Monday, November 22, 2010

This is what death looks like

Ever since I started working in long term care, I've been worried about the first time one of my residents dies. I've had a few that did die, but never while I was there. I'd hear they'd passed a few days later, or months later (former home care clients) and it was sad, but not surprising. Walking in and finding that someone has passed away remains one of my bigger fears, although after the experience I had this week, it's a lot less scary of an idea than it used to be.

Yesterday, after my shift ended, one of my residents passed away. Phyllis was very old and frail, and when I started training at the GreatRep, had recently stopped walking and become wheelchair and oxygen dependent. Her sight was failing, and she had very little appetite. Phyllis began to constantly, under her breath, chant things like "Oh God help me, I can't see, I'm so afraid I'm going to fall, Oh god won't somebody help me why is this happening to me, Lord, why?". No amount of reassuring, hugs, gentleness or anything would soothe her for very long.

Then around 3 days ago, Phyllis began refusing to eat. She started looking more frail, the little veins by her temple becoming more visible like they are on a baby. She seemed less afraid, but more tired. We switched her to a fully pureed diet, but she had difficulty with even that, even though we fed her.

Day before yesterday, Phyllis was put on comfort measures only for her care. We knew that her time was almost over. The night shift caregiver cleaned her room, picked a bouquet of flowers and greenery for her to look at, and set up chairs for her family at the bedside. Phyllis' son came and sat with her all day.

Phyllis is the one who taught me what it looks like when someone is dying; she couldn't drink from a straw anymore, so when she was thirsty, I gave her Ensure by dipping the straw in her cup, holding my finger over the end, and dropping in tiny sips at a time with an eyedropper. Her mouth was very dry, and needed frequent swabbing to keep it clean so she could be comfortable and breathe as well as possible. I did that with little sponges attached to lollipop sticks that were invented for that purpose. Dying people don't go to the bathroom anymore, at least not if they aren't taking in anything. Their circulation slows, so their extremities start to get dark, and look bruised. The last time I saw Phyllis, she was in bed, her son reading in the chair next to her. I wiped her lips, gave her a sip of water, and kissed her temple. Her hair was soft and fine like a baby's. She dozed on and off.

I don't know what the last thing she said or saw was, but her son was in the room with her when she went.

As far as death goes, it was much softer and sweeter than I would have imagined. Elderly people can often remind me in some ways of infants, but Phyllis didn't until right before she died. I wonder if that's common, and if it's the helplessness or the inward focus or what that made her seem so much more like a baby then. I can't think of any right word to describe it other than softness. Phyllis was very soft before she went.

And seeing that made death a whole lot less scary for this bystander. I hope that all my old people get to go as gently as she did.


  1. Hi Kiddo,

    So proud of the way you look at this, and it really is a wonderful thing for her to move on to the next world. It is so much better than here.

  2. "Phyllis is the one who taught me what it looks like when someone is dying"

    What a beautiful statement. Everybody remembers their first.