Art of Dying Volume II - Page 55

Then you know, ‘Okay they've been through that negotiation. They're finally accepting and letting go.’ Some patients lived in the house where everyone went after school for cookies. You know the families where every holiday was a gathering of at least 20 people. If that's how they lived, that's how they're going to want to die. Sometimes staff members will say, "There's too much activity in that room." Well, that's their opinion. If that's what the patient is used to, then, yes, they can die with 15 people in the room. I don't want that many people around me but I respect that's how it is for some people. We assume that family wants to be at the dying’s bedside. I ask them, "Is it your hope or expectation that you'll be present at time of death?" Sometimes we assume that the patient doesn't want to be alone. Some patients choose to die when no one's in the room. My role is to know the patient as a person, and be an advocate for them and their wishes— whatever their wishes may be. Too often people want to educate the patient and their family. Some patients and families don't want to know. They just want to take things as they come. They don't want to anticipate. Expectations cannot be imposed. You have to feel it out for yourself. There's an in-between state. Sometimes patients see things with their eyes open. I actually mean literally their eyes are open and they’re seeing things. They don't always share what they see. There's a reason for the veil between the living and the dead. The dying can see through the veil, but this is a knowing that they're not supposed to share. Once they are in that in-between state, they have an understanding of why we were not supposed to see too much here. Dying patients know that what is being communicated to them is, for the most part, just for them. In the grand scheme of things patients experience deep realizations of peace, and understanding— realizations that they keep from us. It's all a part of the letting go. There is a Buddhist expression, “In death we are all beginners.” Before I started working in hospice, I thought I knew death from all the losses I had experienced. My hospice work has helped me to realize how little I know. Every patient is unique, every death is different. There are similarities for sure, but the more you work in hospice, the more you appreciate the surprises and the mysteries of life and death. LIZZY MILES, MA, MSW, LSW is a hospice social worker in Columbus, Ohio and an editor and writer for Pallimed.org. Lizzy authored a book of happy hospice stories: Somewhere In Between: The Hokey Pokey, Chocolate Cake, and the Shared Death Experience. Lizzy is best known for bringing the Death Cafe concept to the United States. TWITTER @LIZZYMILES_MSW. VOLUME II | 55