Understanding the dying process: insights from Crossing the Creek

Medihelp’s palliative care programme, CareTogether, is designed to support members and their families during one of life’s most challenging times: the end of life. As part of this programme, we recommend Crossing the Creek: A Practical Guide to Understanding Dying by Michael Holmes. This is a compassionate, practical resource that helps caregivers and loved ones better understand the physical, emotional, and spiritual changes that occur as someone nears the end of life. Drawing on his experience as a hospice nurse, Holmes offers a clear and gentle framework for making sense of this complex transition. By understanding what to expect, families and caregivers can offer more meaningful support and find comfort in understanding the process.

Key insights from Crossing the Creek

Holmes compares the dying process to “crossing a creek”. Each person’s journey is unique, but certain patterns often appear. These shared experiences can help loved ones prepare and respond with compassion and confidence.

As the body prepares for death, it’s normal for people to eat and drink less. This is not a sign of giving up. It’s a natural part of the body’s shift towards maintaining comfort. Caregivers are encouraged to follow the individual’s cues and prioritise pleasure over nutrition, avoiding the discomfort that forced feeding can cause.

People often sleep more or experience vivid dreams near the end of life. These dreams may help them review their life and find resolution. It’s important to create a quiet, peaceful space that supports this internal work.

Some may seem confused or report seeing people who have already died. Rather than dismissing these experiences, Holmes encourages us to accept them as part of the natural transition. They may even provide comfort and reassurance.

As circulation slows, hands and feet might feel cold or look mottled. Breathing can become irregular. These are typical signs that the body is gently shutting down and not necessarily a cause for alarm.

Dying often prompts deep emotional or spiritual reflection. Caregivers can offer support by being present, listening without judgement, and helping the person with spiritual or religious practices that matter to them.

The complete version of Crossing the Creek is available as a free download at crossingthecreek.com. This text provides deeper insight into each stage of the dying process and serves as a steady, reassuring guide for anyone supporting a loved one through the final chapter of life.

Integrating the principles from Crossing the Creek with Medihelp's CareTogether programme can enhance the support provided to members and their families, fostering a more informed, compassionate, and personal approach to end-of-life care.