There in The Final Moments
For an insider look at the death process from a hospice worker’s perspective, OUT FRONT had a few words with Deb Krier, a registered nurse who specializes in home health and hospice at St. Rose Health Center.
Can you speak to the difference in people’s attitudes and outlook on life from the time they enter hospice to the time they’re very close to dying?
There are definitely differences. Some people believe there is still hope even though they chose to go with hospice instead of other healthcare avenues. As they get closer to death, sometimes they change and sometimes they fight the dying process the whole way, which makes it tougher on the patient. There are so many variables. Some people who are dying go into it with total acceptance that they are dying.
Some people have no religious background and during the dying process will choose to see a clergyman. Some of them ask to be saved so that they can go to heaven.
In many countries, death isn’t as terrifying. Do you think America has tried to shield the process of dying from the eye of general public?
Years ago, yes. But more recent years, there has been more knowledge and education of hospice and the dying process. I have a continuing education piece that kind of talks about death in America — how people have viewed death many years ago versus the more open communication and education about it that there is.
Can you talk of some stories about what people have seen, said, or reported moments before their death?
There was someone that was just hours from death who said her daughter was going to be coming in to get her (as she was looking out the window). There was no one outside. About 30 minutes before she died, she was talking to her daughter at the foot of her bed. I feel as if her daughter came to get her.
Another client was about 24 hours from death and spoke of seeing angels and how their wings are beautiful and none of them are the same. That person was very comfortable with the fact that they were dying and knew that she was going to go to heaven.
There was a client that fought the fact that she was dying clear up until hours before she died because she kept wanting to get more treatment. If these things worked, she could live longer but the doctors had no more options for her. She became unresponsive and she quit fighting.
I’ve heard stories of people setting up in bed and looking up like they see something or someone before they take their last breath. Sometimes, none of that happens.
Another lady was dying and her husband had passed before her. Minutes before she took her last breath, the dining room light, chandelier, started slightly … slightly swinging back and forth before she died. That was freaky because I saw that happen. The caregivers felt like the husband came through the light fixture to get her.
What are some common sentiments (and/or) regrets you hear from patients looking back on life?
I hear family members talk like that a lot. Sometimes family members don’t think that they have tried hard enough to do things and they will emotionally struggle: “If I had only taken them to the doctor sooner.”
Family members struggle with the fact that dying people will quit eating and drinking, and that is so well known to sustain life. It isn’t headed the direction that people or family members want it to go.
I haven’t really had anyone talk specifically about regrets. I have had patients that have been estranged from other family members that wished that they could talk to them again. In many instances, those family members will come and issues from the past that I see get resolved time and time again. Very, very occasionally does it go negatively.
