In this module, we’ll explore what it really means to walk alongside someone who’s nearing the end of life. We’ll talk about the common fears people face, what they might still hope to do or say, and how their body and spirit begin to shift during this time. We’ll also look at common illnesses/diseases, symptoms of these diseases and how to help alleviate them, and the active dying process. It’s a blend of grounded knowledge and heartfelt presence—so you can show up with both confidence and compassion.

Death, like birth, is guided by the body’s own wisdom. As doulas, we honor that wisdom by trusting the person to define their final chapter and by cultivating steady, dependable presence amid uncertainty. Our task is to quietly witness, validate, and protect their truth—holding their stories in confidence while inviting the questions that help them give voice to their wishes.

1. The Fears of the Dying: Naming What’s Unspoken

Common fears experienced by those nearing the end of life often include a blend of physical, emotional, and spiritual concerns. While each person is unique, here are some of the most frequently expressed fears:

🖤 Physical and Emotional Fears:

• Pain and suffering – Fear of uncontrolled pain or discomfort.
• Loss of dignity – Worrying about dependence on others for basic needs or bodily functions. This includes the loss of self which leads to feeling unloved, unproductive and unwanted as their bodies decline.
• Loss of autonomy – The fear of not being able to make decisions or be in control. One way to alleviate these concerns is to help an individual experience a sense of mastery or control over their own care.
• Being a burden – Concern about the emotional, financial, or physical toll on loved ones. People often indicate this as one of their biggest fears.
• Loneliness or abandonment – Fear of dying alone or being forgotten.
• A terminal diagnosis is often accompanied by a progression of decline and a cascade of smaller losses. These include independence, abilities, roles and sense of control over one’s life.

🕊️ Spiritual and Existential Fears:

• The unknown – Fear of what happens after death, especially if spiritual beliefs are uncertain. Often fear of the unknown is worse than physical pain.
• Unfinished business – Regret about unresolved relationships, missed life goals, or things left unsaid.
• Fear of nonexistence – Anxiety about the end of consciousness or being forgotten.
• Judgment or punishment – Worry about past actions and what may await beyond this life.
• Disconnection from meaning – Feeling that their life or death lacks purpose or significance.