“Gabby, I think mom is dying.” This was a message I received from the daughter of a woman I had the pleasure of visiting with for over a year. Six months ago, she was ready to die and wanted to know why it was taking so long. She was 93 years old, she had lived a good life, her family was (mostly) accepting and had said their own personal goodbyes numerous times, because for months, they thought each day was “the day,” and then it wasn’t.
This can take its toll on the family, as some of you might know.
I am asked often why it is taking so long. My answer is usually something like, “the body knows what to do and we must trust that." We can offer medications for symptom relief, we can educate you on how to provide compassionate and heart-centered care, we can even prepare you for that last breath, but we cannot tell you when it will happen. I have learned to trust that their body will let go when it is ready, and until then I will make sure both patient and those who love them are cared for and supported well.
I arrived at their home to find this beautiful woman letting go. Her body was finally ready, and she was leaning in to it with such grace. The daughter who had called me had been her primary caregiver, and we had been talking every day for the past week as I guided and supported her while she tended to her mother. She was afraid of every sound and movement, which most people are, and I relieved her of her fear. She gave the medications as ordered by the hospice team and was comforted in knowing that her mother was not suffering. Her main struggle was the disconnect between her and her siblings as they often doubted her care, which weighed heavy on her.
Her siblings were not nearly as supportive of her as I was, in fact when I let them know she was dying, their first question was whether their sister had hastened her death by giving the medication, as if to blame her for their mother’s death. I knew at that moment I had two very important things to do during my visit; prepare the family for their mother’s death, which was minutes away, and somehow bring them all together and on the same page, helping them to see the beautiful care their sister provided their mother.
When I am at the bedside of someone who is dying, I am usually sharing it with someone who is preparing to say goodbye. When there is more than one person at that bedside there can often be dynamics and disconnect that can interfere with the peace that needs to be felt at that time. As a hospice nurse I do my best to manage symptoms, educate about the medications and the dying process, and prepare those in the room for what could and might happen. As an end-of-life doula I see my role as a peace maker, using a calming voice, a gentle touch, compassionate words, and sometimes music, to change the energy in the room so that when that last breath is taken, there is a sense of peace. My goal is to combine the roles of nurse and doula so that I can ensure that the person who is dying can do it without pain, or fear, or negative energy in their space, and the person(s) saying goodbye can feel or find a sense of peace within. And if I can do that, I can also help to reduce some of the grief those at the bedside will feel.
Moments before this lovely woman took her last breath, I let them all know she was close. The daughter I had been speaking with most, took her mother’s hand and sat quietly at the bedside. Her sister came in, with energy that seemed angry, and said, “did my sister make this happen?” I looked her right in the eyes, and with a calm voice I said, “absolutely not, your sister has provided beautiful, thoughtful, and compassionate care. The amount of medication she gave your mom over the last few days is not enough to hasten her death, and this morning she only gave one small dose which gave her body the peace and permission it needed to be able to let go with ease, and grace. Your sister honored your mother on this journey quite beautifully.” She looked at her sister, with tears in her eyes, and said, “thank you.” And then their other sister came in, the one who has never said a word and has not been involved, and asked me, “can she hear us?” I proceeded to share how I came to learn that yes, they absolutely can hear us, and assured her that whatever she says to her mom, she will take with her. The other two scooted over, making space for her, and she looked at me again, “what do I say?” I took her hand, looked at all three of them, and said… “tell her you love her, that you will miss her, and say goodbye.” And she did. They all did.
When she took her last breath, there was no anger, no animosity, and no harsh words. There were just three daughters sitting at the bedside of their mother who was dying, and they were together, comforting one another, and saying goodbye. This is what I always hope for, and I see it as my role, but I am also always prepared for whatever might take place at the bedside, difficult or beautiful.
When someone is dying and others are preparing to say goodbye, those last moments at the bedside are significant in so many ways. What it comes down to, at least for me… is removing fear and uncertainty, respecting curiosity, not making it about me, considering all feelings, never pointing fingers or passing judgment, and finding a way to bring everyone together when that last breath is taken, so that when it is, that person feels peace. It doesn’t always happen, sometimes that is okay too, but I always do my best to reduce the negative energy in the room and finding peace if possible.
You can find my book, "At the Bedside" here: https://a.co/d/jiR81za
This book is filled with patient stories, as well as some bedside tips for caregivers.
I also offer a class by the same name, which is an introduction to becoming an end-of-life doula. You can find the class details here: