For fifteen years, nurse Laura M. sat beside dying patients during what she called “the quiet hour”—that sacred space between this world and the next. At first, her role seemed clinical: manage pain, track vital signs, comfort grieving families. But over time, she discovered something far more profound.
When people are dying, they stop performing and start confessing. So Laura began writing down what they said. After witnessing more than 300 final breaths, she uncovered seven universal truths that appeared again and again, spoken by different voices but carrying the same message. What she learned was both haunting and hopeful: most people don’t fear dying—they fear not having really lived.
These seven lessons offer us a gift: the chance to wake up before our own quiet hour arrives.
The Seven Truths from the Quiet Hour
Love More—And Love Differently
George, a 92-year-old World War II veteran, hadn’t spoken to his brother in forty years. As he lay dying, he whispered to Laura, “I won the argument, but I lost a lifetime”. His words carried the weight of decades wasted on pride and stubbornness.
In all her years at bedsides, Laura realized something striking: no one dies wishing they’d been tougher or more right. Instead, they wish they’d been kinder, more forgiving, and more generous with their love. We treat love like a side project, something to get to after we handle the “important” things—but love turns out to be the only project that truly matters.
What you can do starting today:
Send the message or make the call you’ve been putting off
Apologize for where you’ve been wrong, even if the other person was wrong too
Choose connection over being right in your next conflict
Tell someone you love them before the day ends
Don’t Save Joy for Later
A retired engineer once confided to Laura, “I was so scared of being poor that I became rich in fear.” He died just three months after retiring, never using the savings he’d built his life around. His story echoes a pattern Laura saw repeatedly: people postponing happiness until after the raise, the move, or the milestone—but life doesn’t honor those timelines.
We create mental bargains with ourselves: “I’ll be happy when…”. But someday is a mirage that keeps moving further away. The good china sits unused in the cabinet. The dream trip gets delayed another year. The special occasion we’re waiting for never feels quite special enough.
What you can do starting today:
Use the good dishes tonight instead of saving them
Book the small trip you’ve been thinking about
Wear the outfit that makes you feel good, not just on special occasions
Let joy become your default setting, not your reward for finishing everything else
Forgiveness Sets You Free
Some of Laura’s patients fought their last breath not from fear, but from unfinished pain. One woman gasped, “I can’t die angry,” and her breathing remained labored and distressed. When her estranged son arrived, and she forgave him, her entire body relaxed. She passed away peacefully thirty minutes later.
Unforgiveness doesn’t punish the other person—it poisons you. It’s a weight you carry every single day, growing heavier with time. The irony is that holding onto anger hurts you far more than it ever affects the person you’re angry with.
What you can do starting today:
Write a letter expressing your feelings, even if you never send it
Forgive me on paper if you can’t do it in person yet
Release one grudge you’ve been carrying, no matter how small
Remember that peace isn’t a prize you win—it’s a release you choose
The Best Things Are Free
When Laura asked her dying patients what they missed most, their answers surprised her. They didn’t mention success, possessions, or achievements. Instead, they said: “The smell of rain,” “The sound of birds,” “My dog’s breath in the morning”.
A CEO who built a multimillion-dollar company told her, “I mistook being busy for being alive”. He had spent decades chasing the next deal, the bigger office, the higher number—and in the process, he’d stopped noticing the simple pleasures that actually make life worth living.
Simplicity isn’t a lack of something—it’s a luxury we often don’t recognize until it’s almost gone. The smaller your world becomes, the sharper your sense of wonder grows.
What you can do starting today:
Unplug from all devices for one whole day this week
Count how many moments make you smile without screens or spending money
Take a walk and notice three things you’ve never paid attention to before
Sit outside for ten minutes and just listen to the world around you
Regret Weighs the Most
More than any painkiller could measure, regret hurt Laura’s patients the most. One patient said, “I didn’t regret failing—I regretted never auditioning”. The pain wasn’t about what went wrong, but about what was never attempted.
We waste decades trying to appear competent instead of being courageous. We choose safety over meaning, comfort over growth, approval over authenticity. But here’s the truth: failure fades from memory within months or years, while regret hardens into something you carry for the rest of your life.
What you can do starting today:
List three things you’d most regret not doing or attempting
Start the first one before this week ends
Take one small action toward something you’ve always wanted to try
Choose courage over comfort in one decision today
Presence Is the Greatest Gift
Laura said the saddest sound in her fifteen years of hospice work wasn’t the heart monitor stopping—it was the phone vibrating beside an empty chair. One father admitted, with tears, “I was always somewhere else—even when I was home.”
