Always Well Within

Calm Your Mind, Ease Your Heart, Embrace Your Inner Wisdom

How to Live and Die with Presence, Compassion & Grace

Letting Go w/ Love and Mindfulness | Terminal Illness

One of my readers asked me to write about living with terminal illness.

Since, I haven’t faced the shock of a terminal diagnosis myself, punishing rounds of treatment to forestall an ultimately incurable illness, or the emotional turbulence that insists upon coming along with a final prognosis, I wondered what I could write that wouldn’t seem intellectual, impersonal or trite.

At the same time, I think about impermanence often.  I’ve studied the Buddhist teachings on death and dying.  I’ve had moments I thought might be my last.  And I spent a year wavering around 84 pounds, not sure whether my weight would go up or down.

So perhaps something I share today may provide comfort, bring insight, or help you release attachment to this life, whether you are facing terminal illness or not. Because learning to let go is crucial to finding a deep abiding peace whatever your stage of life.

What Do You Believe About Life and Death?

How you respond to and live with a terminal illness, will depend to a great degree upon what you believe about the purpose of life, what happens at death, and the strength of the emotional habits  you’ve formed over the years.

Do you know what you believe about life and death?

I believe the purpose of this life is to work with my own mind and heart, to transform destructive thoughts, harmful emotions and negative behaviors into positive ones, and to learn to rest in the awareness of mind rather than all the passing chatter. Because the projections – thoughts and emotions – are transitory, whereas the awareness of mind continues beyond death.

I see the material aspects of life as secondary, a means to support the evolution of one’s awareness.

The onset of terminal illness, I believe, is the time to especially shift one’s emphasis to letting go of attachment, resting in the awareness of mind, and recognizing this body is but a transitory phenomena.  Because you can’t die a peaceful death if you’re attached to your possessions, your body, the experiences of this life, and your family and friends.

The revelation of terminal illness, as shattering as it will probably feel at first, can serve as an urgent call to wake up, get in control of your thoughts, emotions, and habits, let go of attachments, and live your best life possible in every moment you have left.

I know it often won’t feel that way, but if you can keep returning to these tasks as a baseline and as your most essential purpose, life will have more meaning, your heart will open in love, and you will be able to face death with more confidence.

That’s what I believe about the purpose of life and how to prepare for death to arrive.

But the important thing is to be clear about what you believe.  Because what you believe will determine the quality of this last part of your life.  If you’re unsure, this is the chance to turn your attention to the spiritual side of your existence and begin a journey of discovery.

How do you you want to live and die?  Just like many people live on automatic, you can deal with a terminal illness on automatic too.  You can die on automatic too.  But is that what you want?

Presence: The Way to Find Peace in Life and Death

Three words – presence, compassion, and grace – came to me in one of those liminal moments as the essence of this piece.  They represent how I want to live, how I would like to be should I face a terminal diagnosis (as opposed to a sudden death), and how I would like to die.

So let’s start by looking at what presence means and how it can radically change the flavor of your days.

Mindfulness, love + letting go | Terminal illness


Presence is the ability to be mindful and aware in the present moment without getting pulled into the past or future by thoughts and emotions.  And, until it comes time to leave this body, I feel presence means being fully embodied not just floating around in mental activity.

I know from how my mind and heart are right now, I’ll go through many emotions when I learn of my own impending death, emotions like shock, anger, denial, regret, and, for me, especially fear.  You can read more on releasing regrets here:  How to Avoid the Top 5 Regrets of the Dying.

The practice of mindfulness meditation settles the mind and emotions, but it doesn’t eradicate them entirely.  Naturally, the thought of  losing your life and all you hold dear will stir up your emotions to a fever pitch.  Or you may move into numbness or denial, seemingly emotionless states.

When you practice mindfulness, you don’t suppress thoughts or emotions, but instead you develop the ability to bear witness to them without engaging them, becoming them, and allowing them to negatively influence your thoughts, emotions, and behavior.

In other words, don’t jump on the train of negative thought patterns and unhealthy emotional habits.  That only creates suffering for yourself and others.  This is not the way to a peaceful life or death.  Instead, learn to observe whatever emotions appear, understand their transitory nature, and let them pass by.

This practice of equanimity is simple, but not necessarily easy, especially when you’re living with a terminal illness.  You may feel heightened emotions in almost every interaction and experience as you try to figure out the right steps to take to extend your life as long as possible, provide for your survivors, or cope with changes in relationships or your work status.

