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A Donation FromThe AngelKIT Foundation
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Copyright: Susan Binau & The AngelKIT Foundation
The AngelKIT is Developed by Nordic Wizards with inspiration from Jeannie Lee
Front cover: Graphic designers Nannali Juliet Trierand Nanette Vabo
AngelKIT Logo by Nannali Juliet Trier
Editor: Ellie Maas DavisPressque, LLC
www.angelkit.org for more information
A Nonreligious Donation
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For Ch !"ina and Me#e, once an$ls on ea%h
y&are now an$ls in Heavenh
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In frantic emergency rooms and otherwise sterile corridors, the AngelKIT is designedto bring basic human comfort to hospital patients nearing death. Its meant to aid the
hospitals staff and those others who are directly involved in experiencing a patient,
friend, or family members passing. Knowledge of the dying process, and its physical
signs, can make all the difference in being able to create a calm, comforting environment.
The AngelKIT give professionals and laypersons tools to help ensure terminally ill
patients pass with a sense of honor and dignity.
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Dear Relative, or Friend,
Although death is just as natural as birth, death is surrounded by taboo. As a general rule,
we find it difficult to talk about it, but with knowledge of the details and facts, those whoare dealing with a terminally ill loved one will be better equipped to support them andmake them more at ease during the final stages of life.
Its extremely hard to watch someone you love die. Many patients suffer long,progressive diseases that take huge mental and physical tolls on family and friends.Under such stress, it can be difficult to communicate with one another, the medical staff,and the person who is dying. Its very important that potential conflicts are not discussedwhen a familys stress is at a high. Its better to acknowledge difficult moments and letthose moments pass. The dying persons needs must always be the priority, so chooseyour battles wisely and with great care.
More than anything, its important to remember that you wont have all of the answersand thats okay. Inevitably, a lot of what the dying process comes down to is an ability tolet go. While you focus on doing all you can for your loved one, keep in mind that your
heart will lead the way in the care and sustenance youre able to provide.
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The AngelKIT will help. It has a lot of what youll need, but what you may lack inimmediate, firsthand knowledge, youll be able to supplement by following your instinct.I believe you, the reader, have the answers for whats right for your loved ones. I humbly
hope that the AngelKIT helps guide you in making your loved ones last moments allyou and they want and need it to be.
With love & hope,
Susan BinauAuthor and Cancer Survivor
SUnable are the loved to die. For love is immortality.~Emily Dickinson
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Contents
The Story Behind the AngelKIT 8
A Definition of a Worthy Passing 9
The Journey towards Death 12
Division of Roles 17
How to Best Use the AngelKIT 19
Grief and Mourning 23
The Music CD and the Science Behind It 24
Prayers 27Helpful Links 29
About the Author 30
Acknowledgements 31
Notes 33
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The Story Behind the AngelKIT: A Word from Author Susan Binau
After I survived colon cancer in 2006, I decided to dedicate my life to supporting
families dealing with serious illness and help those with a relationship, whether
professional or familial, to someone who is near death.
My deepest wish is to give people hope, inspiration, and tools to face difficult times.
Since my own near-death journey, I have spoken with thousands of peoplehealthcare
professionals, relatives of the dying and terminally ill, and children left behind after a
parents passingwhove provided me with priceless knowledge that I carry in my heart
each and every day.
The idea of the AngelKIT came to me in a dream. The premise is twofold. First, its tohelp caregivers feel less alone in the process of losing a loved one; secondly, to help
caregivers realize that simple things can make a big difference in the way their loved one
experiences the process of death. This kits purpose is to make death as dignified as
possible for the dying person, and as gentle as possible on their relatives.
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A Definition of a Worthy Passing
Based on research with terminally ill patients, their relatives, and the healthcare
professionals, who care for them, a worthy passing might be described as and include:
Everyone involved complies to the wishes the dying has expressed
If possible, talk to loved ones about our wishes as well as their wishes regarding
death
Its optimal to openly discuss where and how death will likely occur
An assurance that the dying has professional treatment and the most possiblepain relief
To ensure that the room is set up and ready for the final journey
Confidence that friends and relatives are familiar with the process of death
Cooperation between relatives and the professionals is optimal
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Many of the people I have talked to mention that in the last hours of their loved ones
life, there was serenity. They describe the death in terms such as:
With a little smile, she passed peacefully away.
