Who am I and what can you do through the last hours of life
These blogs come to you from my book, A Guidance Through Death. I am Cassandra Christenson, a retired Registered Nurse. I have worked for years doing hospital and home nursing learning what is needed when death is near. One of my patients, Carlene, asked me in the early 1980s, "When it gets close, will you be there and talk me through it?" Her family and I were there for her in that last hour. I learned what one woman needed in her dying and now I want to share that with you. My patients and my work continues to teach me what we all need to know when called to the bedside of a loved one.
- Trust your self, your open heart and intuition for what is needed and how to be there.
- Talk even though the person's eyes do not open and seems too ill to hear or even understand. Share with him or her knowing that the life of the one ill hears. Perhaps this is true even if you do not get there in time. Spend time with the wonderful body (a wonderful body no matter how difficult it looks) that has held your loved one all those many years and talk knowing you are heard.
- Speak with vulnerability, respect and a deep sensitivity to the person and the situation.
- Keep sentences spare. Be close, your face in alignment with theirs. This is a time for intimacy.
- Sometimes it is difficult leaning over a bed railing or peeking through the bars. So you may wish to talk with the staff about lowering the railing, giving the assurance you will not leave the bedside unattended with the person vulnerable for a fall. Have the call cord within your reach for when you need to leave or ask how raise and lock in the side rail for safety.
- If the person is home most families do not keep railings in place. They feel if there is no agitated movement and the person too ill to move on one's own then they would rather there be a more natural environment for being together. Then raise them into place when the person is alone. This allows loved ones to sit, put their head down or even lie down on the bed no matter how narrow the mattress. I have seen a mother get into bed, place her dying son's head on her heart, surround him with her arms, her legs at each side of his body so the unconscious man could feel safe leaning back into her arms her head against his cheek. Then all of us, about 10 or so, and I circled about the bed and sang, prayed and laughed with the joy of it all. You will find your own way to be there at such an important time of life.
- Introduce yourself.
- Say a little about why you come to be there.
- Let the person know if there is something you want to do, such as draw a chair near, put the railing down, or "I will sit by the window, puff up my pillow and sleep near through the night." “I am leaving for a moment. Will be right back.” "I am leaving now and Jane will be here in an hour."
- It is good to let the person know how long you plan to be there, "I do not know for how long I will be here." or "For an hour." "I will not leave without telling you."
- If you you are fearful or unsure of yourself, share that, both the doubt, the gratitude and love,"I am a little afraid but I am so glad to be here with you.” "This time with you is very important to me." “Forgive me if I am a little awkward".
- There may be things you want to say before the moment is gone.
- Think what would be helpful to say or do if you think the person may also be fearful or confused.
- Tell the important things going on or you think the person needs or would like to know. "Today is Monday, the middle of May. It is two in the afternoon. This is Saint John's hospital." or "You are here in the living room. We brought in a hospital bed. It makes it easier for us. And we want you a part of what is happening." "Robert sent yellow roses right here by you." "Peter is coming in from Montana. He will be here tomorrow at midnight. He wants to be with you." "Lilly's graduation is tomorrow. I will come and tell you all about it." " I am here so Marsha can get some sleep. She will be here tomorrow at ten. She loves you so much as do I."
- Remember these are ideas, you want things simple and spare so not to overwhelm but reassure with knowing what is going on around the person and with the people important.
- It is important not to assume there will be death. But having said that, I once told a person who had been unresponsive for days, "It looks like it is getting close, if there anything you need to say or do this is the time to do it." And within a few moments he opened his eyes,wanted to get up and go to his office which was the small room next door. His wife and I helped him to his desk where he sat for 15 minutes looking things over then died.
- Know the importance of touch, words or your quiet presence.
- Be brave to do what you want or need to do, but do only what is in keeping with who you are.
- Reevaluate priorities. Look at "rules" and how things are "always done" to determine the relevancy in this situation.