We added Final Gifts to the Aging With Freedom Book Club out of love for this classic.

Final Gifts, written in 1992, is a beautiful book written by two hospice nurses, Maggie Callanan and Patricia Kelley. The theme of the book is the unique communications our dying loved ones share with us, the survivors, in their dying.

This book has become a touchstone for caregivers of the terminally ill and dying. And both the spiritual and emotional dimensions of whole-person wellness are addressed. As caregivers our own wellness matters. While death may be the failure of the physical body, it may also be the full realization of emotional closure and spiritual fulfillment. 

Callanan and Kelley undertook a study of more than 200 hospice cases after they noticed repeating patterns in behavior and gestures among their patients. They concluded these consistent communication patterns were a symbolic language of the dying. 

Final Gifts – Nearing Death Awareness

Nearing Death Awareness. Nearing death awareness is the special communication of the dying. It usually occurs when patients are approaching or are in the dying process. Most patients who have signs of nearing death awareness are more peaceful after the experience. It is believed that the person is beginning to transition from this life.

These messages of the dying may be a symbolic communication to ask for permission to die or address a need. Some things they may need include resolving previous conflicts, receiving a visit from a friend, or knowing that you will be okay without them. What they say often has meaning to them and is linked between this life and death. For example, if they traveled a lot, they may say, “I need to pack my bags” or “I need to get on the plane”. A patient who was a boater may talk about the tides. A rancher may describe his horse waiting to take him for a ride. — The Hospice of the Florida Suncoast

The authors observe that the dying’s statements and gestures have meaning. Caregivers often dismiss these messages as hallucinations or mental confusion. Callanan and Kelley suggest these statements are better understood as the dying communicating what it feels like to die. The dying are permitting you to be present during their dying and are sharing it.
Often close to death, the dying will talk of traveling, leaving, packing, going on a trip or going home. The dying may share this with you in symbols. They may talk about someone dead as if they are still alive. “Aunt Rose was here today” or “Mom sends you her love.”

Final Gifts: A Beautiful Book Written by Hospice Nurses

Final Gifts encourages us to be present and honest with our dying loved ones. Listen close, the authors tell us. Buried in these seemingly incoherent ramblings are loving messages that will bring you peace with your loved one’s passing. This book is a caregiving classic. A book to be reread. Over the years, we find this book to be comforting, having been present during loved ones’ passing. Death can be stressful and disturbing for the attending family and friends. We are empathetic with the suffering in life and finality of death. We’re reminded of our own mortality when attending another life’s closure. Final Gifts offers perspective to receive these special end-of-life moments as gifts, not burdens. Today, with parents in their late 80s, it is still a good reminder to stay present.

Final Gifts – Nearing Death Awareness

“There is a sacredness in tears. They are not a mark of weakness, but of power. They speak more eloquently than ten thousand tongues. They are the messengers of overwhelming grief, of deep contrition and of unspeakable love.”

Washington Irving


Martha Atkins at TEDxSanAntonio 2013: More to dying than meets the eye

Final Gifts Near Death Awareness Brene Brown

Chicago Tribune: Striking similarity of dying words (6/19/2013)