Element of a Vigil Plan?

No matter what your religious or cultural background, many people find talking in these final days and weeks to be a rich and meaningful experience.

There are many benefits to conversation:

• Conversation allows for exploration of a life well-lived.
• Conversation grounds loved ones in experience and life, which is calming and healing.
• Conversation allows for wisdom to be transferred orally.
• The benefits include lower anxiety, pain, and breathing challenges for the person dying.

When you are talking with your ailing loved one, listen for comments that tell you how they like their senses to be engaged.

Think about how you could engage their senses once they are bedridden. You could open the window so they can hear cheerful birdsong, light a candle with their favorite scent, or bring their pet up on the bed for a cuddle. All of these can be suggestions on the vigil plan.

What Makes a ‘Good Death’ for Your Clients?

In our work, we don’t use the term “good death,” because there is no single definition of that term that fits everyone. We strive to support people in having “as good a death as possible.” Providing clients with information about their options at end-of-life helps them make a plan that aligns with their values.

We encourage clients to complete their end-of-life legal paperwork (ie: advance directives and wills), to write letters, to have conversations they need to have, to tell their stories – to engage as openly and truthfully with their loved ones as possible. These things can pave the way for a better death. We know that healing can happen until the last breath.

All of that being said, we’ve all heard the sayings about “best-laid plans.” It is possible that not all issues will be resolved, and not all pain will be controlled. Things could be a bit messy, or maybe not. We support people in making space to hold more than one truth, to relax into the gray areas.

How Can We Start the Conversation About Death?

If you or your loved one aren’t ready to talk about your own death(s) — this is actually the norm — don’t feel something is wrong with you! We’ve found that there are simple ways to ease into the conversation that are a little less threatening, whether you are talking about your own plans or trying to get a loved one to open up about their preferences. You can talk about deaths and funerals you’ve witnessed or attended. What did you (or they) think went well? What did you (or they) hate? Was there an outcome that you (or they) want to avoid for your own family? How can you (or they) start working to have a plan for that now? Glean parts of this conversation to create the outline of a vigil plan.

You can get support and more information on making a vigil plan from the Evening Star End-of-Life doula team.