Presence isn’t just physically being there—it’s being fully awake while you’re there. It’s putting down the phone during dinner. It’s making eye contact during conversations. It’s choosing the person in front of you over everything else demanding your attention.
Distraction is the modern disease of the living. We scroll through life like it’s a rehearsal, not realizing this is the only performance we get.
What you can do starting today:
When you eat your next meal, just eat—no phone, no TV, no multitasking
During your next conversation, truly listen instead of planning what you’ll say next
Spend thirty minutes with someone you love without checking your phone once
Remember that one day, someone will give anything to have just one more moment of your undivided attention
Stop Pretending and Find Peace
As bodies weakened, masks fell away. One woman laughed as she removed her wig and said, “Finally, I’m done pretending”. In her final days, she experienced a freedom she’d never allowed herself during all her healthy years.
We spend enormous energy maintaining images that don’t serve us. We pretend to be busier, happier, more successful, and more certain than we actually are. We edit ourselves for approval, performing for audiences who are too busy performing themselves to really notice.
Authenticity feels terrifying—until you realize it’s oxygen. The peace you’re desperately seeking is hiding behind your willingness to be honest.
What you can do starting today:
Say what you really mean in one conversation instead of what you think people want to hear
Share something true about yourself with someone you trust
Stop pretending to be okay when you’re not
Let someone see the version of you that isn’t edited for approval
Planning for a Life of Fewer Regrets
These seven lessons reveal what matters most—but how do we ensure our wishes are honored when we can no longer speak for ourselves? How do we protect both our quality of life and the peace of mind of those we love?
Death Can Come at Any Moment
One of the most brutal truths Laura learned was that death doesn’t wait for us to be ready. Young, healthy people ended up in her care after sudden accidents or unexpected diagnoses. Middle-aged adults with “plenty of time” found themselves facing terminal illness with no preparations in place.
Research shows that 42.5% of older adults require medical decision-making before they die. Among those who need decisions made, a striking 70.3% have already lost the mental capacity to make those decisions themselves. This means that most people cannot communicate their wishes when critical healthcare choices must be made.
Planning matters regardless of your age or current health because life can change in an instant—and without clear documentation of your wishes, your loved ones face impossible choices during the worst moments of their lives.
The Foundation: Your Advance Directives
Two essential documents work together to protect your wishes: a living will and a healthcare power of attorney (also called a healthcare proxy).
A living will is a written document that describes the specific medical treatments you do or don’t want if you become unable to communicate. This includes decisions about life-sustaining treatments like breathing machines, feeding tubes, CPR, and pain management preferences. Think of it as your voice when you can’t speak—it tells doctors exactly what you want done (or not done) in specific medical situations.
A healthcare power of attorney is different. This document names a specific person (your healthcare agent or proxy) who will make medical decisions for you if you can’t make them yourself. Your agent can make all types of healthcare choices, not just end-of-life decisions. As long as you can communicate, you make your own decisions—but the moment you can’t, your designated agent steps in to advocate for you.
Why both documents matter: Your living will covers anticipated situations you can document in advance. But healthcare involves countless decisions that can’t all be predicted. Your healthcare power of attorney ensures that someone you trust can make decisions when your living will doesn’t specifically address them. Together, these documents provide complete protection of your wishes.
Research shows that people who have advance directives receive care that better matches their preferences and are more likely to die in their preferred location. Families of patients with advance directives report less stress and more confidence that they honored their loved one’s wishes.
Keeping Your Documents Current
Creating advance directives isn’t a one-time task—it’s an ongoing responsibility that changes as your life changes. Outdated documents may not protect you because medical preferences often shift based on your current health, family situation, and values.
Review your documents annually when you’re healthy. Set a specific date each year (like your birthday or January 1st) to read through your advance directives and confirm they still reflect your wishes. Life changes constantly—you might move to a different state, end or begin relationships, or simply change your mind about medical treatments.
Review your documents quarterly (every three months) when your health changes or you’re managing a chronic illness. New diagnoses, hospitalizations, or declining health often shift what matters most to you. What you wanted when you were healthy might be very different from what you want after living with a serious illness.
Why outdated documents fail: Each state has different legal requirements for advance directives, so a document created in Texas might not be valid in Colorado. People named as your healthcare agent might no longer be appropriate choices due to divorce, death, or relationship changes. Medical treatments you specified might not reflect current options or your current values. Without regular updates, your advance directives might not actually protect your wishes when you need them most.
Who Can Help: Life Transition Coaches vs. Attorneys
Creating effective advance directives requires translating complex medical and legal concepts into documents that truly protect your wishes. Two types of professionals can help, each serving different needs.
