Must death be silent?

Grace was eighty-four.

On Monday morning she didn’t want to get out of bed. This was unusual for Grace. She said nothing was wrong…she just didn’t feel like it. I had this feeling. I’ve learnt over the years in my work to trust my feeling even though sometimes the outward facts don’t support it. In the nurses station I said that I thought Grace was preparing to die. I was reminded that nothing was wrong with her. 

Come Wednesday I was sure my feeling was accurate. Though all her physical obs were fine and she said nothing specific there was a sense about her…an energy to her that said she was leaving. I didn’t say anything, just tried to get to her room a little more as she was mostly alone but a few minutes was all I ever had as we rushed to and fro trying to meet the urgent needs of the many residents.

By Friday the physical signs started. I rang her daughter who lived some distance away but her daughter suggested Grace often got to this stage and then rallied. She asked me to keep her informed. I wanted to tell her I was sure her mum was  going. I wanted to tell her that her mum  was on her own most of the time. But for the former I had no facts and for the latter well the last thing I wanted to do was guilt her.

Returning to work after the weekend Grace’s dying had become a fact in all staff minds from the assistants to the doctors. I rang her daughter again able to be much more sure but the daughter was stressed to the max with ‘life goings on’ and was still convinced her mum would rally yet again. At the nursing home we initiated the relevant care…two hour turning, mouth washes, pain management. All the boxes were ticked. So she got someone with her every two hours for a few minutes at least. As I looked at her I wanted to stay, to sit, to hold her hand, just to be with her. But of course I was paged and away I had to fly.

Tuesday morning she’d stopped swallowing, didn’t make sense when she talked and went in and out of consciousness. I rang the daughter again and said,

“If you want to say goodbye to your mum you’d better come now.” She arrived late afternoon and Grace died in the early hours of Wednesday morning.

It was good that Grace got to see her daughter, that her daughter got to see her mum but…

For that nine days Grace was mostly on her own. When she was still able to communicate she asked her doctor in my presence what was wrong with her. He patted her gently on the cheek and responded “You’ll be right love”. Later I asked him why he didn’t tell her she was dying. He looked at me as if I was an idiot.

“We don’t know that for sure Leesa.”

“But you put it in her notes!”

“Yes but we don’t want to scare her.”

Grace ‘s end of life directive indicated she didn’t have any desire for a religious person to come and talk with her. Personally I think that’s a shame. Not the religious bit but rather that when a person is passing and they do have a visit from a minister at least they get to talk. About death, about their life, about whatever. The more people are letting go of religions the more silence seems so be our only response. I’m not saying we need religion. I am though saying we need something else.

Grace got silence.  Grace got to spend eighty percent of her last nine days alone. And when her body was removed it was snuck out the back door so the other residents didn’t know because…we don’t want to upset them do we?

For me at least the whole process seemed wrong. Our silence about death seems wrong. Her aloneness seemed wrong. Our sneaking her out seemed wrong.

I understand death is scary. But our avoidance cannot surely be the answer. So often I see people experiencing the grief process alone because it makes others uncomfortable. But to watch someone dying alone, and in ignorance of what is happening to them…well it was profoundly disturbing.

Life…of which death is a part… matters far too much to be ignored and to be snuck out the back door. Oh I know folk are dying all the time…I understand that in our western countries dying is a gentler process than elsewhere. But I also know that where we can do better we should. Our uncomfortablity with death left Grace alone.

We need to face death, to talk about it, to try to understand it and mostly, we need to be there…both for the dying and for those left behind. 

That’s my opinion anyway.

6 thoughts on “Must death be silent?

  1. This is profound. I have to agree with you that death should not involve silence. There should be people there, celebrating the life of the person who is passing on.

  2. This hits home. As you know I care for my 90 year old mother. I’m used to hospitals, used to seeing in and out-patients close to death or beginning the last process of it. When I lived in UK, older people are left much the way Grace was left – on her own most of the time even though the medical staff know the patient hasn’t long to live. In Southern Europe, as I’ve said in my blog, death is very much a part of life, and older people are hugely loved and respected…still. Although I agree that death is a part of life, I’m keener to be up front and say that death is the ultimate objective of life (not in content but rather as the consequence of life – seems obvious but the acceptance of this I think is a philosophical question). Yes, we’re losing a fundamental justification of death which religious faith provides us. And yes, the consequence of that is a loss of bearings – moral, philosophical, existential, you name it. The consequence of this loss of bearings is a consequential disappearance of morality and moral behaviour which as you ay has to be replaced with some other framework. Problem is, most people are still figuring out what that framework could be. So, we’e left empty and helpless with no response to all the Graces dying around us. Leesis, I’m beginning to see some of the telltale signs in my mother. After all we’ve gone through, I don’t want to be somewhere else when the process starts and ends – to put it crudely, we have a duty of care to the dying, apart of course from our emotional involvement. And your comments about having a pastor or religious visit the dying is a good one – because they accept the trappings and consequences of death and are convinced of death’s objectives if you like. So, they are exceptionally well prepared (or should be) to accompany the dying on that final stretch, with love, with affection, and with hope.

    • So nice to hear from you Ana and what a great response.

      I think for me the most significant thing re the religious ministers being at the bedside is simply that no one has replaced them. It used to be said that counsellors would replace ministers for people to talk to but that didn’t happen. The priest was free…todays counsellor costs a fortune and certainly will not sit by your bedside discussing your upcoming death with you whatever the framework of belief.

      And the average bear, at least here in Australia avoid the word, and the reality of death as much as possible.

      For me the framework is simple. Let’s be there for each other in honesty and kindness. We may not understand the philosophical underpinnings of life and death but we all know how much we need each other.

      I wish you the best with your mum…cheers Leesa

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