Bearing Witness | Caring Choices

Working as a hospice social worker and as a social worker in a nursing home provides me unique opportunities to advocate for my patients, residents and their family members. With every elder I encounter, I feel like I am bearing witness to their final journey (whether it be years, months, weeks or hours) in this human life. It is a privilege to do so.

Not everyone is psychologically or emotionally comfortable facing the end of life – whether their own or that of someone for whom they provide care. Certainly when my Mom was in her final hours of life, I didn’t want her to die; but I also knew that she could not live much longer in the end stage of her disease. The signs were becoming clear very quickly:

She stopped eating. Within 48 hours, she went from eating small amounts of oatmeal for breakfast or half of a grilled cheese sandwich with a half cup of tomato soup for lunch, to eating nothing.
She stopped drinking. Her last drink was some iced tea with lunch the day before her death.
She stopped going to the bathroom.
Her temperature seemed to fluctuate between feverish and cold.
She slept more deeply than I’d ever known her to sleep. She stayed in her bed for her final 24 hours.
I noticed that her feet turned slightly purple and blotchy; her fingertips turned blue.
She would occasionally awaken enough to know I was in the room; every once in a while she would speak. Sometimes she spoke to me; other times she spoke to my Dad while staring into the corner of the ceiling above her. (Dad died five years before Mom.)
Her breathing slowed, became more shallow.
Her eyes became glassy; when she slept, her eyes were half open, half closed.

When I got awake on Sunday morning, these signs were even more prevalent and I knew I’d better call my brother and have him come to the house to say his final goodbyes. I knew Mom would die that day. I would bear witness to her final day on this earth and although I had episodes of deep sadness and bouts of sobbing, I also had moments of profound peace and joy. When Mom was talking to Dad in whatever faraway place he was, she called his name and asked him to wait and her voice trailed off (“Dale, wait…”). I felt as though I was witnessing Mom stepping with one foot into the great beyond and Dad holding out his hand to greet her. It was serene and her breathing was unlabored. My brother arrived and suggested I take my teenaged son out of the house for a bit. My brother needed to spend time with Mom and bear witness on his own. While we were away from the house, my brother called and said “Mom’s gone.” When we returned home, Mom was laying in her bed and looked as though she was simply napping. She looked more peaceful than she had in years (because of her daily struggle to live with COPD). I knew that peacefulness was because Dad had taken her hand earlier in the day and guided her to their eternal life together. I also knew my own peace that day because Mom died as she wanted – in her own bed, in her own home and without my brother or me having to make agonizing, heart-wrenching decisions in the midst of her final hours. We were able to just to sit and hold her hand, say our final words, begin to find peace in our own ways, and bear witness.

Caring Choices wishes for all to find peace at the end of life and to bear witness for each other without the distraction of agonizing decision-making. You can talk about this; you can prepare for your own peaceful journey.