Being Present at the End of a Person's Life Is Precious!
The Circle of Life
I think it's a pretty safe bet to make that most people value the ability to be present when a child is born. Particularly as we move forward into the 21st century, more people are choosing creative birthing options that allow for more than just the parents to be present when the beloved child makes their entry into the world.
I loved the experience of birthing each of my children! And, many years later I was there when my granddaughter was born, even getting to cut her umbilical cord!
It was not that long ago that women were not very present, even for the births of their own offspring! There was a time when women were sedated to the extent that they had to be woken up much later to learn their babies had been born, what their gender was and finally to see and hold them.
We since have learned that it is essential within the first seconds of birth for the baby to make contact with the mother and of course vice versa! It would be hard to imagine choosing to be unconscious for such a life affirming and life altering experience!
Yes, there are times when it is medically necessary for a woman to be unconscious at the time of birth, but even in the case of caesarean section, women can opt to have only local anesthesia thus allowing them the ability to be fully present when their child is surgically taken from their body.
Studies have been done that reflect the importance of the bonding that takes place in those early seconds and minutes following birth. It is now common knowledge, and we all have come to expect that childbirth is to be done fully present and participating.
But what about the time of a person's death? Do we have any sort of practice or ritual around that? Many cultures certainly do have rituals around death that make it more of an inclusive time of the family and others who may care to be present.
With the advent of hospice care allowing people to live out their lives in the comfort of their own homes, people also can die at home as well. This is a huge boon for the person in question, but also for the loved ones of the person who is dying.
I recall vividly the last few months of my husband's life, though it was fourteen years ago! What I remember is that he was able to be at home and we weren't forced to spend a lot of time in doctor's offices or hospitals. Of course, his diagnosis was terminal, so we weren't expecting any surprises or any sort of medical intervention. That isn't always the case with people at the end of life. I feel so very fortunate that my beloved spouse could be at home and in his own pajamas, with our family pets and our little rituals of comfort that we would share.
I remember also that I felt a bit scared about the time of death. It was going to be the first time I faced this kind of thing with a beloved family member and the idea of his dying in the house was a bit frightening, and of course very, very sad.
What I hope to share with you today is how the experience of being present at the time of my husbands passing was ultimately very positive and a bit liberating. Perhaps in reading this, you will be moved or inspired yourself. Perhaps if you have a loved one fighting a battle that is going to result in their passing, this will give you a sense of hope or peace? I certainly hope that my experience can be of help to you, my readers.
When the Time Comes
One of the most positive parts of my shared experience of my husbands end of life was the intense intimacy we developed between us. When you allow a person who is dying to share their heart and soul, their fears, their hopes and dreams; you allow the person to live as fully as possible! There is simply no greater gift you can give a person at the end of their life than your full attention. Oh, it can be very, very difficult to let the person talk freely about their fears and their feelings about their impending death! But, to not allow this flow of feeling and expression is doing a huge disservice to the loved one.
I remember there were times when I would think my heart would break; literally break into pieces and need to be repaired; just listening to the pain and fear in my husbands voice as he would share his feelings. Yet, it was also so very nurturing to lie together in the dark and hear his voice as he expressed that he was going to miss me when he was gone. I remember feeling a bit angry and saying that "you will be gone, so you can't miss me, but I will be here and I will miss you!" Of course, I usually just thought such thoughts and didn't share them aloud.
One thing that helped us is that we seemed to take turns grieving. On the occasions when he was particularly upset about his impending death I usually was in a place emotionally that I was able to just listen and hold him and reassure him.
Conversely, there were many times when I would decompensate and fall to the floor in tears of utter anguish with the prospect of losing the love of my life. On those occasions, he was so beautifully able to hold me up and support me through my grief!
Though our marriage time together wasn't terribly long, I feel that I got to know him better and more intimately during the 13 months of his terminal diagnosis than I've ever known another human being in my entire life! That includes my precious and beloved children! There simply has never been before, or since, a more intimate relationship than the one I had with my dying spouse.
It can be very liberating to know that a death is to transpire. Liberating I suppose in the sense of it's inevitability, which removes any onus or responsibility to "fix" anything. I can assure you if there were any alternative options or treatments we would have been on top of that, but in their absence and with the certainty of a terminal situation, one can let go of so much!
In fact, we chose his headstone together and we found a quote that we both liked and wanted to be placed on the headstone. The quote was lengthy, but the piece that I remember was "When all that is left of me is love... give me away." The quote is the essence of what I want to share about the death and dying experience. I feel that in spite of how difficult and painful and scary the last few weeks of my husbands life were for me, as I thought about the ultimate end that was coming whether I was ready or not; it was one of the best gifts I've ever been given, and certainly one of the most precious gifts that I ever gave to another.
Be there with Love
On what became the last day of my husbands life I had my first chance to panic about the end that was to come.
For the two months or so, leading up to the final day my husband would take a nap every afternoon. I would sit and find something to do and after a couple of hours I'd go upstairs to our office/spare room where he'd be sleeping and stand outside the room at the doorway just watching. I would sometimes have to watch quite some time to make sure I could see the rise and fall of his chest as he breathed in sleep. Sometimes, as it got closer to the time of his death, I would panic and fear he had passed while I was just watching some crap TV show in the living room! I would be so scared and my breathing would almost stop as I paused to watch him. I would be relieved when his eyes would flutter and he'd see me standing there and call me to him. We'd embrace; sometimes I'd lie down and spoon with him, before he'd rise for the evening.