Being human, you will lose it — sometimes for minutes, sometimes for hours, sometimes for days.

Whenever you get lost in the past, the future, or a swirl of emotions, the key is to just come back to the present moment and continue to practice awareness without self-criticism.  Instead, be loving and gentle with yourself.

Through this repeated process of returning to the center of awareness, negative thoughts and emotions will lose their hold on you.  Everyone has this native ability to be mindful, but it takes many repetitions for it to become your natural way of being.

The only place you can find peace is in the present moment.

Now is the time, if there ever was one, to actively train your mind so you can live and die in peace.  Use whatever challenges you to practice enlightened qualities like patience, tolerance, understanding, love, compassion, and the practice of presence.  If you do, you will be using this last part of your life in the best possible way, to become a better human being as well as a more evolved spirit.

Realize Your Full Potential Through Compassion

I believe we cannot realize our full spiritual potential without activating compassion, the wish for everyone to be free of suffering and the commitment to do all we can to relieve their suffering.

A terminal diagnosis can easily become all about “me.”  A cascade of  alluring emotions will do its best to engage you and keep you occupied with yourself.  You’ll most likely be drawn to doing everything you can to extend your life.  You may become very busy in the activity of staying alive.  As your life force weakens, you’ll probably struggle with fatigue and pain as well.

However, an over focus on the self often brings more emotional distress and may even exacerbate pain.

How can you use your last days on earth – whether they add up to weeks, months or years – to reduce self-cherishing and cultivate a compassionate heart, thereby putting emotional suffering to rest?

One way is to shift your focus from your own suffering to relieving the suffering of others through the practice of giving and receiving, known as “Tonglen” in Tibetan.  While the intent of this practice is to benefit others, this simple method of breathing in suffering and sending your happiness out on the breath may also bring you relief and make your journey toward death more meaningful.

The following instructions describe how to practice giving and receiving on the breath for all beings. But you could instead practice for a single individual or for everyone who suffers with your same disease, if you wish.

Sometimes, visualize that your heart is a brilliant ball of light.  As you breath out, it radiates rays of while light in all directions, carrying your happiness to all beings.  As you breathe in, their suffering, negativity, and afflictions come toward you in the form of dense, black light, which is absorbed into your heart and disappears in its brilliant while light without a trace, relieving all beings of their pain and sorrow. – The Heart of Compassion, Dilgo Khyentse Rinpoche

Through this practice of exchanging oneself and others, you’ll gradually dissolve your own self-cherishing and transform your negative emotions, which will lead to more happiness in life and more peace at death.  The practice will also soften your heart and gradually gives rise to an unstoppable love as vast as the sky.

And isn’t that the best way to meet death, in a state of expansive love?

Create the Space for Grace to Arise

What is grace?  I feel grace is an expansive feeling of love, connectedness, and deep knowing that occurs when we are centered in awareness.  It occurs when we let go of the conceptual mind and no longer feel lured into attachment or aversion by what we perceive within and around us.

Let go in life + death to discover love + peace.

Many people think grace or blessings come from a source outside ourselves.  But I believe that we create the space for grace to manifest through letting go, again and again.

These are some ways you can invite grace along as you journey through the last stages of your life or actually in any part of your life.

The practice of presence itself creates the space for grace. Know that every moment is a small death, an opportunity to let go of what came before and to resist anticipating the future.

When we live without preconceptions, anything is possible and so the door to grace opens.  In 2006, one of my friends was given three days to live.  Three days!  Can you imagine? He’s still alive today, more than ten years later.  Another friend was put into hospice, but she didn’t die. Despite the severity of her cancer scans, she kept living for another five years.  You can read her formula for a sweet life here.

I’m not sharing these stories to give false hope, but to illustrate how letting go of preconceptions can allow grace to enter into one’s life.  It may not happen in a dramatic way as in these stories.  It may come as small moments of grace, when you let go of your concepts about another person or what is going to happen next.

When we resolve unfinished business, we also create room for grace to appear.  Try not to leave this world with anger in your heart.  Make it a point to process unfinished emotional business before you go.

Make a list of people with whom you have unfinished business.  If it’s not wise to converse with them in person, you can visualize each person who troubles you and quietly tell them everything you would like to say before you depart.  Then put yourself in their shoes and imagine how they would respond.  Dialog in this imaginary way until you feel a sense of reconciliation or resolution.