He held my hand and pressed it softly before he closed his eyes.
Im sure she could feel my presence.
He had no pain.
Such memories satisfy us and help us in the process of grievingknowing we did what
we could to be present, available, and show our love. Ultimately, thats all any of us can
plan or hope when it comes to supporting a patient in the final moments of life.
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Concerning a Dying Person
Speak in a normal tone. Dont speak in third person as if the person is already dead or
cant hear you. Try to have patience throughout the process; sometimes we get impatientbecause we know the person is in pain, but its exceedingly important to have faith, act
rationally, and remain calm. If youre upset by anything, go out of the room. Return only
once youve composed yourself. If youre sharing the watch, take turns watching over the
dying to ensure that everyone takes rests.
If you feel uncomfortable with anything, try to find someone you trust and talk to them.
At hospitals you can often find help and support (such as caregivers psychologist andpriests). Ask the staff if they the can recommend somebody. We offer links in the back of
the book you might find useful and have concise chapters about the process of dying and
grieving. Maybe you dont have the energy to read it now; read it whenever you feel the
time is right.
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The Journey towards Death
Like birth and life, the process of dying is unique to each individual.
With a terminally ill person, the dying process usually begins well before signs of deathbegin to show; there are signals and indications of imminent death that are well known to
healthcare professionals, though while sitting aside the deathbed of one of your loved
ones, it can be difficult to know exactly what to expect.
The most common question among relatives is when it will happen. And thats hard, if
not impossible, to say. Terminally ill patients getting worse and worse by the month willprobably only have months to live. A patient getting weaker each week, weeks. And the
patient whose condition gets worse every day, probably only days. Apart from that, life
and death often surprise us. Theres no exact schedule; there are only warning signs and
symptoms to look for.
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Months Prior to Death
Some people prepare for death mentally and contemplate life and death. Others never
really do and do not want to talk about it. In my experience, almost everybodybe it
hours before death or weeks beforehandat some point recognizes that their death is
imminent. During the months preceding death, a persons appetite is often reduced. Oftenthere is also a significant weight loss. The person also sleeps more than usual, and there
is a certain withdrawal from everyday life.
Weeks Prior to Death
This is the time during the journey that the dying person begins to sleep most of the time.
Appetite is further reduced; it seems to take more energy to process the food than it doesto eat it. Theres also a gradual loss of thirst. Elimination is affected. There may be
incontinence; bowel control may also be lost during this period. Though not eating and
drinking in this period has reduced the contents of both bladder and bowel.
The person may seem to withdraw more and more from life. Disorientation is common;
altered senses of perception can be expected. One may experience delusions, such as
fearing hidden enemies or feeling invincible. Caregivers can best help by assisting the
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person with physical tasks, while being sensitive to their feelings and attending to their
comfort as much as possible.
Days and Hours Prior to Death
The person may now refuse to eat or drink, and goes in and out of consciousness. Youmight speak a few words with the person, and suddenly they drift off to sleep. It may feel
like the person is between worlds. The body temperature lowers; arms and legs are
cold, blotchy, and purplish. Pulse becomes irregular. Skin color changes, breathing
changes occur; the breathing can become more labored, and sometimes congested.
If not unconscious, during the last twenty-four hours, there may be a surge of energy. Theperson may talk to loved ones, or ask for food after days of no appetite. This surge of
energy may be quite a bit less noticeable. The surge of energy is usually short-lived, and
the previous signs become more pronounced as death approaches. It is widely believed
that hearing is the last sense to go so it is recommended that loved ones sit with and talk
to the dying person during this time.
When death is imminent, the person usually becomes unresponsive and may have theireyes open or semi-open with a glassy fixed stare, not seeing their surroundings. Hands
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and feet will be cold; the jaw will be open as they often breathe through their mouth.
Eventually, breathing will cease altogether as the heart stops and death has occurred.
A Word on Children Dealing with a Parents Imminent Death
A warmhearted priest from Denmark says: If you dont talk about the dead, they die
twice.
