Vigil planning: who sits when

This guide is about that organisation. It is practical. It assumes the medical care is in place, and focuses on the question that hospice teams hear most often: how do we do this without anyone collapsing.

When the vigil starts

There is no exact moment. In practice, vigil-style care begins when the person can no longer be left alone for long stretches — usually in the last days, sometimes in the last week or two. The huisarts or the hospice team will usually say, in plain terms, when the dying phase has begun. That is the moment to set up a schedule. The signs the team will be watching for are the ones described in Signs that death is approaching.

The principle: rotation, not endurance

The instinct of close family is to stay through everything. In the first day this is possible. By day three it is not. Sleep deprivation and emotional overload reduce people to a state in which they cannot give the presence they want to give.

The principle VPTZ volunteers and hospice teams use is straightforward: rotation. Multiple people, each in shorter shifts, with planned rest in between. A common pattern is 4 to 6 hour shifts, with at least one person on at all times, and a second person nearby or on call for the harder hours (often the night). If the family is small, a VPTZ volunteer can take a night watch so two relatives can sleep. The volunteer is free of charge.

A sample shift schedule

A schedule does not have to be elaborate. A sheet of paper on the kitchen table is enough. The point is that everyone knows when they are on, when they are off, and who to call.

Day 1, Tuesday
06:00 – 12:00   Anna (partner)
12:00 – 18:00   Mark (son)         + visitor: sister-in-law, 14:00–16:00
18:00 – 00:00   Eva (daughter)
00:00 – 06:00   VPTZ volunteer     (Anna sleeps in next room, on call)

Day 2, Wednesday
06:00 – 12:00   Mark
12:00 – 18:00   Anna
18:00 – 00:00   Friend Lisa
00:00 – 06:00   Eva               + VPTZ volunteer in second chair

A few rules of thumb that families and hospice coordinators tend to converge on:

• Two people overnight if possible. One sleeps lightly, one is awake. They swap halfway. No one sits alone through a whole night for more than one night in a row.
• A handover of five minutes. The person finishing the shift tells the person starting: medication times, what changed, what the patient asked for, what the doctor said.
• A "rest house" away from the room. A second bedroom, a sofa, a neighbour's spare room — somewhere shift-off people can actually sleep, not in a chair beside the bed.
• Phones on silent in the room. One designated phone (often the partner's, or a single shared phone) for medical calls.

What to do during a shift

The shift is not performance. Most of it is sitting. Some of it is small care:

• Be present. Sit close. Speak to the person by name. Dutch palliative guidance and VPTZ training are consistent on this: hearing tends to remain until very late. Speak to them, not about them.
• Mouth and lip care. A damp swab, a little lip balm. The dying body cannot drink, but the mouth can be made comfortable. The wijkverpleegkundige can show you how.
• Music or silence. Whatever the person asked for. Many families play one quiet album on repeat — it becomes the soundscape of the room.
• Touch. A hand held, a hand on the shoulder. Gentle, not constant.
• Note what you observe. A small notebook: time of last medication, time the breathing pattern changed. The next person, and the doctor, will use it.
• Call when you need to. If breathing or pain looks distressing — not just unfamiliar — call the huisarts or the hospice line.

What not to do: rearrange the room, take long calls, plan the funeral within earshot, argue.

When to bring children

There is no single answer, but there are good defaults.

• Children old enough to ask: ask them. "Grandma is very ill and might die soon. Would you like to visit her? You can leave whenever you want." Most children, given the choice, want to come.
• Prepare them for what they will see. Pale skin, shallow breathing, perhaps the rattle, the smell of a sickroom. Not dramatic — factual. "She will look very tired and her breathing will sound strange. That is normal."
• Short visits, with an exit. Ten or twenty minutes is enough. A familiar adult goes with them, and stays close enough to leave together when the child is ready.
• Let them do something. Bring a drawing, a flower, a song. Children often want to give, not only to be present.
• Talk afterwards. A walk, a snack, a question or two. Not a lecture. Stichting Achter de Regenboog and MantelzorgNL both have age-appropriate Dutch-language materials for talking with children about a dying relative.

For very young children (under four or five), the choice is the parents'. Many families bring them in briefly so they have a memory of being present; others choose not to. Neither is wrong.

When the death happens

The moment itself is often quieter than families expect. A long pause, a sigh, then no further breath.

There is no medical emergency. Nobody needs to be called in the first minutes. Sit. Take a breath. The person you are sitting with is the same person they were a moment ago.

When you are ready — and this can be twenty minutes, or an hour, or more:

1. Call the huisarts. A doctor must come to confirm the death and write the verklaring van overlijden (statement of death). Outside office hours, call the huisartsenpost (after-hours GP service). If the person was in a hospice or care institution, the staff there call the doctor.
2. Call the people in the immediate circle — the small list agreed in advance. Not the wider network yet.
3. Call the funeral director (uitvaartondernemer) when you are ready. There is no rush. In the Netherlands, the body can usually stay at home for a number of hours before formal arrangements begin; the exact time depends on conditions and local guidance.
4. Call the VPTZ volunteer on shift, if there is one, to let them know they do not need to come.

The 72-hour folder you may have prepared earlier — see The 72-hour folder — is the document the next person will reach for. The Personal Portal keeps the same information accessible to the people you have chosen.

Plan it

• ☐ Now, while it is calm: draft the shift list. Names, hours, who relieves whom.
• ☐ Share it: send it to everyone named, so no one is surprised into a role.
• ☐ Agree the call tree: who phones whom at the moment of death.

When the time comes, the list already exists. No one should have to improvise a rota in the hardest hour.

In the app

In the app you build the vigil plan together — who sits when, who to call at the moment of death, what the family should do in the first hours afterwards — and share it with the people who will be in the room.

Join the beta ->

Closed beta — access by invitation.

Sources

1. VPTZ Nederland — volunteer model and training for terminal care at home and in hospices. https://www.vptz.nl
2. Pallialine / IKNL — Richtlijn Stervensfase (clinical guidance on the dying phase). https://palliaweb.nl
3. MantelzorgNL — practical guidance for informal caregivers, including children's involvement. https://www.mantelzorg.nl