Terminal Illness

by Tim Isbell    Posted 11/2012, added second half in 4/2015, a tuneup in 9/2018.

It's hard to be present as someone's life winds down. We want to help, but what can we do? We wonder, “Why must this person die like this? Why must they endure the humiliation of the inability to do even the most basic things for themselves?”

There are no easy answers. We have the (correct) sense that our place is to be present, even though being present in this last season is extremely challenging. Into this situation, I offer two helpful concepts and four practical actions that Christians can bring to the bedside of the terminally ill person.


Two helpful concepts

Preparing to officiate a funeral recently caused me to look through my funeral resources folder. There I rediscovered a couple of useful items dealing with terminal illness. Since then I've put them to use and expect to do so again. Perhaps they will help you.

Addressing the angst of being a burden instead of a do-er.

The terminal patient may have enjoyed a long life of "doing" for themselves and others. But those days are over, and now they can only lie passively while others do to and for them. As uncomfortable as this is, they are in good company. It was also the arc of Jesus' life.

Jesus also grew up and lived an active life that included building things as carpenters do. Then there were the years of very full and active ministry: preaching, teaching, healing, leading, pushing back the powers of darkness, and more. Then one night came his arrest in the Garden of Gethsemane, followed by an unjust trial, a physical beating, the mockery of being paraded through town like a criminal, and the humiliation of death by crucifixion. Unlike us, Jesus had the power to rise at any time and retake control. But for reasons we only partially understand, he allowed people to do horrible things to him. Ironically, much of his "work" as our Savior occurred during Jesus' passivity, a time when God was very much at work.

As terminal illness drags us to the end of life, we have no choice but to allow people to do things to and for us. But we can trust that God is very much at work in and around what remains of our life. Indeed, such times provide God the space to do some of his best work. How? Often during our passive time, God works to reconcile family members to us, to each other, and even to himself. It is also a season that God uses to touch our friends and neighbors. And it is a time when we join in the suffering of Christ, including in excruciating and humiliating ways. Throughout this final season, we are in the good company of one who chose to suffer this same way: Jesus. Jesus trusted that God, the Father, was in control - despite all appearances to the contrary, so can we.

Understanding this first concept helps us be "present" with terminally ill people. Sometimes the Spirit of Jesus will open a door where it is appropriate to share the idea with them - or with a caregiver(s).


Addressing the apprehension of the end of the dying process

Terminally ill patients are understandably apprehensive about the moment of death, and what lies beyond. To gain perspective, In Our Greatest Gift, Henri Nouwen offers this illustration. 

Imagine for a moment that you could magically visit a baby still in the womb. The unborn child knows nothing beyond this life in a small, warm, dark place, with the occasional bump or muffled sound coming from somewhere beyond. So you show up and begin to tell the baby that it will soon to go through a painful process called "birth." You explain that he/she will painfully squeeze through a small opening into a much, much larger world. The baby has no way to comprehend the birth process leading to this larger world. The baby has every right to fear birth and the life afterward.

Now consider that the world in which you and I live is like a much larger womb. Christian faith teaches that after we endure the suffering of dying we are reborn into a much bigger and grander place than anything we have yet experienced. Dying is very much like the birth process as it moves us into a much more magnificent world. Of course, we are apprehensive about the suffering and pain of our second birth. And of course, it takes faith to look forward to the life beyond our second birth.

If we are caregivers in such situations, our assignment may be to remind the sufferer of this next life. 

For more on this, check out Trusting What's Over the Edge.


4 Practical resources at the bedside of a terminally ill person

I've experienced this terminally ill season with a few people, and most recently with my mother who passed away in January 2015. In the years prior I shared the above two concepts with her. While traveling to spend the last few days with her, I began to think about how to best use this time. The four items below emerged in that experience. During her last couple of weeks, I went over the first three items daily, and the fourth one occasionally. At first, she was mostly awake and responsive, but this decreased each day. Even when no verbal response remained, and she seemed to exist only "behind a curtain," I could sense God's Spirit actively ministering to her, behind that curtain, through these items.

Scripture reading

Scriptures about God's provision are particularly useful at the bedside. Assume the patient hears more than they can acknowledge, and that God's Spirit speaks to the patient through the scriptures in ways that you cannot. Here are a few useful passages: Psalms 16.1, 5-11, Psalms 23, Psalms 71.18-21, Isaiah 35.4-10, John 5.24-26, John 11.17-27, Romans 8.1-2, 11, 14-17, 31-39, 1 Corinthians 15.40-59, 2 Corinthians 4.16-5.1.

In my last days with mom, I also used these Identity in Christ scriptures to help her remember (or grasp for the first time, maybe) exactly who God says she was. After all, if anyone knows who we were created to become, it's our Creator. Knowing who we are "in Christ" is a very powerful concept at any time in life, and especially at the end.

Read or sing hymns or Christian songs

I'm not a good singer - not even an average singer. But I bring songs to the bedside of people who are passing. It's best when we know or can anticipate the kinds of Christian music the they like. I don't actually sing very often, though I may try a verse here and there when I can remember the tune. Most often I read the words as if they were poetry, often as close to the cadence of the song as I can remember. I trust God's Spirit to add the tune "behind the curtain." So when you minister to terminally ill Christians, find an old hymnal and look for a section of songs often called "Sustaining Grace" or something similar. For the passing of a younger person, find some appropriate contemporary Christian songs.

My mother was an excellent church pianist. So she knew a lot of old hymns. I was reluctant to sing to her because I knew she would hear how off-tune her son was. Still, occasionally I'd try a verse or two. She never complained. Indeed, it settled her spirit even when she was otherwise uncommunicative. 

Pray

There comes a time to stop asking God to heal. Sooner or later we all die. In such times, it's appropriate to pray for peace, reduction of pain, and God's presence. Scripture teaches that God is present in such situations, but sometimes the dying person does not sense that God's presence. So ask God to be present in a tangible way.

As the time to pass approaches the patient often is concerned about family members - for their spiritual conditions or interpersonal relationships. So pray for these things. Entrust and lift up their family members to God.

Voice praises to God, as well as prayers of thanksgiving for the good things in life, especially acknowledging the value of God's presence in the difficult times past. God's best answer to prayer is not physical healing or more time to live; it is his presence. The bedside of the dying patient is a place to remember this. 

Assurance of resurrection

The Apostle Paul is right: if there is no physical resurrection, then our faith in Christ is in vain (1 Cor 15.12). If you are not clear on the physical resurrection of Jesus, and his promise of the same for his followers, then take a look at these sermons: Simply Christian (a 2-sermon series based on book by the same title by N.T. Wright) and If Christ is Not Raised (a single sermon based on teaching of Timothy Keller). 

Authentic, historic Christian faith does not just promise an eternal spiritual existence, it promises a resurrected body. Once you understand this, you are ready to assure the terminal patient of this truth. One scripture I often use in this regard is Isaiah 35. It is a beautiful text to declare that God will replace their broken body with a resurrected and glorious body - better than the old one, even when it was at its best. 


Acknowledgment

In addition to my personal experience, the concepts on this web page are informed by 
  • Ronald Rolheiser’s book: Against an Infinite Horizon, chapter 6. 
  • N.T. Wright's book: Simply Christian, and
  • Timothy Keller's teaching. 
I recommend all three of these authors highly.

Blessings,

Tim Isbell 11/2012, and revised by adding the "4 Practical resources..."... in 4/2015.



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