Many people avoid talking to their children about theirs or a loved ones imminent death.
They want to spare the child heartache, but ultimately, with silence, there is more
confusion and additional suffering.Not
talking to a child about a parent or close loved
ones impending and probable death is never a solution.
There are instances when terminally ill parents promise theyll come back. This does
nothing but keep a child waiting. You can always hope for the best, but when it comes to
death and dying, honesty is the best policy. Be clear about the process, discuss the details,
and ask the child his or her feelings every step of the way. Yes, its painful to lose a
parent, especially if a child is young, but whether or not the child has siblings and
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regardless of age, he or she must be made aware of whats likely to happen and what the
worst case scenario is.
An activity that helps bridge understanding is to create a memory box. Its a place
where children can keep pictures, letters, quotes, and other memorabilia of the person
they love who is dying. Help the patient write notes to the children they haverelationships with; tape their voices, use videotape, do anything to keep their memories
alive.
Children cope differently. Seeking help from professionals, insight from support groups
in your community, and guidance from your church can make all the difference.
Transparency is an important step for the surviving parent; its also an incredible tool to
help ensure a better quality of life to a surviving child.
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SIn the night of death, hope sees a star, and listeninglove can hear the rustle of a wing.
~Robert Ingersoll
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Division of Roles
It can be very demanding to sit with the dying and sometimes it takes longer than initiallyexpected. It is important that the relatives take time for breaks; maybe all you need is a
moment in the fresh air or maybe you need to go home for a shower and a change of
clothes.
Luckily, there are often more relatives that can take turns to sit by the dyingother times
there is only one. If this is the case, caretakers can relieve the pressure on the relative, so
the person can take a well-deserved break knowing that the dying still has a warm hand
to hold. If there are only a few relatives, ask the staff if they can help by for example
contacting volunteers that can relieve the stress, the local priest or others that are needed
in this process.
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Divide the Roles between the Relatives
Some can be in charge of controlling the visiting hours, for example, on an excel
document. Others can be in charge of bringing fresh flowers, some are better equipped at
communicating with the staff, and maybe someone is good at informing everybody via
email or phone calls. The better the relatives work together, the better everyone feels and,without a doubt, this affects the patient in a very positive way.
What Is Typically Happening to the Close Family?
On the emotional level, we now have to say goodbye to one of our loved ones, and at the
same time make sure that everything happens as peacefully and painlessly as possible.
For many people, they are dealing with death for the first time, and they have no clue
what to do. More often than not, our hearts tell us what to do; its natures gift to all
mankind. Talking and sharing with others is also a good way to find the best possible
solution. After talking to so many people, whether youre in Europe or in USA or
anywhere else, while traditions may vary, its universal to want the best for your relatives
and friends, especially during their final days.
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How to Best Use the AngelKIT
Hospitals are often uncomfortable places to die. A dying person and their relatives often
need more attention than its possible for healthcare providers to give. The AngelKIT
supports the team of professionals that might not have the time they wish they had. Its
basis is common sense, years of experience, and science. With these helpful measures,you will be able to focus on whats important for you and your loved one during this
process.
In your kit, you will find an LED candle, a CD, lip balm, an Angel, as well as general
information on the dying process.
Turn down harsh lights, make sure the patients linens are clean, and remember to letsome fresh air into the room once in a while. The use of the candle will help make the
room as calming and peaceful as possible. Normally, hospitals dont like people to use
real candles; hence, LED candles are an amazing substitute.
Sound checks are welcome. Tuning out the regular hospital noise often instantly relieves
stress and brings comfort to patients and families. Thats why you will also find a CD
with meditative music. The ability to hear sound is the last sense to leave a dying person.Whether its from a disc player or laptop, the CD is proven to calm people and relax
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them. Even though your loved one is not awake, theyre still able to hear and feel the
soothing melodies.
MusiCures CD-sampler represents a cross-section of the MusiCure program. These
shorter examples of the complete series are linked into one continuous movement, which
can be heard and experienced as a coherent journey through what can best be describedas MusiCures relaxing and inspiring universe.