In the same way, don’t forget to express your love, appreciation, and gratitude.  When life gets busy, it’s easy to forget to say, “I love you.”  Be sure to express your gratitude to everyone who has helped you in this life.

When you give away all your possessions, you create multiple chances for grace to arise as well.  You can’t take it with you, right?  So don’t let attachment to possessions get in the way of leaving this world with grace.  Start giving away your possessions. And don’t concern yourself with what will happen to it all after you’re gone when you’ll no longer have any control.

Just imagine how light and free you’ll feel without all the stuff and the worries that go along with it.

When you get your affairs in order, you won’t leave a mess for anyone else.  You’ll also take a load off of your mind, and grace loves to appear when the mind is spacious.  Do you have a living will?  A last will and testament?  Are your papers in order?

When you accept that you are moving on and let go of your attachments to your loved ones, you also create so much space for grace to manifest.  This is the big one, isn’t it?  But it doesn’t mean you stop loving.  Quite the opposite, love as much as you can in these precious final moments, take the time to review your life, and be sure to say your good-byes.

When you accept that this body and indeed this life is but a transitory phenomena and feel ready to let go of your temporary abode, grace will arrive in full measure.

Grace will come when we let go of clinging to our possessions, our experiences, our body, our loved ones, our thoughts, and our emotions.  You don’t have to wait to be diagnosed with a terminal illness.  You can start letting go in any moment, and live your entire life in grace.  But once you’ve been diagnosed, this is the best way focus your mind and heart during your remaining time.

How’s the State of Your Mind?

According to the Buddhist tradition,  the state of your mind at the moment of death can influence your future.

At the moment of death, two there are two things that count:  whatever we have done in our lives, and what state of mind we are in at that moment.  Even if we have accumulated a lot of negative karma, if we are able really to make a change of heart at the moment of death, it can decisively influence our future and transform our karma, for the moment of death is an exceptionally powerful opportunity for purifying karma. – Sogyal Rinpoche, The Tibetan Book of Living and Dying

So feel encouraged.  If you work with your mind and heart now, you’ll be setting the positive wheels in motion for all the days and lives to come.

We all know we’re going to die, but we don’t know when or how.  Most people choose to ignore that fact, assuming their end to be far off in the distance.  But the truth is, you never know what will come next.

So whether you’ve been diagnosed with a terminal illness or not, decide right now what’s truly important in life.  When you look back from your deathbed, what will really matter? Then put all your energies into it.

Do you have any stories to share about living or dying with presence, compassion, or grace?  I would love to hear in the comments.

Sources and Related Reading

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Thank you for your presence, I know your time is precious!  Don’t forget to sign up for my e-letter and get access to all the free resources in the Always Well Within Library. May you be happy, well, and safe – always.  With love, Sandra


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  1. Wow, Sandra, this one stopped me in my tracks. What more important topic could any of us write about or contemplate? As you acknowledge, it is hard to speak from experience if you haven’t faced this in your own life. I haven’t either. But like you, I’ve thought about it a lot.

    One year, when I still had a word of the year, my word was “prepare.” When I received this word, I knew in my heart that it meant I should prepare to die. Not in the sense of any premonition of impending death, but with the sense that death is always with us, and all of us will die. I spent that year making my peace with death, as best I could since it was still somewhat abstract. And while I knew that I could not predict with any certainty how I would handle the reality when my time came, I did find a measure of acceptance and peace. And even curiosity and anticipation. Mixed with the soft sadness of letting go.

    Your post is full of gentle compassion and wisdom. Each loving suggestion is an invitation to look with honesty at the door we will all pass through, to consider what lies beyond it, and how we want to approach it. Thank you so much.

    • How courageous to spend a year contemplating impermanence! I’m inspired to hear how you found a measure of acceptance and peace. That’s exactly what’s awaiting for all of us, though it’s a process to get there. And, curiosity and anticipation too! That’s truly wonderful. If we can get to a place of curiosity, we’ve let go so much aversion. Maybe not all, but quite a bit!

      Thank you for sharing your experience, Galen! I’m sure it will inspire others.

  2. Lily

    Thank you for this timely, lovely post! There’s so much here for me to look at and work with, starting right now. I appreciate you and your writing here so much!

  3. Firstly, how brave of you to tackle this topic Sandra and the way in which you did it with compassion and wisdom and yes, I would add grace was simply beautiful.

