How to die


People live as they die.

If they constantly worried about their health and each and every little pain and symptom in life, they will worry until the end. If people were unconcerned about their health in life they will be slack in seeking help and treatment. If they were bad-tempered and impatient in life, they will die impatient and bad-tempered. Gentle people die gentle deaths.  (I am excluding violent deaths from the statement above.)

In Hospice I am amazed to see with how much stoic dignity some people die. Many of my acquaintances have died in the past 14 months under our care. People that I knew were dignified, in life, died peaceful dignified deaths. Up to the end they will say “please” and “thank-you.” I have witnessed, and experienced people hold onto life with every fibre in their bodies (as did Vic). I have also seen people “decide” to die. We see it in their eyes. Death is a decision.

Dying is not a two-minute thing… some people die slowly over many days. In these slow, lingering days it is our job to keep the dying pain and symptom free. Comfortable surrounded by their loved ones.

In a perfect world people die at Hospices surrounded by their loved ones – in theory that works, only in theory.

Many people are dropped off at the In-Patient-Unit and as soon as it is “decent” the family will leave to rest… Some don’t return. Some do after many phone calls updating them of the gravity of their loved ones condition. Some will pop in for the final moments. Some don’t. Some stay. They enfold their loved one with compassion and love, complementing us in our job. Some people die with their loved ones united in prayer; others die with the family singing gentle songs. Some die telling their loved ones to f… off…..

I have come to the conclusion that people without a spiritual and/or religious base die bad deaths. They swear at their families and the world until their final day… They worry about their new cars; a business deal – some have alcohol sneaked into the IPU. They deliberately remove their diapers and urinate on the sheets; one even defecated on his sheets defiantly grinning at the staff. A final “f— you” act. No, he was fully conscious of his actions and the effect that it has on those caring for him. He was dying from cancer not Alzheimer’s.

Seeing someone die is quite amazing. It is a beautiful experience witnessing the soul leave the body. There can be no doubt that there is life hereafter.

A young woman died in the IPU. She lingered for 8 days. Finally only her mom was left next to her bed gently whispering words of love and encouragement. After she died we prepared her cancer ravished little body for collection by the undertakers. When they arrived I escorted them to her room. She lay there with an angelic smile on her face. I called her mom and said “you have to see this…” When her mom had left her side it was just a tiny little bag of bones that lay there. When her mom next saw her she had this peaceful, angelic smile on her face. Truly a message for heaven for her grief-stricken mother.

I hope that I will be stoic and brave in death. That fear of the “Great Beyond” will not overwhelm me. I hope that I will be dignified and brave in death. I am such a ninny in life.

Stepping Stone’s first death


Vic was the first Stepping Stone Hospice death.

I was clearing up some filing at the office when I came across Vic’s case notes. Tears ran down my cheeks when I read the observation of the Hospice nurse…

21.11.2012:- Pt gradually getting weak but stable. Pain controlled and up and about

20.12.2012:- Very weak but stable. Pain controlled

3.1.2013 Pt experiencing obstruction. Started on SD (Syringe Driver). Buscopan, Zantac, morphine over 24 hours. Prognosis short

8.1.2013 Pt seen by Dr Sue, very weak. Actively dying. Not eating or drinking. Vomiting much better. Pt still responsive even in deep sleep. Continue SD

11.1.2013 Pt terminally weak but stable on SD. Actively dying. Family up to speed with progress

18.1.2013 Pt R.I.P this am. Peaceful and comfortable at home

Vic’s suffering had been reduced to a couple of lines. A couple of words. No mention of her vomiting blood or did I forget to mention it to the nurse? No mention of her being unable to breathe because of the pain. “Pain controlled”…

The pain of Vic’s death is as fresh as it was a year, a month and 11 days ago.

We have now lived many Hospice deaths. Some have been friends, some strangers that became friends and some strangers that remained strangers. I feel the pain of the mothers whose daughters died in the In-Patient-Unit. I held them and comforted them, but I could not take their pain away. I tried to prepare them for the emptiness that would follow the funeral…the guilt, the anger, the loneliness.

I know that our Nursing Sisters are compassionate and caring. I know that I would want to die in the Unit. I know the staff will light candles to shield me from the harsh fluorescent light…. I hope that Lorraine Msini will softly sing Amazing Grace as I end my journey on earth. I have truly learnt that death is not the enemy. Living is.

I no longer cry for those who are dying. I cry for the ones who are left behind. I cry for the emptiness I have seen in mothers eyes… the raw, undiluted pain… I know that when I see them in a few months’ time they would have learnt to mask that raw, undiluted pain and emptiness in their eyes.

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