Thursday, February 04, 2010

The Four R’s - Spiritual Tasks of Dying

The Four R’s - Spiritual Tasks of Dying
By Rev John-Brian Paprock
For Capital Newspapers
Originally published in Life & Legacy, November 1, 2009
Original photo by John-Brian Paprock published with article
Life & Legacy is a publication of Capital Newspapers, Madison, Wisconsin

Dying has been considered an auspicious and sacred time of life as long as humankind can remember. Religious rituals, reaching back to the beginning of human awareness, are filled with symbols and explanations of the great mystery of human limitation. Funerals and memorials are among the grandest and most elaborate ceremonies in all cultures. Even when the personal experience of dying is limited by abrupt causes of death, religion and cultural practices can help in coping with the loss of life.

Living the days and moments as death approaches can also be an intensely intimate and deeply spiritual time. Before the moment of death, there may be opportunity to bring conscious closure to one’s life, to tie up the loose ends and put things in order.

In the last twenty years, a lot of study has been done about the needs of the dying patient. Researchers have noticed that, beyond the medical issues, there are psycho-spiritual needs. At a personal level, it can be hard to separate psychological, spiritual, religious and cultural needs. There is agreement that the patient’s non-medical needs are as important as the medical needs at the end of life. Hospice and palliative care programs have incorporated a team approach which includes medical staff in conjunction with social workers and chaplains.

Dying patients can be enabled and empowered to control the circumstances of their death, the completing of their life, where there can be peace. This is a major part of what is called “quality death.” Everyone is unique and so which of the tasks of dying will vary according to time, energy and inclination. Here are some the tasks that dying people can use.


For most people, there is some need to reconcile the past. There are two kinds of reconciliations: forgiving someone and asking for forgiveness. Sometimes this can still be done in person. Sometimes this needs to be done symbolically or with some restitution or repentance. This is also a task to integrate difficult experiences and regrets of unfulfilled dreams and expectations.


Every life is unique and has value. Remembering key events with loved ones or with the world through story-telling or life history reflection with a volunteer can help put things in order. This is a task to let loved ones know how special and unique they are and that will be missed. This is also a task of gathering gratitude.

One issue that comes up for the dying is what they are leaving behind. So, in this task of remembering is also being remembered. One activity can be developing a spiritual legacy by writing an ethical will or gathering letters and testimonials or planning a community and/or religious memorial. The planting of a tree is a popular choice.


For many, their religion and culture rituals can fulfill many of the needs of dying. Along with simple family rituals, like Thanksgiving gatherings, they can bring spiritual nurturance and meaning. For many, pastoral visits by a spiritually significant person can be important – priest, shaman, imam, rabbi, minister, family member.

Even without religious connotations, a simple ritual in the context of one’s spiritual beliefs can bring meaning and communicate the significance of one’s life in the grand picture of life.


Letting go of life can be hard even with all the comforts of medicine, family and religion. Coming to final peace and saying good-bye can be considered acts of courage for many. Giving the time and space for individual good-byes is a gift that is the treasure of both the dying and the living.


In the book Dying Well (Ira Byock), the tasks of dying are summed up in five statements to say to loved ones: 1. Forgive Me. 2. I forgive you. 3. Thank you. 4. I love you. 5. Good-bye.

The tasks of dying can be overwhelming at times. If there are places and times of distress, confusion or other difficulties during the dying process, there are people who can help. One thing can be assured – others have gone through this before.

After reviewing these tasks of dying, they seem to be tasks the living could be doing long before dying.

Rev. John-Brian Paprock is the Orthodox Priest of Holy Transfiguration Orthodox chapel on Madison's northside and a chaplain at University of Wisconsin Hospital and HospiceCare, Inc.

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