    Personally I used to believe that death meant you were gone, forever…blankness, nothingness. But when my husband was dying some years ago I discovered that this was far from the truth…I won’t go into the story of how that happened…but I knew, absolutely 100% knew that there was so much more than my poor mind had ever realized.

    And this knowing helped me support him and love him through his dying moments and to finally let him go. 🙂

    • Thank you, Elle. And thank you for sharing such a personal story. From your story, I can see that having that strength of clarity of confidence makes a a complete difference in facing the death of a loved one, and I’m sure it will as well in facing our own death. I feel it can make a big difference when we can shift from feeling like death is bad and fearful to feeling it’s a natural unfolding of this life into whatever might be next.

  4. What an important post, Sandra, because, as you said, we just never know when death will occur for any of us. I think my main worries about my own death are the pain and suffering that my body will maybe have to endure before I leave it. I have read so may stories of near death experiences that I actually do not have fear of what will happen after death—- I am looking forward to a birth into some other realm and hopefully, more opportunities to learn about love, compassion and trust. I do fear the deaths of friends and family, though, because I don’t want them to suffer and I don’t want to lose them. So much for my being detatched 🙂 Thanks for exploring this topic in your usual gentle, graceful, loving and compassionate manner.

    • Thank you, Jean! I completely understand those concerns, Jean. Most often, there is suffering and pain as we move toward death. I think these practices can help with that, not making the pain go away but bringing some ease to it by having a more spacious perspective. You have a beautiful heart so I can fully understand how it feels difficult to see others in pain. I’m not sure that ever gets easy, but at least we can do all we can to love them and ease there pain.

  5. A pleasant surprise to see a quote by Ajahn Chah featured. I’ve been learning from his student, Ajahn Brahm, for many years now.

    My mother-in-law was ordained as a Buddhist nun. Before she passed on, she read the Tibetan book of living and dying. She passed on peacefully.

    If we decide that this is the best way to leave the physical world, then we need to start practising living in the moment now. Regular meditation practice helps to prepare the state of mind for the crucial moment. As you have said, we don’t know when death is going to occur.

    • Hello Evelyn,

      It’s a very special quote, isn’t it!

      I’m happy that your mother-in-law died peacefully. Thank you for telling us. It shows it’s possible.

      I so agree with you, we need to start practicing now if we wish to have a peaceful death.

  6. Vicky White

    Wow Sandra, what an awesome post handled with grace and gentleness. Thank you. I’m going to need to read this a few more times.

    I like to think that letting go of our stuff is preparation for letting go of life when the time comes. I do seem to have the gift of being able to let go of people, things. I shall see one day if my theory is correct…. for me 🙂

    Native Americans have a saying: let today be a good day to die. I see this as being about being present, not attached, and also having no unfinished business – a good thing to aim for.

    I’ve been thinking a lot about death and I this is the year I get my things in order – will, living will, end of life care instructions. Way overdue.

    My aunt, 94 had a stroke recently – she’s been independent and with it till now. Now she’s in a home and unable to do anything for herself. I find it hard to see her like this. Who knows what’s going on, on another level, but she has no quality of life really, is now not interested in eating anything but fruit which she only gets when we bring it to her. She’s losing weight and they’ve put her on Ensure which is mostly sugar. I think about our tendency to try to keep people alive and I think if I was in my aunt’s situation, I’d choose to just fade away at this point – if I had any say in the matter.

    I watched my mother have a stroke and lose her ability to function or speak, and she was like this for five years. In her case I witnessed a beautiful completion between her and my father who she hadn’t talked to for more than 30 years. All with no words. Soon after this she finally let go and passed away. I can see why she needed to hold on for those five years.

    So it’s different for everyone. I think if we’re lucky enough not to go suddenly in an accident or similar, we have a better chance of not leaving anything undone, but however it happens, it’s definitely a good thing to prepare ourselves for.

    • Dear Vicky,

      It’s so lovely to see you!

      I feel the same way. Letting go of stuff now is bound to soften our attachments. And taking care of your affairs will help too. I think these steps already help us to feel lighter and freer so they benefit us in life as well. We still have attachment to our body and our identity to work with, and that’s plenty. It will be easier without all the stuff! It’s amazing that you have the gift of letting go of people and things, that will surely make it easier at death.

      I’m sorry your Aunt is suffering. It sounds like she does want to fade away. I hope they aren’t force feeding her. I’m sure you are a source of comfort for her.

