Final Messages
Last week, when I interviewed Michele Mason about caring for her neighbor, Andy, during his final days, she told me that the experience made her less afraid of her own death.
"It was incredible to watch Andy let go and accept his death." Michele said. "It made me feel less afraid to die."
When we watch a close friend or relative pass away, most of us can't help but reflect on the eventual conclusion to our own story. And many caregivers, like Michele, find that helping a dying patient makes the prospect of their own death a little less frightening. Particularly if the loved one dies peacefully, without a lot of pain, helping someone at the end of his life can be a humbling and awe-inspiring experience. This is the thesis of Final Gifts, by hospice nurses Maggie Callanan and Patricia Kelley, a book I recommend to anyone who has a dying relative or friend.
Callanan and Kelley talk about the special consciousness -- what they call "Nearing Death Awareness" -- that is common among people who die from a prolonged illness or chronic condition (as opposed to dying in an accident or from a sudden heart attack or stroke).
As they approach death, these patients often seem to pass in and out of consciousness, and to talk about seeing dead relatives or being in an idyllic setting.
Andy exhibited this "Nearing Death Awareness" toward the end, according to Michele. He talked about seeing his mother, his father, and his wife. He also seemed to think he was in a beautiful place, and he'd occasionally wave as if to someone at a distance. The authors of Final Gifts explain that it's common for dying patients to talk about traveling and about loved ones, often those long dead, who will make the journey with him. Callanan and Kelley interpret this as a way of sorting through one's past and coming to terms with death.
As a dying person becomes less alert, he may talk in symbolic language that's hard to understand. Caregivers often assume the patient is confused or delirious. But Callanan and Kelley urge caregivers to listen carefully and do their best to understand, because these messages often touch on unresolved issues or relationships that may prevent the patient from dying peacefully.
The authors describe one terminal patient, for example, who was agitated and restless and kept talking about getting in line, as if she were going on a trip. She seemed to welcome this prospect, but she also repeatedly expressed concern for the husband she was leaving behind. It wasn't until her husband sat down with her and explained his plans for coping after her death and reassured her that he'd be okay on his own, that she was finally able to relax. She died peacefully a few days later.
Callanan and Kelley call Nearing Death Awareness a "final gift" because it helps dying people make sense of their lives. It's a gift for caregivers, as well, because it grants them a more profound understanding of their dying loved one -- and of their own mortality.
Image by Flickr user TaranRampersad, used under the Creative Commons Attribution license.
Final Messages


My Dad told my Mom to call my brother and me, after about 6 weeks of hospice care following colon cancer(3 years, a few "procedures") and a stroke. We arrived to find him in good spirits...he had been "waiting for the grim reaper, leaving the door open" for weeks. He HATED being bed-ridden and wearing a diaper! We got there to visit with him, my Mom was there, and an uncle he was particularly fond of happened to stop by that day too, along with my oldest son. We chatted, listened to some of his favorite music, and let him lead the way to what to talk about. About 6pm, he started to "ramble", saying numbers, like "42-67", 65-32", etc. Later, I realized that since he had been a carpenter for 50 years (his gold union card was one of his treasured possessions), and had worked all over the city of Chicago after he arrived here from Glasgow in 1948, that he was giving me addresses of places he had worked on. My Father-in-Law just passed away a month ago, and he was an accountant for the IRS, and he was saying "sums and numbers" as his last coherent words! I guess our jobs really ARE that important to us! My Father spent the next 2 days "asleep" while I sat next to him, playing his music tapes for him, and talking to him, telling him I hoped he was with his relatives again, and that even though I would miss him, I understood that he had to leave me. The 4th day, his eyes were wide open(no blinking), and he was breathing irregularly. I played his tapes for him again, and the hospice nurse walked in, just as he stopped breathing...he had always told me the doctor told him he had the heart of an 18-year-old, and he would joke that he'd better "give it back to that kid, he must miss it!" She stoked his hand, and he took a few more breaths, then I turned to her and said, "Do you recognize that song?" It was Gershwin's "Someone to Watch Over Me"...I wasn't sure if he was "thanking me" for watching over his death, or if he was assuring me that he'd be watching over me from then on...but he took his last breath and was still. Yes, he knew when it was coming, and he knew he was loved by those closest to him. And despite the many times I have cried over missing him, yes, I am less frightened of death now.
Thanks so much for your letter. It's great that you could ease your mother's mind before she died. I'd love to hear from other readers who've had similar experiences.
My brother and I knew something was keeping my mom from letting go - it wasn't until I promised her that I would always be there for my brother (he'd always been a little less the responsible) that she finally let go. I made my promise to her around 1 o'clock in the afternoon and she passed at 7pm that evening. So I totally agree with what the article on the importance of last minute communication to ease the way.