When a Life Transition Coach Is Right for You
Life transition coaches (including end-of-life doulas) are trained professionals who specialize in advance care planning, healthcare education, and supporting people through illness and life changes. They’re ideal for most people with straightforward situations.
Benefits of working with a life transition coach include:
Creating comprehensive advance directives that go beyond basic legal forms to truly reflect your values
Understanding medical realities in plain language so you can make informed choices
Receiving values-based guidance that helps you clarify what matters most to you
Getting ongoing support as your health and preferences change over time
Accessing services that are typically more affordable than attorney fees
Life transition coaches complement your medical team rather than replacing them. They bridge the gap between complex medical information and your personal values, helping you understand options without feeling overwhelmed.
When You Need an Attorney Instead
Some situations require legal expertise that life transition coaches aren’t trained to provide. Consider hiring an attorney when you face complex family legal disputes that might result in someone legally challenging your medical decisions, significant estate planning complications beyond straightforward advance directives, or situations requiring legal intervention in family conflicts.
Attorneys provide stronger legal protection in contested situations, but they typically focus on legal documents rather than the healthcare education and ongoing support that life transition coaches offer.
For the DIY Approach
If you prefer creating your advance directives independently, consider using the comprehensive resource Beyond the Living Will: Creating Effective Advance Directives (available on Amazon). This guide provides detailed information for navigating advance care planning without professional assistance.
However, remember that professional guidance—whether from a life transition coach for standard situations or an attorney for complex legal matters—ensures your documents truly protect your wishes and comply with your state’s specific requirements.
How Life Transition Coaches Help You Live With Fewer Regrets
Laura’s seven lessons teach us what matters most in life. Life transition coaches help you honor those lessons while ensuring your practical wishes are documented and protected. They provide specialized support across multiple areas that directly connect to living and dying with fewer regrets.
Comprehensive Advance Care Planning
Life transition coaches create complete living wills that extend far beyond the basic forms many people use. Standard forms often include only yes-or-no questions about specific treatments, but comprehensive planning explores your values, fears, hopes, and the meaning of quality of life for you personally.
Coaches schedule regular reviews and updates as your life circumstances change. Just as Laura’s patients wished they’d been more present in their relationships, life transition coaches help ensure your advance directives stay present to your current reality rather than reflecting outdated wishes from years ago. They work with you to ensure documents reflect your true values, not just generic medical preferences.
Healthcare Education and Literacy
One of the most valuable services life transition coaches provide is translating complex medical information into language you can understand. Remember the CEO who told Laura he “mistook being busy for being alive”—many people feel similarly overwhelmed by medical complexity, never taking time to truly understand their options.
Coaches bridge the gap between doctors and patients by helping you understand medical options in plain language, free of medical jargon. They attend your appointments, ask clarifying questions, and ensure you truly understand the choices before you. This education empowers you to make decisions based on understanding rather than fear or confusion.
Healthcare literacy directly impacts quality of life and quality of death. When you understand your options, you can choose treatments that align with what matters most to you—whether that’s longevity, comfort, independence, or time with loved ones.
Illness Navigation Support
When serious illness strikes, the healthcare system becomes overwhelming. You might see multiple specialists who don’t communicate well with each other, receive conflicting advice, or feel lost in a maze of appointments and decisions.
Life transition coaches coordinate care among your multiple providers, ensuring continuity and preventing things from falling through the cracks. They attend appointments with you, ask the questions you might forget to ask, and ensure you understand the answers. This support prevents the feeling of being “always somewhere else—even when you were home” that Laura’s dying patient regretted so deeply.
Coaches help you avoid the regret of not understanding your options or not advocating for yourself when it mattered most. They ensure your healthcare journey reflects your values rather than defaulting to whatever the system offers.
Dementia Care Coaching
Dementia presents unique challenges because the disease progressively takes away your ability to make decisions. Research shows that among patients with glioblastoma (a brain tumor that often affects thinking), only 6.9% had advance directives in place, and most lost decision-making capacity before addressing their wishes.
Life transition coaches help with early planning while you still have full capacity to make decisions. They address cognitive decline scenarios specifically, helping you document preferences for care as dementia progresses. Perhaps most importantly, they support your family through the progressive changes, helping them understand what to expect and how to honor your wishes even as you lose the ability to communicate them.
Planning for dementia while you can still think clearly prevents the agonizing decisions and family conflicts that arise when no one knows what you would have wanted.
Grief Coaching Throughout the Journey
Laura witnessed how unresolved grief and pain made dying harder. Life transition coaches address grief throughout your journey, not just at the end.
