When the end is near

All of us have a life cycle and we all know that it ends with death.  In an extended care facility death is always present.  It is something I have become accustomed to.  Since my arrival, in late summer of 2012, eight residents on mom's wing have passed away.  The first resident I didn't know very well but I still found it shocking.  But today, I'm no longer shocked rather I see it as a blessing because I know, the suffering is over for everyone.  The resident is no longer in pain and the friends and family can finally find peace and relief.

Over the past months I have observed things and I see similarities.  When a resident is taken from the facility it means that they are very sick and their personal directives indicate that extraordinary measures to maintain life are to be taken.  So their room sits empty.  There is no point in asking any of the workers how they are doing because they either don't know and if they do, they are not allowed to divulge such information without family consent.  So, workers, volunteers and residents watch and wait.  We watch the room and we wait for the name to come off the door and NEW resident move in.  Then we wait for an obituary on the memorial wall.   It's sad really as many of the healthier residents knew them for quite some time and even before the dementia got a hold of them, yet they aren't given the chance to say goodbye before they pass.  I find it sad too because I see them everyday and I develop a bond with all of them at some level.  I know their names and I most times I get to know the family or the caregiver and I am fortunate to get to know about the person they were.

There was a resident when I first arrived.  She was old and she was sick.  She never spoke much and if she did, often it made no sense.  Yet when I would bring her a juice, she would always say thank-you.  One day I set another resident at her table.  She motioned for me to come close and I did.

"Get that f*****g bitch away from my table." she said.  I was shocked by what she said and also by the fact that she said it so clearly and concisely.

This resident loved small stuffed animals and when I found some of my daughters old 'Beanie Babies' I picked one out, a squirrel, and I gave it to her.  She loved it and for many months the squirrel was by her side.  When I saw the paramedics take her from her room, I was happy to see that the squirrel was with her on the gurney as they took her away.  That was the last time I saw her and I was saddened by the news of her death only days later.  Yet, at the same the time, relieved.

In other situations the residents will have a personal directive that indicates they want palliative care only, which is provided at the facility so the resident is in a quieter, less intrusive environment than a hospital.  Family members and friends will come together.  A cart of food and beverages will be outside the room and staff will keep it stocked with anything the family needs.   Pastoral workers will come and go.   Sometimes for days, tired family members will take shifts, never leaving the side of their loved one.  Until one day the cart  is gone and then we know that the person has passed away.  Family will gather their belongings and in what seems an instance, any memory of them is gone.  Again, it is saddening but at the same time very heart-warming knowing they did not die alone and that they were deeply loved.

Finally, dead comes very unexpected at times.  On one occasion as I was helping my mother with her lunch, I watched the undertaker come and go towards mom's wing.  I quickly looked around to see who wasn't there.  Two of the 26 residents weren't at lunch that day and I could not resist the need to go and see.  I caught up to the undertaker and he went towards the nurses station.  I stopped at the open doorway of one of the residents who wasn't at lunch and I saw her, peacefully forever asleep on her bed.  Just the night before her and I were joking how jiggling the Jell-o was as it literally bounced out of the bowl.  We both laughed and now there she was, in front me, gone. 

Today when I went in I saw the daughter of a resident in the hall.  Her father had been ill but seemed to be on the mend.  I asked her how her dad was today and to my surprise she told me he passed away in his sleep, last night.  Again, I was shocked as only two days ago I patted his shoulder and he said,  "Hello my raven haired beauty" because he could never remember my name.

There was an eerie quiet on the ward, just like when the other resident had passed away in her sleep.  I don't know if the calm is death lingering in the air or if it is the peaceful spirit of the person that has passed.  It is a pleasant serenity that I can't seem to describe as it is almost surreal.   But I do know that when a resident passes in their sleep they leave a presence and I don't fear death anymore.  I hope that when the end in near for mom that she simply goes to sleep.  I don't welcome the day but I know the day will come.