In addition to the LED candle and the MusiCure CD-sampler, you will find lip balm in
the kit. Lip balm is another way to care for the terminally ill, who often have dry,
chapped lips. Moisturizers for the skin can also be soothing. Ensure that your loved one
has enough to drink, and that his or her lips are soft and moisturized. Even though she
may not be conscious she can hear, sense, and feel thirst.
Rituals have a place. Prayers, poems, quotes, and last words offered with a soft voice can
have significant effect. Enjoy these sacred, eternal moments. Now more than ever, ethics
and behavior matter. Details like dim light, calming sounds, and basic knowledge of what
is about to happen can make dying more peaceful. Tell your loved one what youre doing
at all times. Tell them what you feel and what they have taught you. Recall experiences
youve had together. Its never too late to say, I love you, I forgive you, or Please
forgive me. From moment to moment, listen to what your heart has to say.
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Touching the dying person can be very important. The dying person will feel your
presence. Its important they dont feel alone. Use this guide as inspiration, but you can
also use your intuition. Remember to be gentle and to make slow movements. The
comforting touch of a relative can be a calming experience. For the dying person, it is
very important and, for the relatives, its an opportunity to do something useful. Amassage can release tension and relax the patient, which improves your and their sense of
wellbeing.
During the final stage of life, there is an increasingly special place for touch; this could
be in the form of gentle massage, simply holding a persons hand or even just a
practitioner's presence. Through the act of compassionate touch, body workers can be
instrumental in showing families that despite the decline of their loved ones body theyare worthy of the same tenderness and care as a newborn baby. Just as touch is one of the
first forms of communication a baby receives, it may be one of the final ways we talk to a
person who is dying.
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Massage Steps for Hands:
1. Softly place one of the patients hand between yours for a few seconds. Using yourthumbs, gently massage the palm of the hand.
2. Massage the back of the hand, working in between the bones to help release anytension. Do not press too hard.
3. Massage each of the fingers and the thumb in turn, squeezing, rotating, and caressingthem tenderly.
4. Using light strokes, draw your hands down your partner's arm, down the hand, andoff at the fingertips. This finishes the hand massage.
5. Move round to the opposite side of your partner. Now repeat every stage of the handsequence for this side of the body.
Massage Tip:
Find a comfortable position for working on the patients hand. You may find it best to use
an extra pillow if one is next to the bed. You may also add lavender to the oil if you want
a calming scent.
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Grief and Mourning: After Death Occurs
It is just as noble and meaningful to be a part of creating a worthy death, as it is to save
lives.
Upon a loved ones death, many relatives wish to sit for awhile, before they go home.
Some might find it comforting to say a prayer; two prayers, one non-denominational and
one Christian, are included near the end of this booklet. Another idea is to put flowers by
the dead and light candles. Many also have a tradition of opening the window, so the
soul can fly away. If there are relatives coming from far away and they do not make it
while the dead is still in the wardroom, there is the option of saying goodbye in the
hospital chapel.
In so many ways, its cheerless to care for a dying patient. But while its undoubtedly sad,
it helps the grieving process to have made sure that the terminally ill patient experienced
the optimal death with the least amount of pain as possible. It takes courage to be there
for someone who is dying, and such courage will guide families and friends as they
mourn the loss of their loved one.h
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The Music CD and the Science Behind It
MusiCure, music as medicine, is a series of special composed soundscapes written
and produced by the celebrated Danish born composer Niels Eje.
The MusiCure productions originally stems from the Musica Humana Researchproject where independent medical researchers, working closely together with the
composer, have carried out numerous controlled clinical trials with this music and
documented the effect with scientific methods on several different patient groups in
Scandinavia and the United States.
MusiCure it deliberately intended to have a soothing and relaxing effect, and at the
same time create positive mental stimulation and inspiration. The creation and
development of the music is based on feedback, knowledge, and insight provided by the
medical research.
What makes MusiCure special is the fact that the music has been created from scratch
specifically for the above-mentioned purposes. Since 2003, scientific articles describing
the research results have been published in international medical journals, such as:Intensive and Critical Care Nursing,Pediatric Anesthesia,European Journal of
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Cardiovascular Nursing,Heart & Lung: The Journal of Acute and Critical Care,Journalof Clinical Nursing, et al.
