My hospice patient is declining and it is so much sooner than I expected. A month or so ago when I first met her, she was sitting up and oh so chatty and friendly. Today, she is immobile and non-vocal, only waking some, with raspy breathing on occasion. It's not long now. I sat with her, held her hand, sang several songs, was just present with her since we couldn't have a conversation. And oh she smiled! She has such a marvelous smile that lights up her face. And let me know I was getting through, that my visit was important. Before I left, I said my goodbyes to her in one of her awake moments, something the chaplain I worked with alongside my last patient suggested, thanking her for our time together, telling her how glad I was to get to know her some, and wishing her peace if she had to go before I saw her again. She mouthed, "thank you."
You know what the hardest part about hospice is for me? It's not the dying, because that's what they're doing. That's their job, so to speak; mine is to accompany them a little bit on that journey. It's leaving the room each time that's so difficult, knowing that quite possibly, no one else will sit with her again today, hold her hand, talk to her, be with her, except to try to feed her or change her diaper or do other physical caretaking, which is, of course, valuable--and they are chatty, friendly people, usually, but there's a busy-ness, a rush to it because the staff are always stretched very thin. Visitors are rare in these places; families don't come everyday necessarily (my last patient's son did, though, for lunch, but that still meant she sometimes went 24 hours between visits, until the very end.) So, I'm not criticizing either staff or family, just noticing one way of dying. People think hospice means round the clock care, and it can close to the very end, but oftentimes there are months before that. I just think it must be so lonely to die in a nursing home (I haven't had a hospice patient at home yet.) And, though in some ways I wish I could stay all the time, until they die, I can't. I just hope her family is there in the very end.
Oddly, and this surprised me as much as the leave-taking being the tough part, I remember the blankets--the quilts wrapped around my very first patient, the pastel afghan always covering my second because she was always cold, and for this one, both the pink quilt she had made herself that once covered her bed and has now been put away and the purple single-crocheted afghan which I think she also made that covers her now.
Funny, it reminds me how I can still recall most of the babies' blankets we had and their wonderful scent. Blankets of the dying are more bittersweet and not at all sweet smelling, even if much of their world regresses to the infant-like, and again we wrap them in comforting cocoons of pinks and purples, yarn and fabric.