No, I’d never been to this country before.
No, I didn’t know where the roads
would lead me. No, I didn’t intend to
We tend to hold fairly uncomfortable feelings about death and dying in our American culture. We seek to avoid it as much as possible and much of our behavior is devoted to a “death-denying, drugged-up, tube-entangled, institutionalized” death (Halifax, 2008). The truth is, the statistics are stacked against us…we are all going to die eventually. We can try to avoid it, distract ourselves, and deny it, but it is still there. Joan Halifax's beautiful book, Being with Dying, is a source of wisdom to help us on this journey including lovely and helpful meditations for the patient and the care taker.
To able to be fully present with someone at this time of their life can also be one of the most beautiful and meaning-filled moments we can have with them. Several years ago, my mom had a sudden acute episode that landed her in the hospital. I watched her decline rapidly over 4 days. One day she could no longer heft herself up out of the chair to use the walker to get to the bathroom. I watched hope drain from her. I was alarmed that this go-getter, always optimistic and fiercely independent woman had given up, and I called Hospice. I had the Hospice nurse chat privately with my mom without me present to ensure she felt comfortable sharing her true desires. She was transferred to a rehab facility and the next morning at 6am I received a call from the nurse saying all her vitals had tanked overnight. “Did I want to send her back to the hospital?” I knew somehow this was an end for her and that transferring her would be a tremendous disruptive and uncomfortable. And for what purpose? Luckily, because of my experience working in end-of-life issues I also knew that I did not have to send her to the hospital. So I said “no” wait until I get there. When I arrived, my very agnostic maybe atheist mom said very weakly, “I want to go to the angels now.” I thought “wow, that is not my usual Pat. Ok.” I told her softly that I would help her. I immediately called hospice. The rehab facility graciously allowed us to remain in a private room where she died quietly two days later in peace and pain free. In those two days I sat with her just quietly holding her hand and dabbing her mouth. I was just there fully present and helping her the best I could with her wish, not mine, to now leave earth.
Many times the person who is ill and dying knows when their time is coming and it is often us who are in turmoil about loosing our beloved. They are often just fine and are ready for the transition! We sometimes become fearful of having very necessary conversations with them. But is this fear that they will be uncomfortable about this conversation? Or is the fear or own discomfort with the unknown? Somehow, if we can just listen to our beloved carefully, they very often tell us exactly what they need and want. Some people want extreme life-persevering measures taken. Many are ready to transition.
As Joan Halifax puts it “there is no one right way.” Some people want all their loved ones to be with them when they die. Some people do not want much fanfare and will actually not let go until everyone has left the room. This is how it was with my mother. I held her hand for hours. I finally succumbed to lay my head down for a few minutes of rest. I awoke a moment later with a start and my mother had peacefully passed away. Knowing her, I am not surprised that she waited for me to disconnect from her before letting go. Perhaps the biggest gift we can give our loved ones is to honor their wishes and not force our own upon them.
Begin now. One of the things we can do now while we are alive is to begin to have these conversations with our family members. What do you wish if you are ill or incapacitated? These conversations sometimes need the grace of time because not all family members and even ourselves may be ready to understand and resolve our own issues. But if we can do this before a catastrophic event then our beloveds and ourselves have a better chance of having the peace we wish for at that final moment of closure. A resource that is helpful is the Conversation Project which has many tool kits available. Another resource which I provide to my patients is Five Wishes form which provides a nice format to have the conversations with our families. Finally, even if we have an advance directive, often they are often in a safe deposit box or with a person not with us at the critical time. So often suggest to people to put this important document on a mini-drive and keep in their wallet, as I do.
A Lovely Walking Meditation Practice: If your beloved can still walk slowly, you can walk with them in quiet synchrony. Joan Halifax describes doing this with her own dying father in the hospital. A walking meditation is one which brings the mind, breath and body together. Thich Nhat Hanh says we can even encourage a longer in-breath by thinking to ourselves as we take two steps “I have arrived, I have arrived.” And then we take three steps as we breathe out saying “I am home, I am home, I am home.” The practice slows us down, and encourages breath, and pulls us fully into this moment, the present moment right now. In this very moment, now, all is ok.
Breathing And Just Holding Hands: At some point, your loved one may not be able to walk. At this time, you can simply hold your beloved’s hands, just holding and breathing, doing nothing, requiring nothing. Just being in the space with your loved one, with a gentle embracing of hands. No talking is necessary. You are there with them in this moment.
Peace and love to you
Being with Dying , Joan Halifax
No Mud, No Lotus, Thich Nhat Hanh