Someone approaching death, the twins said, might experience less steady breathing or lower body temperatures or begin withdrawing from family, and loved ones often appreciate the "courageous conversations" that clue them in.
It's also important, they said, to honor death's less tangible dimensions, such as when dying patients speak in metaphors — often announcing that they need to put on new shoes, catch a plane or just "go home" — or speak aloud to deceased loved ones they believe are welcoming them.
"We don't know if that's a real experience, but we see that again and again," said Gina with a smile. "If it's a comfort to the patient, we support it."
Their office is a place of organized chaos, where nurses stop by for advice, phones ring to announce new admissions (with 20 to 30 deaths per week, there's lots of turnover) and Tina and Gina tap into the latest information on their laptops, all while finding time for the personal visits they make to every patient.
The scenes can be hard: the time the cancer-stricken young father dictated letters he wanted his daughters to read at key milestones in their lives, or the dying mother who asked Tina and Gina to make plaster molds of her hands so her preschool children would have something to remember her by.
The twins, like everyone in those rooms, broke down in tears.
If you want to know why patients and their families deluge Gilchrist with letters of thanks about the sisters, look no further than the way they view such moments.
"If you can't show your feelings at a time like that, you might be in the wrong field," said Tina. "This work isn't for the squeamish."
Gina, of course, agreed.
"It's a privilege to be there," she said.
An earlier version misstated when the sisters graduated Towson University. The Sun regrets the error.