On that last day, he spent most of it in bed. Never once during the entire illness did he spend a whole day in bed, or in his pajamas prior to this! I knew of course that the time was getting nearer, as I was a nurse and he was a physician. Between us we knew his kidneys were failing and I began being the one to dose his medication those last few days, rather than his handling that himself. I knew that getting forty milligrams of morphine an hour was a pretty clear indicator that he didn't have a lot longer.
Yet, that evening the hospice chaplain surprised us by stopping by unexpected. My lovely husband was happy to get up and he came downstairs in his pajamas and we all three sat in the living room. It was April first, 2002. I will always remember the chaplain asked my husband, "How long do you think you have left," to which my husband replied "two weeks; longer if I rally." We spent a bit more time talking together and then the chaplain left. It was time for my husband to go lie down again in bed, but this time I had to almost pull him up the stairs. Suddenly he was so incredibly weak he barely could get up the steps. I got him settled in bed and then came back downstairs to contemplate the situation.
I remember lying on the couch and thinking about the coming weeks. I realized I'd been extremely fortunate to be able to maintain my own life all these months. I could go for a jog, or a long walk; grocery shop or even have lunch with a friend, and never really worry that I'd be gone too long and miss the end of his life.
But, after helping him to bed I was overwhelmed that the time was quickly coming that I could no longer go off very long without risking his dying alone.
I was determined that this not happen! I don't know if it was more important to me to be present or to him, but I just recall that it felt that I would do anything to be sure he would not die alone.
I finally went upstairs to our bedroom and decided to get ready for bed. He briefly spoke to me about wanting to brush his teeth, but said he could not get up to do it. I got his toothbrush and put toothpaste on it and brought it with a cup of water to the bed. But, in that short time he was no longer coherent and was unable to brush his teeth. I finished my own ablutions and crawled into the bed next to him.
Almost immediately he became extremely restless and was tossing and turning in the bed. Then I remember smelling a burning smell; kind of the smell that you get from an electrical wire that is hot. It was quite distinctive and almost familiar, but disturbing. I ran to the door and stood at the top of the stairway to see if perhaps something was burning downstairs. But once I got to the stair's the smell was no longer there. I returned to the bed, and the smell was there again only stronger.
Finally after about 30 minutes of his being very disoriented and seeming to be asking me to help him I tried to give him a small pill for anxiety. He was unable to swallow water and was no longer coherent at all. I then made the phone call to Hospice and left a voice mail for our nurse. I told her that I felt he was dying. This was about 10:15 pm. Fifteen minutes later he died. I was overwhelmed with the need to save him! I don't know if was the nurse in me, or the wife that simply couldn't accept he had died, but I was unable to turn off his oxygen. I kept feeling his pulse. Finally, the hospice nurse returned my call, and we called time of death at 10:36 pm.
I remember now that my little dogs were both in the bed with us. And as my husband died I saw the dogs look up from his body to the ceiling. And that funny ozone/burning smell dissipated almost immediately after he passed. I think in retrospect that the smell was his soul as it left the body. And my dogs being closer to nature and without guile or skepticism, saw his soul as it ascended upward from his body.
There is certainly more to tell, but it's not really pertinent to my story or the purpose for telling it. What I've wanted to convey was that it was important to me and to my husband that he not be alone at the time of his death. And that by being present we both were blessed!
It was a huge blessing to me to have been there and if I had not, I think it would still haunt me to this day! I feel that in spite of his being incoherent, that in his deepest recess of being he knew that I was there and it gave him the comfort to let the process happen and allow his life to end. Yes, I know that his death would have taken place with or without my presence. But how lovely it must have been for him to know he could surrender and not have to fight any more?
The Beauty of your Presence
Some months after my husband died I began to really think about how much of a blessing it was to have been present at the end of his life. I recall thinking about how in our society we absolutely believe in being present for a birth and we celebrate that with gusto.
It occurred to me that it was every bit as precious, though perhaps not very joyful, to be present at the time a loved one takes their last breath. I felt I was honored to be the last person with my beloved husband and to have been present when he left the world. It was suddenly so obvious to me how similar being present for a death was to being present for a birth. I don't think it feels this way to people who've not experienced being present at a person's time of death, but I can speak for my own experience and it was rich. Even being present for a birth is not a daily occurrence, unless it is part of your occupation to be involved in labor and delivery. Birth is a rare and special occasion that we may get to witness a handful of times in life if we are lucky. Some of us will never be present for a birth or a death. But, if you ever find yourself being faced with the end of life of a loved one, you now have a choice to make.
You can choose to be there or not. Sometimes the dying person won't welcome you in, but many times you will get this chance. I would tell you that if the opportunity arises to be present at the time of passing of a loved one, please take it! You will be so blessed though it may not be apparent to you for a long time afterward.
But, I can share I feel like I was blessed a hundred fold to have been present and to share in what might have been a lonely, solitary death otherwise. My dear Mother passed away many years after this, and sadly I was not with her at the time. I know she went in her sleep or as close to it as possible, but oh how I wish that I could have been there. I was with her the very day before and we spoke on the phone, so at least I know that she knew I loved her. But it would have been so nice for us both to have been together.
I don't wish to be morbid, but we all will lose people we love. We won't always know the time is coming, but if you ever are in such a situation I would want to let you know that the choice to stay for the end is every bit as enriching as being there for the beginning.