Short answer: nature-based end-of-life care is a family toolbox of six things you can bring to the bedside: light, air, plants, water, sound and touch. Open the curtains, crack a window, bring in the garden, offer a cool cloth, play or sing what they love, and hold their hand. The caveat: this sits alongside hospice and medical care, never instead of it. Check with the care team before using herbs, oils or touch on fragile skin, and keep open flames away from medical oxygen, which fire officials warn makes fires burn hotter and faster. This is general information, not medical advice.
This piece is for families and caregivers. If you're a doula or want to train as one, see nature-based death doula training.
Why nature, at the end
Hospital rooms are built for machines. Home rooms can be built for people. You can't change the diagnosis, but you can change the room, and that's a job a whole family can share.
The research here is suggestive, not proof, and we won't oversell it. Two studies worth knowing:
- In a classic 1984 study in Science, Roger Ulrich found that 23 surgery patients whose windows looked out on a natural scene had shorter post-surgery stays and took fewer potent painkillers than 23 matched patients facing a brick wall. Those were surgical patients, not dying ones, but it's a reason to open the curtains.
- In 2020, researchers at the University of British Columbia found that some hospice patients who had become unresponsive still showed brain responses to sound. The study can't say whether they understood what they heard. It's still a reason to keep talking.
The toolbox
1. Light
- Move the bed so they can see out a window, if the care team says it can be moved.
- Open the curtains in the morning, and soften the light at night.
- Let them see the sky. Sunrise and sunset are good anchors for long days. Our bucket list for someone who is dying has more ways to bring one last sunrise to the bed.
2. Air
- Crack a window, even a little. Outside sounds and air make a room feel less sealed off.
- A fan on low can feel good. Ask the nurse about it if breathing is a concern.
- No smoking, and no open flames if there's oxygen in the room.
3. Plants
- Fresh-cut flowers or herbs from their own garden.
- A pot of something they can touch and smell: rosemary, mint, lavender.
- Skip heavy scents if they're nauseated, and anything they're allergic to.
Plants are the deepest drawer in this toolbox. Read plants at the deathbed for what herbs families have used and how.
4. Water
- A cool cloth on the forehead.
- Washing their hands or feet with warm water and a few herbs, slowly. We describe how in end-of-life rituals.
- Ask the hospice nurse about mouth care and sips; swallowing changes near the end, and they'll know what's safe.
5. Sound
- Their music. Their language. Their people's voices.
- Recordings of birdsong, rain, or the ocean if they can't go out.
- Singing, even badly. Volunteer groups like Threshold Choir visit bedsides to sing.
6. Touch
- Hold their hand. Rest a palm on their shoulder.
- A light hand massage, if they like it and the nurse says skin can take it.
- A soft blanket, their own pillow, the dog on the bed.
Putting it together: a day at the bedside
Morning: open the curtains and the window, say good morning, wash their hands. Midday: flowers or herbs within reach, quiet music. Evening: soften the light, tell a story, sing something. Night: one person sits, a battery candle on.
It doesn't have to be perfect. It has to be kind, and it has to be theirs.
When the time comes
For the final hours, read how to sit vigil with someone who is dying. If you're planning ahead, our end-of-life planning checklist includes the room, the music and the people you want there. And if you want to keep them at home after death, read caring for a body at home after death.
Learn the whole toolbox
Otherside's live four-week course, A Nature-Based Toolkit to Support the Dying, is taught by death doula and grief companion Elayne Sallemi. It's for anyone caring for someone at the end of life, and covers the plants and simple preparations families have always used to ease the dying, starting with what's in your kitchen and garden.