      That’s an amazing story of reconciliation between your mother and father. It truly shows us that we can’t always know what’s best with our conceptual mind. Those five years must have been difficult for you mother, but I image it was very liberating to complete with her former husband.

      Thank you for sharing so openly, Vicky. I’m sure your stories will encourage others.

  7. Thank you for this thought provoking and kind post. Death is something we tend to handle very poorly in our culture, like suicide, mental illness or anything that makes people uncomfortable. They would rather just not deal with it, but that’s not going to help any of us – living or dying.

    It occurs to me that we only need to strive to express presence, compassion, and grace through our beings in life, as death is part of life. There is really no need for us to segregate it. We just need to continue this part of life mindfully and gently.

    • I so agree, Debbie. Ignoring death will not really help us. And you are so right, if we can embrace all these positive qualities now, death will come more naturally.

  8. Thank you for posting this Sandra and for tackling the subject of ‘dying with grace’ head on. We talk so much about what it takes to have a peaceful, graceful life but most people don’t want to even think about death or give in room in their minds.

    I have had this subject on my mind for some time and have been quietly working with the idea of who I want to be in relation to my death (not that it’s impending or anything). And although at this stage it is simply a ‘concept’ I truly hope that when that time comes, I can be embrace it with acceptance, grace and peace.

    Perhaps preparing for death, the process of ‘letting go’, is the same one that prepares us for life <3

    • I’m inspired that you’re reflecting on death, Allanah! I feel this can make a big difference in the quality of our life and our death. I understand how it might feel like a concept at first, but with time I think it brings us closer to acceptance and even embracing the change as you say. And, I agree, facing death is so much about preparing to truly live.

  9. I appreciate reading your post Sandra. You have done a beautiful job discussing a sensitive issue.

    It is interesting that, “According to the Buddhist tradition, the state of your mind at the moment of death can influence your future.” I have as well believed for many years that death was final, however I’ve come to be open to the idea that there may be more in store for us after we pass away from this earth.

    In either case, living our lives to the fullest and appreciating the present will be what matters, so that we know we have made the best use of our time here on earth.

    • Hello Cathy,

      Yes, Buddhist believe in reincarnation or the awareness moving into a different realm of existence. Like you, I can’t say I believe this with certainty, but I’m surely open to it. I’m in accord with your conclusion either way, to live the best life possible this precious present moment.

  10. Laurel

    Dear Sandra,
    Thank you SO much for your writings. They are validational to so many aspects of my ever deepening spiritual path.
    I especially cherish your observations on death and dying. I was privileged back in my early forties to be by my aunts bedside in the three day vigil of her last days. She showed me the reverencing of beauty in Nature, encouraged me in my love of the Arts, listened to my fears (since I grew up with my dad’s alcoholism/mental disorder and a mother who was emotionally paralyzed). She was my spiritual guide, the exemplar of living from one’s heartspace, one of the truly authentic souls I have ever met, my life teacher and nurturer.
    It was she who allowed me to See through her example the way of how to fully Live, how to Die and I had the privilege to turn the tables of my “tell me a story, Aunty” to answer her “let’s walk down our memory rendezvous once more”…. I softly reminded her of our shared moments of ordinary life miracle-moments over and over for hours over the course of those last hours, thinking they were helping her. In truth, she wisely helped ME yet again because I had a treasure trove of recently mined diamonds of memories to help me through the grieving. She not only had given me a handwritten journal to accompany me ” someday, when” …but she had given me the gift of experiential immediacy to carry me to the heart place of what has sustained me these last 18 years in “a thought connects to a thought” visits. There isn’t a day that goes by that we don’t meet in the ethers of memory, in the flames of love energy that spring eternal. I hear her tingling laughter in the babbling brook, the Spring wind, the crunching leaves, the heady aroma of maple taffy on snow…and we pick meadow flowers, Queen Anne’s lace and clover and chicory once again….it’s no wonder that she lives on in my watercolours, in the beauty of the bubble, the dewdrop, the cobweb and we walk together ALWAYS WITHIN.
    THANK YOU, Sandra.

    • How beautiful, Laurel! What a special relationship. Your experience of the dying process with your aunt shows us that we can gain so much by being present to death rather than denying it. That walk down memory lane is such a good way to conclude and as you point out, soften the pain of grief. I’m honored you’ve shared this story with us. I think it will give other courage.

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