The effect of adjunctive treatment with MusiCure demonstrates the following
documented results: Reduced feeling of anxiety, pain, and stressand an increased feeling of
wellbeing
Diminished use of medication, i.e. tranquilizers, sleeping drugs and sedatives
Significant reduction of the bodys production of stress hormone, cortisol
Increased production of the beneficial hormone, oxytocin
Improvement of sleep quality and rest for all patient groups
The MusiCure series are widely used as a supplementary treatment in many hospitals
worldwide, as well as a tool for relaxation, stress relief, and positive inspiration for
thousands all over the world.
Today, the MusiCure CD series consists of 10 original CD releases, which in
Scandinavia is sold exclusively at pharmacies, because of the comprehensive researchdocumentation behind this specially composed music.
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In 2007, MusiCure and composer Niels Eje, together with executive producer Inge
Mulvad Eje, received the prestigious first prize at the Blair Sadler healing arts
competition in Nashville, Tennessee, USA.
More information about MusiCure and the research behind the CD series can be found at:
www.musicahumana.org and www.musicure.com
Disclaimer:
MusiCure is created as a supplementary tool for stress relief, positive inspiration, and motivation.
Through controlled clinical studies published in international medical journals, this music has been
proven to be able to reduce stress, anxiety, pain, and to minimize the use of medication, but it is not ableto heal or cure diseases in itself. The word cure (as a part of the combined brand name) should be
understood in the same way as it is used in words like manicure and pedicure.
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Psalm of David
The Lord is my shepherd; I shall not want.
He maketh me to lie down in green pastures:he leadeth me beside the still waters.
He restoreth my soul: he leadeth me in the paths of
righteousness for his name's sake.
Yea, though I walk through the valley of the shadow of death;
I will fear no evil: for thou art with me; thy rod and thy staff they comfort me.
Thou preparest a table before me in the presence of mine enemies:
thou anointest my head with oil; my cup runneth over.
Surely goodness and mercy shall follow me all the days of my life;
and I will dwell in the house of the Lord for ever.
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Prayer
My pain is gone, I rest in peaceI need not fear, my souls release.
Though tears and sorrow I depart
To forever live inside your heart
As friends and loved ones gather near
My memory will linger near.
B. Robert Clark,
12.29.10
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29
Books for Further Inspiration
Doreen Virtue
Daily Guidance from your Angels
Elizabeth Kubler-Ross, MD
On life after Death
On Children and Death
Raymonda Moody, JR, MD
The Light BeyondLife After Life
Stephen Levine
A Year to Live
Who Dies?
Viktor E. Frankl, MD
Mans Search for Meaning
Helpful Links
www.griefshare.org
www.hearthope.com
www.compassionatefriends.orgwww.missfoundation.org
www.worldprayers.org
www.candlelighters.org
www.growthhouse.org
www.hospicefoundation.org
Angel Kit Foundation
www.angelkit.org
Nordic Wizards
www.nordicwizards.com
http://www.nordicwizards.com/http://www.nordicwizards.com/http://www.angelkit.org/http://www.angelkit.org/http://www.hospicefoundation.org/http://www.hospicefoundation.org/http://www.growthhouse.org/http://www.growthhouse.org/http://www.candlelighters.org/http://www.candlelighters.org/http://www.worldprayers.org/http://www.worldprayers.org/http://www.missfoundation.org/http://www.missfoundation.org/http://www.compassionatefriends.org/http://www.compassionatefriends.org/http://googleads.g.doubleclick.net/aclk?sa=l&ai=BCz-UVCoRTemiMsrKsQf6y9WQAYaXz78BkpvpjwHAjbcBoJUtEAUYBSCb0agGKAk4AFDC47m2-P____8BYMm-rofco9wQoAHcjuP-A7IBD2R5aW5nLmFib3V0LmNvbcgBAdoBN2h0dHA6Ly9keWluZy5hYm91dC5jb20vb2QvdGhlZHlpbmdwcm9jZXNzL2EvcHJvY2Vzcy5odG2AAgGoAwG4AwHoA4kF6AOyBegDoQH1AwAEAAT1AxAAAAA&num=5&sig=AGiWqtxtxsRqhkk6oeiPuzTeBCi0yEEqWw&client=ca-about-health_js&adurl=http://www.hearthope.comhttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BCz-UVCoRTemiMsrKsQf6y9WQAYaXz78BkpvpjwHAjbcBoJUtEAUYBSCb0agGKAk4AFDC47m2-P____8BYMm-rofco9wQoAHcjuP-A7IBD2R5aW5nLmFib3V0LmNvbcgBAdoBN2h0dHA6Ly9keWluZy5hYm91dC5jb20vb2QvdGhlZHlpbmdwcm9jZXNzL2EvcHJvY2Vzcy5odG2AAgGoAwG4AwHoA4kF6AOyBegDoQH1AwAEAAT1AxAAAAA&num=5&sig=AGiWqtxtxsRqhkk6oeiPuzTeBCi0yEEqWw&client=ca-about-health_js&adurl=http://www.hearthope.comhttp://www.griefshare.org/http://www.griefshare.org/8/6/2019 ANGELKIT Booklet US
