At End of Life

Yesterday I had a conversation with someone who talked about her father’s life and, specifically, the end of his life.  She suggested that it would be helpful if someone prepared you more for what was going to happen and when, easing the process for the family and, perhaps, the loved one as well.  If you had a better understanding, perhaps it was a chance to say anything that needed to be said or gather anyone that needed to be present.

I’ve been thinking about those comments in both the context of my work with older adults and in the context of my own life. This week marks the anniversary of my mother’s death and I inevitably reflect on the end of her life as this date approaches.

So often, family members are unwilling or unable to see the end of life even when it is fast approaching.  Even with hospice services on board, many families refuse to believe that they could actually be facing a final farewell with their loved one. Denial, as we say, is more than a river in Egypt and hope, somehow, often continues to surface.

The last time that I saw my mother she was in the hospital.  My brother and I, 24 and 25 years old respectively, both living at some distance away, were there to see her and, despite the oxygen tubes snaking into her nose, she was still and fully herself.  Breast cancer may have been winning the battle but Mom was still Mom.  I told her that I was having some elective eye surgery the following week, correcting a surgery done initially when I was 10, and she asked me if maybe I should wait a bit.  I told her not to be silly and that I would see her in two weeks.  I realize, in retrospect, that she knew that the end was near and was trying to tell me that.

My brother and I got into the elevator to leave. We were alone in that silent metal box and, as it moved down towards the hospital lobby, we both began to cry.  I looked at him and said, tears streaming from my eyes, “We will never see her again.” And we held each other tightly.  When the elevator doors opened, we wiped our eyes and then, with unspoken accord, went right back to believing that what I had said was wrong, inconceivable, impossible.

Of course, my mother knew the truth and on that following Friday morning she took her last breath, my father at her bedside holding her hand. If it were now, would I have accepted it any better? Would I have had the conversations I wish I had with her, would I have apologized for all of the times that I was difficult, challenging and uncaring about her feelings? Would I have asked her what I should know and remember, what I should know about parenting, how I should care for my dad with her gone?

I have stood at many bedsides in my career, talked to many families, tried to help them through this painful, inevitable, part of life. Yet, while I know the words and the process, I also know that letting go of hope, letting go of that person you love is hard to accept and hard to believe.

Can anything fully prepare us for loss? I don’t think so.  While we may understand with our logical minds, our emotional selves often cannot comprehend, much less accept. Yes, we all need to know how to make peace with end of life, to acknowledge that all life begins and all life ends.  Yes, we have to remember that what matters is how we live and interact and connect through the years of life. And, at the same time, we must also show ourselves some grace as we negotiate the difficult process of losing someone we love.