I was sitting at the bedside with the wife of a man who was nearing the end of his life. This is not unusual for me, as it is my profession, and a position I find myself in often. The difference in this scenario, is that she is my friend. We met in a situation similar to this one, only at that time, I was the hospice nurse and she was the best friend. We were there together when last breaths were taken, and we have been friends ever since.
Shortly after we met, her husband was diagnosed with cancer. She asked me to be there with and for her in the end, which I agreed to without hesitation. For the first year, his symptoms were managed well. He was a strong and stubborn man, determined not to go down without a fight. Some days, you couldn’t even tell that he was fighting this battle, he never let it show.
Theirs was the kind of relationship we all hope to find; it was a deep friendship, partnership, and love affair that made most people feel envious. He loved her, with every ounce of his being and she never questioned his commitment to her in anyway… and he felt the same. He told me once that she was the sprinkles to his cupcake.
Over the past few months his condition worsened, and his decline happened quickly. He was in a lot of pain, he lost his balance and could no longer walk, and he became bedridden. I encouraged her to hire caregivers right away, knowing the physical work would be too hard for her. I spent hours on the phone with her, explaining the dying process, and I tried to help her plan their last few months in a way that would ensure his comfort, but also leave her with a kinder last memory of their time together. Unfortunately, I also watched as the weeks passed by, a normally strong and vibrant woman crumble, and die her own internal death as well, which was heart breaking.
I went to her home one day and took her for a walk around their neighborhood. She hadn’t showered and I am sure she was in the same clothes she slept in, probably for several days, and she was painfully thin. We sat down on a bench that looked out over the lagoon and she started to cry. She said, “I can’t take this anymore”. I just held her in my arms and let her go through whatever she needed to, allowing her to let go of some of what she had been holding in. She said that this was harder than she imagined, that knowing someone you love was going to die and there was nothing you could do about it but sit back and watch, was hard enough, but it felt as though everything else between them died weeks before and he was no longer the man she knew and he looked at her like a stranger and it was killing her inside. I have seen this before, it is exactly what it looks like when someone is dying, right in front of your very eyes. Until you go through it yourself, you cannot begin to understand the depths of pain someone experiences when watching someone they love begin to die.
I turned and faced her, I put my hands on her shoulders and I said, “ok girl, you’ve got this. I need you to try harder to be stronger”. She looked at me with such pain in her eyes, and said, “this IS me trying”. And it was at that moment that I realized that no situation is the same, that no death or dying process is the same and that whether you are a hospice nurse, or a friend, or both, you have to find a way to help this person get through these next few days without them shattering into a million pieces. You are their super glue, you are there to help hold their pieces in place when they no longer have the strength to, which is not easy. You can't tell them how to feel, you have to allow them to feel and comfort them through it.
We stayed on that bench a little while longer and we talked about their life together, the wonderful memories they’ve shared and the love they felt for one another. I encouraged her to let their love guide her through the next few days and draw from that loving energy to be as present as she could possibly be for her dying husband. We walked back to her home, she showered and put on a dress she knew he loved, and she joined me at his bedside. We turned on some classical music, which he was very fond of and we reminisced about their life together.
As we sat at his bedside, I could tell he was very, very close. I had assumed earlier that he had a few more days, but I knew then, at that moment, he only had a few hours, perhaps less. The minute I realized that, she had too, and she looked at me with knowing in her eyes. She put her hand in his and she said, “baby I am not going anywhere, you are not doing this alone”. We sat there for several hours sharing stories, some laughter, some tears and so much love until he took his last breath. When she was certain he was gone, she whispered, “I am gonna miss you so much”, and then she kissed him on his forehead, and said goodbye.
This was a few years ago. We have stayed in contact, but she moved away, and I have not seen her since the funeral. She sent me an email recently, it was the anniversary of his death. She wanted me to know how much she appreciated that day on the bench, the words I had said to her, forcing her to shower and feel pretty, knowing that in her heart, she would carry their last time together with her, and while at the time she didn’t see the point, she sees it now. She knows she was there for him in those last moments, that she said what she needed to say, and that she let him know how loved he was. She thanked me for not backing down, and for encouraging her to make those last moments the best they could possibly be, despite how difficult it was. I knew she needed a better last memory than she was setting herself up for.
As I continue to evolve as a hospice nurse and an end of life doula, I strive to make those last moments as meaningful as they can be. It certainly does not remove the ache or the pain someone is feeling, but that memory, when those last breaths are taken will stay with us forever. Whether you work in hospice, or you are a friend or a family member of someone who is having to say goodbye to someone they love, please be mindful of how truly hard it is to navigate the dying process. No matter how prepared you are for what will happen, watching someone you love die can break you into a million pieces and it really does feel like there is no coming back from that. Take their hand, walk with them through the process, support them, listen to them, let them vent, let them cry and let them know it is okay to laugh and smile too, because all of those emotions are valid. And while we feel the need to tell them to try a little harder to be stronger, that might just be their version of trying hard and we need to respect that.
Photo credit: This photo was taken by Frances Freyberg, please visit her website and see all of her beautiful work: www.francesfreyberg.com
Thank You this is a must read for everyone in healthcare.
You painted the picture so well . . . as always. As a hospice volunteer, this reminder is always needed. Thank you.