At the Hospice Foundation of America's annual bereavement teleconference last week, the national panel discussed "spiritual distress" as people lay dying.

People who are verbal sometimes say they don't want to die because they don't know what will happen. Some worry they are going to hell.

Dying people who can no longer speak, or are in a coma, sometimes express spiritual distress by grimacing and thrashing.

So how to help those in spiritual distress?

For the verbal, ask them "What would you like to have happen when you die?" For those worried about hell, the response was something like: "What actions or words would you need to take to get rid of that fear?"

For the nonverbal, calming suggestions include music, hand-holding and breathing in tune with their breathing.

Do you have any fears or worries that you think might cause spiritual distress at the end of your life? And what would eliminate those fears?

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