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MY GRANDMOTHER had a washing machine in the kitchen. As a young girl, that was my place to perch and ask her questions while she cooked:
"Nene, where do eggs come from?"
"They come from chickens."
"Nene, where do chickens come from?"
My grandmother knew everything! But neither of us knew the meaning of the word "hospice" until I was about 36. That is when the hospice nurses came like a team of angels to turn my mother's living room into a makeshift hospital room for my grandmother.
Perched in that big hospital bed, Nene looked as fragile as a baby chick. At first, she struggled to speak. "You know who I miss?" she asked me, her voice labored.
"Who do you miss, Nene?" I replied.
"I miss m-m " then she dozed off to sleep before she could answer.
This exact scene recurred three times. Sadly, "Who do you miss, Nene" would be my final question to her.
During that difficult transition when my grandmother was dying, hospice gave our family a tremendous gift. They managed my grandmother's physical needs so that we could embrace those intensely emotional moments at the end of her life.
FINAL LODGING
Literally, the word hospice means "lodging for travelers." In some cases, as we near the end of our life's journey, death is somewhat predictable in the course it will take.
In these cases, hospice can set up that final lodging place in our own homes. But their services don't stop there. They care for the patient but also help address the family's needs by offering emotional, psychological and even spiritual support.
Support is adapted to the needs of each particular situation, and sometimes it comes in the form of massage, music or even art.
It takes a special gift to work in hospice care. I talked with two local caregivers: Dana Peveler, who is manager of Mary Washington Hospice, and Judy Murphy of Hospice Support Care.
When I asked them what families need to know about hospice, they both had the same response. Families are sometimes afraid to bring in hospice--afraid that it may be too early, or afraid that it will be misperceived as "giving up."
On the contrary, they noted, the earlier you can bring needed service to the family and patient, the better. Even if you call hospice too soon and the patient recovers, that's fine. Both directors recounted stories of people who recovered during hospice care and "graduated" out again.
NEEDS OF THE DYING
Hospice staff work as a team to address families' varying needs.
For some families, the needs are for physical assistance, but for others, the needs are more emotional. Perhaps the family's main need is for help coming to terms with the impending death or for help resolving unfinished business.
Peveler and Murphy mentioned that, sometimes, the patient simply longs to be touched. Perhaps too many people are afraid to touch the dying.
The book "Final Gifts" was written by two hospice nurses in part to help us understand the needs of the dying. They need to feel a sense of belonging. They often want some knowledge and even some control over the dying process. And very often, they wish to communicate with us about their "nearing death awareness."
"The experience of dying frequently includes glimpses of another world and those waiting in it," authors Maggie Callanan and Patricia Kelley say.
To us, the attempts of the dying to communicate may seem confusing, but they need for us to listen closely and try to understand.
A PROFOUND EXPERIENCE
You might think hospice workers would be drained from the intensity of the work. Not so. Hospice workers seem to find their work richly rewarding.
"Being with the dying is one of the most intimate experiences on earth" writes Joyce Huchison, hospice nurse and co-author of the book "May I Walk You Home?"
I found this sentiment echoed in all my research. It was certainly a profoundly intimate experience for my mother, sister and me as we sat around the foot of Nene's bed until the wee hours of the morning.
While hospice managed her pain, we were free to reminisce about her life. After we told every story we could recount, we began to sing the songs to her that she had sung to us
Although we had never paid much attention to these words before, on this night, they were eerily poignant:
THE ANSWER
While writing this article, I mentioned the topic to my sister, who was with me and my mother during Nene's death. When I told her about the needs of the dying to communicate their experience with the living, my sister relayed an odd memory. She said my grandmother had stirred once from her unconscious state and simply said the word "mother."
So today, over a decade after my grandmother's passing, I finally heard my answer. My grandmother was missing her mother.
Dr. Delise Dickard welcomes reader comments and questions. For contact information, go to
Dr. Delise Dickard a licensed professional counselor, is the director of Riverside Counseling in Fredericksburg.
