How to plan a bedside vigil at home

A vigil is the time spent keeping company with someone in their last days or hours. For many families it is the most tender stretch of the whole illness, and also the most tiring. Nobody knows exactly how long it will last. It can be a few hours or more than a week.

Planning ahead doesn't make a vigil less sacred. It means the people who matter most can be present without running on no sleep, and that the dying person's wishes are honored even when they can no longer say them out loud.

If they can still talk about it, ask: who do they want nearby, and who would they rather not have in the room? Do they want music, prayer, silence, the window open, a pet on the bed? Are there words, readings or rituals that matter to them or to their faith?

Write the answers down in a few lines and keep them somewhere everyone can see. If the person can no longer answer, think about how they lived: the songs they played, the people who calmed them, the places they felt at peace. A death doula can help a family put this into a simple vigil plan.

Many families try to keep someone at the bedside around the clock. That is only sustainable if people take turns. Agree on shifts of three or four hours, overnight included, and who gets called if something changes.

It is common for a person to die in the few minutes when everyone has stepped out. Hospice teams see this often. It is not a failure of love, and it is worth saying so to the family before it happens rather than after.

Keep the room calm and uncluttered. Soft light helps, as does a comfortable chair or two for whoever is sitting, a blanket for them, water, tissues and a small notebook to jot down times, medications given and who visited.

Hearing is thought to be one of the last senses to fade, so assume the person can hear you. Speak to them, not about them. Gentle touch, a familiar voice reading aloud or quiet music they loved can all be comforting.

Keep the hospice nurse line and any after-hours numbers taped near the bed, along with the plan for what to do when death happens, so nobody has to search for them in the moment.

Your hospice team can explain what to expect for your person, and it helps to ask them early. Common changes in the last days include longer sleep, less interest in food and drink, cool or mottled hands and feet, and changes in breathing, including pauses and a rattling sound. Many of these are a normal part of dying and not a sign of distress, but call the hospice nurse whenever you are worried or unsure.

Vigils are physically and emotionally draining. Eat proper meals, step outside, sleep when it's not your turn. Accept the neighbor who offers to bring food. If relatives disagree or old tensions surface, a calm third person can make a real difference.

This is one of the main reasons families bring in an end-of-life doula: to sit overnight so the family can rest, to keep the vigil plan on track, and to be a steady presence when emotions run high.

There is no need to rush once death happens, unless the person's faith calls for it. Many families sit with their person for a while, wash and dress them, say goodbye, or invite others in before calling hospice or the funeral home. Our guide to home funerals explains what is possible.