Caring Currents

Final Messages

Last updated: Nov 07, 2008

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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.