Ten Observations About Living Last Days Well

I am not a professional or an expert on hospice care, but I can offer ten personal observations of what helps people enjoy their last days more. They are only commonsensical, but the end of life is a time, as many people know, when common sense has a tendency to fly out the window. Here is what I think I know.

1. Even if you don't deal with death well, go to see your family members and friends in hospital or hospice.

Visiting dying people isn't about you. It's about them. An effort to be present for the person you love is the primary requirement.

Your loved one's personality is not likely to change when they are in hospice. They will be the same person they were before.

2. It's OK to cry, as long as you don't make their illness all about you.

Genuine tears show how much you care. Some cultures do not permit men to cry, and a loved one's death bed is not the place to have a long discussion on how modern men can cry. But tears, and fighting them, communicate how deeply you feel.

3. It's OK to take children to see the dying.

Grandparents, in particular, long to see their grandchildren. Make the visit to the hospice about making the dying person happy, and give children memories of their loved ones while they were alive.

4. A “Do Not Resuscitate” (DNR) does not necessarily mean someone will not be resuscitated.

DNR's usually apply to out-of-hospital treatment. A patient will not be resuscitated in a hospice, but emergency medical personnel will follow their own rules regarding such an order. Different political jurisdictions handle Speak with your family member or friend about their wishes as early in the course of their illness as possible to know how they want to be treated (or not).

5. The more money is spent on end of life care, the more miserable the patient is during it.

Extraordinary medical interventions are extraordinarily expensive, and they take away opportunities to talk with loved ones, to eat, to listen to music, to engage with the healthy world. When a lot of money is being spent on medicine, usually not enough money is being spent on the simple pleasures of life.

6. The exact timing of natural death is unpredictable.

Doctors, nurses, and hospice workers usually have a sense of how long someone will last. People often live longer or seem to choose a moment for death for their own reasons. Some people will want to be surrounded by people to the very end (my mother did), and some will want to be alone when they pass away (my father did).

And some people don't seem to care one way or the other. Each person is different.

7. Doctors, nurses, and hospice workers usually recognize death as it is rapidly approaching.

In certain physical conditions, heart disease and lung disease for example, there can be unmistakeable signs of the end, rales of short breath, or a distinctive EKG pattern, for example. Usually when a professional tells a family member “Come quick,” there isn't an option for later.

8. People who appear to be comatose sometimes aren't.

A 94-year-old friend of mine was losing her battle with a recurrence of colon cancer. She lay on her bed still, barely breathing. Her family waited in the lobby, not visiting her for two days. I asked if I could go in, the family said yes, so I sat down, held her hand, and filled in on local events of the week as I would have when she was well. After 10 minutes or so she squeezed my hand, and smiled, and then went back to being still. She died the next day. I felt we had had a last chat. She just didn't talk very much.

See Also: World Health Assembly Makes Care For The Dying A Priority

9. Dying people often speak in metaphors.

My father was a fan of seedless watermelon, and I took him a seedless watermelon (that I bought in the dead of winter) a few days before he died. “I'm going to save this to eat it with your (previously deceased) mother,” he told me. Many people speak of getting ready for a trip, or being relieved of their burdens. A few hours before he died, my father told me about a persistent family issue, “You have to deal with it now,” and he laughed. So did I.

10. People who are dying often seem to be here and not here.

People tend to see the religious figures they expect to see, and many people in North America and Europe do not see religious figures at all.

Physically dying may be difficult, but death is peaceful. Carry good memories through your own life by being present for the people you love.