Sunday, August 21, 2011

What we learn from Mother Teresa

 Treat with dignity, a noble life

Mother Teresa went to be there for people dying on the streets of Calcutta. She picked them up and took them to her home with other nuns so they could die with dignity.

We can do that in our own special way. Let us visit together, you and I,  and learn how we can comfort in these last days and hours of life. To  comfort when there is hopelessness and isolation.

A cab driver in NYC asked what I did for a living and when I told him I teach others how to come to the bedside and care that life wind down with dignity and value. He was amazed that should be needed.

But in our countries, many of us have not seen death. Even the critically ill are not usually in our homes. So we do not know what to do or say to comfort through this process. 

The cab driver went on to say, "In my country when people are ill of anything we stay with them until they are well, and if they are dying we do the same thing, we would never leave anyone who is ill or dying. And if they die we stay with the body until it is buried."

 He was from a country in Africa. I was told similar things from people of Mexico. What are your thoughts?

What to do?

Knock gently on the door, come easy to  edge of the bed, lean near, address by first name, share yours and  why you are there. If you are not known tell how you happen to come. 
I often say, "I am a little afraid to be here, but I wanted to be here no matter what". 
Be there with great respect of the person you know to be there inside.  Look around the room, are there flowers to be freshened, comfortable lighting vs a glaring over head light?. Is there a chair you can easily move to be adjacent to the bedside? If not perhaps request one from the staff. It is important you be comfortable to have a comfortable "conversation".  
Sometimes I sit on the arm rest to be just about the right height to be in a relatively normal position for interchange
  • Look for subtle clues of body language to judge how the person is responding to your touch or words, such as change in breathing rate, a sigh, slight wincing of a small muscle, adjustment of fingers, fluttering of eye lashes, squeezing lids of eyes. They may give clue on how you are doing. 
  • Get comfortable in chair, if you wish to just be near.  Be ready to move chair if nurse comes in and needs access to bed.
  • Share approximately how long you will be there. 
  • You may want to hum or sing. Be close and with great dearness and sensitivity.
  • Play an instrument
Even though this person before you does not look like themselves, know that your parent, child, friend is there inside but perhaps too ill to respond but they will be feel cared about, relieved, feel loved and reassured. Or they feel a need for silence and just a loving silent presence. Elisabeth Kuebler-Ross, MD, the wonderful doctor of the heart on the frontier of changing how we are with the dying, said the greatest gift you can give, is just to be there with the gift of yourself. 
If you want to tidy the room or change things, such as moving a chair, changing the water in the vase of flowers or leaving the room, tell the person, "Your beautiful yellow roses are looking a little droopy, I will add  some fresh water."

Monday, August 8, 2011

"Listening" to the message of the situation.

In the story, "Breakfast in Bed"of this blog,  I had said on seeing such beauty and order in the room, that the room was filled with life. Jean corrected me and said, "This is love, this room is filled with love, Cassandra". This firm statement told me Jean's goal for her husband and that care should about love, dignity and respect of him and what he wished,  and that she had accepted that Ray was dying and nothing could be done to "save" him. At some level I heard the message under the words so when he wanted breakfast after being semiconscious for days, I should let go of my nurse self that feared he would choke to death and die. And be there in support of what she knew of her husband and in support of her in wanting to grant him this wish as the "man of the house".

This is a big risk on our part as caregivers. Every thing in our world is to respond to someone in dire distress with a "do something" response. It is a natural  to fear we might cause irretrievable harm. But I think we must rethink this through. His wife, Jean, guided me and reassured me. She made it clear all action in that room was to be guided by love.

Being there in the last hours of life is an act of great love, courage, yielding. We never know what to do in such a hopeless situation, ever, but I have found the situation tells me what to do. And even then I worry I may be wrong. But in the moment we will know we going in the right direction. Or years later we will look back and be encouraged we not only did the best we could, but what we gave helped to create a gentle, even beautiful passing. And what we learned will help us again to reach out to another.

What do I mean by the situation will tell me what to do. I will not know what to do when I open the door to be there for another. But if I knock and go in and feel the helplessness, wanting to run, not wanting to be there and stay and just note what do I feel, see or even know from the past that will help me to know, just be there, nothing to do, nothing to say, just the gift of myself. Then at some point I will do something that feels right. Perhaps it is just quietly bringing  a chair close or leaning near and saying who I am and why I want to be there.