Easing the transition between worlds

Health

By Tara Somerville
Posted 10/24/19

For the last five years I've played music a few times a month at a local nursing home/assisted living facility. At noon when we wrap up, I wave goodbye to the residents and dart outside into the fresh air and head toward my car, maybe stopping in the sun for a minute to chat with a fellow musician.

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Easing the transition between worlds

Health

Posted

For the last five years I've played music a few times a month at a local nursing home/assisted living facility. At noon when we wrap up, I wave goodbye to the residents and dart outside into the fresh air and head toward my car, maybe stopping in the sun for a minute to chat with a fellow musician.

My friend who also comes regularly is usually far behind me. She stays and visits with the residents, hugs them, greets them by name and chats it up in her warm Midwestern style. I don't possess the emotional resilience to befriend people I perceive as so close to the end.

In honor of the Day of the Dead (Nov. 2), I decided to honor those whose life's work is to care for people who are in their final years, months and days. At some of the interviews, I'd start crying the moment the interviewee opened their mouth. After others, I felt so light, fears and baggage around death lifting off me one by one, for hours after.

We begin with Patty Gonzales, who has worked for 24 years in a skilled nursing facility that recently became an assisted living center. She started out as a housekeeper and is now a certified medical assistant who says she loves her work so much she cannot imagine working anywhere else.

Most of her clients have dementia or Alzheimer's and she explains how important it is to constantly engage with them.

"You talk to them every day, even if they look at you like you're not making sense. And you listen. Sometimes it'll be the same thing over and over all day and it's OK. Just as long as they're made to feel safe and that they're being heard. That's what's important," Gonzales said.

Dignity, respect and privacy are her guiding principles through all her clients' stages of health and then through the dying process. "Before they came here they had full lives; they were career people. They're somebody - they have a purpose. We're not here to tell them what to do. We're coming into their home to help them. This is their home, I'm the guest here," she explained.

Eileen Brennen has a similar affection for her work and her clients. She has worked as a geriatric certified nursing assistant or CMA for six years. After working many jobs throughout her life, she says she can't imagine working in any other field.

"It's hard though.They tell you do not get attached but how can you not? You see them more than their families see them. It breaks my heart when they die. It breaks my heart."

About a year ago a lady whom she was close to died on her shift.

"I still get teardrops for her. She was my gal. I wasn't expecting it. She was with it all the way until the last week," said Brennen, who was given the task of preparing the body. "After the family leaves we comb their hair, wash their face, make sure they're clean, make sure their mouth is closed. It's hard, really hard, especially if you're close with someone. And it's really nice when the family includes you. It makes you feel like you're part of them."

For some who are near the end, hospice is called in for support with pain management, medical care and emotional support. Spiritual advisers and social workers visit and families are invited, of course, and are encouraged to assist in resolution of any long-standing emotional issues the dying person may be carrying.

At the end some people choose to stop eating and drinking to let nature take its course more swiftly.

"Some believe there's a thin veil between this world and the next and that veil gets very transparent as they're dying [by fasting]," said Pamela Hovden who has worked in geriatric facilities for 26 years. "There becomes a glowing beauty because they find some sort of peace that is more transcendent. I've seen this happen with folks of all religions. It's all just finding that peace and taking those breaths that help you let go. A lot of times people are either afraid to die because they fear the unknown or are afraid to leave their family because they don't want the family to be grieving. I always feel like it's OK to say to people, 'You can go,'" she added.

Billie Odum, who's been a geriatric nurse for six years, described an incident where an elderly hospital patient who was in relatively stable condition decided it was her time to go. She no longer wanted to be dependent on medications and constant care at home and so she called her family to her bedside and they stayed with her throughout the day. The family and hospital staff watched as a relatively healthy woman chose her time of death, seemingly by will. By dusk she had stopped breathing and the family took her body home before burial, as was customary in their culture.

All the interviewees spoke to how death's power transcends personal belief systems. "I had a partner who was an intensive care unit nurse and an atheist who swore that when someone died he could see the moment their soul left their body and where their spirit was in the room," said Odum.

When her close family member was dying, Odum's family was gathered in the room with him, and his dogs were by his side. When he took his last breath, the dogs seemed to know before anyone else. The cocker spaniel and dachshund leaped off the bed, started barking wildly and ran out the dog door to the back yard and started running in big circles.

"Death is extraordinary," said Odum. "Nobody's knows what's going to happen but life is so extraordinary, how can life after death not be?"

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