Spiritual Concerns in The Living Dying Interval Among Hospice Patients

,patient and priest

Saul Ebema, D.Min.

The reality of life is that each of us has the potential to die at any moment. Yet we go through life with the assumption that we have a certain amount of time to live and we plan our lives, and set up goals, to achieve within our anticipated lifespan. The knowledge that we are dying, after a diagnosis of a terminal illness, drives us straight into crisis mode. The period of time between the crisis of the knowledge of death and the point of death is called ‘the living dying interval.’ The living dying period brings many challenges for the patient and their loved ones. Some of these challenges include:

  1. Periods of remissions and relapses.
  2. Anticipatory grief.
  3. Financial pressures.
  4. Psychological and emotional pressures.
  5. Long periods of uncertainty.
  6. Decision making such as providing a feeding tube or life support.
  7. Side effects of medication used to manage symptoms of the disease.
  8. Lives of family caregivers being interrupted. Some will have to quit their jobs to care for the dying member of the family.

Spiritual Concerns in the Living and Dying Interval

“One major crisis precipitated by dying is a search for the meaning of life. The failure to find meaning can create a deep sense of spiritual pain.[1]” Some patients may not bring up their spiritual concerns, but are troubled by these spiritual concerns. Pastoral counselors can identify these concerns and explore them with the patient.

The following are a list of spiritual concerns a dying person might experience:

  • Inability to find meaning in life and death.
  • Inability to have a meaningful relationship with family and loved ones.
  • Loss of independence and the reality of not being able to take care of themselves without help.
  • The fear of being cast out of the world in which the healthy live. This involves the fear of being stuck in a nursing home or hospital.
  • Feeling a sense of abandonment.
  • Feeling isolated from family, community and sometimes from God.
  • Anger about being sick.
  • The reality of a bleak future here on earth can also be terrifying.
  • This may be triggered by the feeling of being a burden to the family.
  • Issues regarding whether they will go to heaven or not. This often leads to heightened fear of going to hell.

Recognition of these spiritual issues will help in the counseling process and will also lead to a good death.


[1]Kenneth J. Doka and John D. Morgan, Death and Spirituality: Death, Value and Meaning Series (New York: Baywood. 1993), 131.

Everyone knows that the task of being a Hospice chaplain is harder than any field in professional chaplaincy. Our goal is to train chaplains and prepare them for competent service within the Hospice industry.

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