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About the Author:
Susan Binau is a Danish motivational speaker, philanthropist and the author ofTillSickness Do Us Part: How Love Survives in Difficult Times,A Dignified Farewell, The
Lion and the Scenic Route, and Mommy, Can I Have Your PC If You Die: The Story of a
Family Struck by Cancer. Susan is the founder of the Female Courage Foundation andNordic Wizards. Susan and her husband Alan live with their 4 children in Denmark, and
enjoy their second home in Florida, USA throughout the year.
About the Composer:
Niels Eje was educated at the Carl Nielsen Academy of Music and later studied with
Lothar Koch at the Berlin Philharmonic. He has toured all over the world performing
concerts in the United States, Japan, England, Sweden, Mexico, Germany, and France,among others, and including his native Denmark. In 1998, together with Professor Lars
Heslet, he developed Musica Humana, an interdisciplinary research organization aimed
at creating soothing musical environments in hospitals. Once a Denmark-based initiative,
MusiCure is now an international movement. To learn more about their efforts go to
www.musicure.com, and to learn more about the science behind the music go to
www.musicahumana.org. In 2007, Niels Eje was awarded the First Place Professionalin the Blair L. Sadler International Healing Arts Competition.
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Acknowledgements
A special thanks to my late father who taught me important lessons during this journey,
and to my partner Nannali Juliet Trier for making time for this important work. I extend
gratitude to Ellie Maas Davis for being sharp, precise, and finishing my sentences in a
loving and patient way, and to Jeannie Lee for her guidance and energy, Nanette Vabo for
her creativity and wisdom, Jan Horde for being a true friend, and Inge Mulvad and
Composer Niels Eje for sharing years of research and experience.
I am indebted to Klara Balling, MD, for her insight and expertise. None of this would
have been possible without all the friends and volunteers of Celebration in Florida whohelped us put the Angel Kits together.
A special thanks to author and cancer survivor B. Robert Clark, who wrote the beautiful
prayer in the booklet.
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As always, I appreciate my husband Alan and my four children who wait patiently for me
to return to the world after working on a project. And again, I am also indebt to those
who, over the last three years conducting my research, let me ask the hard questions andto those spirits who, having now passed, give me courage to attempt to make the passing
less difficult for others.
h
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Notes
Dear Reader,
The following pages are for your and your familys notes, thought, reminders, andmessages to each other. Its also a good place to jot your doctors advice and anythingelse you find important.
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STo live in hearts we leave behind, is not to die.~Thomas Campbell, "Hallowed Ground" , by Thomas Moore
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S Although it's difficult today to see beyond the sorrow,
May looking back in memory help comfort you tomorrow.
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The information provided in this booklet and kit, graphics, images, CD, Angel, lip balm and massage oil is forinformational purposes only. It is not to be construed as medical care or medical advice and is not a replacement formedical care given by physicians or trained medical personnel. AngelKIT Foundation does not directly or
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It is your responsibility to evaluate the information and results from tools we provide. If you are a health careprofessional, you should exercise your professional judgment in evaluating any information, and we encourage youto confirm the information contained on our website with other sources before undertaking any treatment or actionbased on it. If you are a consumer, you should evaluate the information together with your physician or another
qualified health care professional.
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