They help you process anticipatory grief—the mourning that begins before death as you face losses of independence, abilities, and dreams. They support family dynamics, helping loved ones communicate during difficult times and preventing the kind of lasting rifts that George experienced when he “won the argument but lost a lifetime” with his brother.
Coaches also focus on preventing caregiver burnout, recognizing that family members need support too. Caregivers who receive proper support can be more present—offering the gift of presence that Laura’s patients valued so highly.
Your Call to Action: Three Steps to Living Without Regret
Laura’s 300 patients taught us that time is precious and finite. The question isn’t whether you’ll die—it’s whether you’ll truly live, and whether your wishes will be honored when you can no longer voice them. Three concrete steps can help you honor both the emotional truths and practical realities these lessons reveal.
Step 1: Ensure Your Documents Are Current
Check that you have both a living will and a healthcare power of attorney for your state. If you don’t have these documents, you’re leaving your loved ones to guess your wishes during medical emergencies. If you created documents years ago in a different state, they may not be legally valid where you live now.
Verify your documents meet your current state’s requirements because each state has different rules about what makes advance directives legally binding. What worked in your previous state might not protect you now.
Review and update based on the recommended timeline: annually when healthy and quarterly when health changes. Set a specific date on your calendar right now for your next review. Don’t wait for a crisis—by then, you might have already lost the ability to make these decisions.
Step 2: Connect With a Life Transition Coach
Find a professional in your area who specializes in advance care planning and end-of-life support. Because the field of life transition coach and end-of-life doula is entirely unregulated, anyone can use these titles regardless of their training or competence. This means finding the right person requires careful evaluation rather than relying on credentials or certifications.
Ask potential life transition coaches specific questions about their experience, approach, and knowledge of advance directives, healthcare navigation, and grief support. Request references from past clients or healthcare professionals they’ve worked with. Pay attention to how they communicate and whether their approach feels right for you.
Establish a relationship before crisis occurs. Just as Laura’s patients regretted waiting to express love and forgiveness, don’t wait until you’re seriously ill to address these crucial preparations. Building a relationship with a life transition coach while you’re healthy means they already understand your values when difficult decisions arise.
Create a partnership for ongoing support. Life transition coaches aren’t one-time consultants—they’re ongoing partners who help you navigate health changes, update your documents, and ensure your wishes stay current with your life.
Step 3: Live the Seven Truths Starting Today
Use Laura’s morning check-in: Ask yourself each morning, “If today were my last, what unfinished moment would I regret most?” This question cuts through all the noise and reminds you what actually matters. Then do something about that answer before the day ends.
Practice evening forgiveness—especially of yourself. Before bed, consciously release one grudge, one resentment, one way you’re holding onto anger. Remember the woman who couldn’t die until she forgave her son—don’t wait that long.
Do one purposeless, joy-filled thing each week. Not something productive, not something that checks a box—just something that makes you feel alive. Use the good dishes. Watch the sunset. Call the old friend. These moments are what people remember at the end.
Conclusion: Wake Up Before You Have To
When asked how she handled witnessing so much death, Laura smiled softly and said, “It’s not about death. It’s about clarity. Dying people aren’t sad—they’re awake. My job is to wake up before they have to”.
After 300 final breaths, Laura discovered that every confession, every tear, every whispered goodbye pointed to the same truth: We chase success, control, and attention, but every chase ends in stillness. What matters is who we loved and how we showed up while we were still running.
Those seven truths became Laura’s compass and saved her life long before they ended anyone else’s. Now they can be yours.
Stop scrolling through your life as if it’s a rehearsal. Say what you need to say. Touch what you love. Spend what can’t be saved—your time, your laughter, your tenderness. Protect your wishes with proper advance directives so your loved ones aren’t left guessing during impossible moments.
Because someday, someone will hold your hand during your quiet hour. Make sure you’ve already lived what you came here to say. Make sure your voice will be heard even when you can’t speak.
Your next breath is promised only once. Use it wisely.
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At present, no official organization oversees end-of-life doulas (EOLDs). Remember that some EOLDs listed in directories may no longer be practicing, so it’s important to verify their current status.
End-of-Life Doula Schools
The following are end-of-life (aka death doula) schools for those interested in becoming an end-of-life doula:
Remember that there is currently no official accrediting body for end-of-life doula programs. It’s advisable to conduct discovery sessions with any doula school you’re considering—whether or not it’s listed here—to verify that it meets your needs. Also, ask questions and contact references, such as former students, to assess whether the school offered a solid foundation for launching your own death doula practice.
