Graceful Passages. The Eleventh Hour. The way of the dying.

Several of us have been with people as they are actively dying. Family, friends or even strangers. No one really prepares us.  We think it’s the end but really, it’s a beginning.  When you are close to someone this process can be hard to comprehend, accept and internalize. 

My interest in the dying started when my best friend’s mother died at Hospice.  She was unexpectedly in a situation where death would be the outcome.  I intuitively knew, how one showed up and honored the dying, and the process was important. My friend was a good teacher in what she modeled to me.  The hospice workers also helped to navigate the experience. 

As a point of reference about me, I have always been interested in that moment where the dying man looks up, reaches his arms out and says, “Gertrude!” Something about me wants to witness these things I have read and heard about.  Maybe as a form of evidence solidifying there is a spiritual place we go.  Be it the other side, heaven or a different dimension. A form of proof, to clarify what I already believe.

Recently my 107-year-old patient was moved to our Inpatient facility. I went down to visit as soon as I knew.   I simply sat with her in silence. Three weeks prior, during my visits to the caregivers home my patient was eating, talking and very much alive.  We talked about her 108th birthday on each of the visits.  Each time she told me she would not see that birthday.  She was sure of it. 

Back to the Inpatient facility.   Later a nurse came in to check on her and as we talked I said I bet you have a lot of stories. She said I do.  I asked if she would share them with me.

The nurse had been working at Inpatient hospice for four years.  She told me many times the dying sees children. As they get closer to their transition the veil becomes very thin between this world and the next. They see children about 4-5 feet above the floor. Typically, the children are playing.    One little boy dying in this facility looked up and told the nurse there were three boys playing and they were loud.  He asked if they could they keep it down. He told her the name of each boy. Later she checked the patient logs and the three children he named were children who had recently died in the facility.

She told me when patients look to the corners of the ceiling they typically see angels. You can ask them what they see, and they will tell you angels as if it’s obvious.  Many patients within two weeks of their death talk to their dead parents, siblings, spouses or pets carrying on entire conversations.  They reach for the ceiling with their arms towards something they see.

In each room at my hospice there is a bathroom.  The nurse told me that the bathroom doors will open and shut on their own with no one there. It happens all the time-it’s Spirits.  She told me patients see people sitting in a chair in the room, people we can't see.  We call those greeters. These are spirits coming to help the person cross over.   I was completely engaged in her stories. These are similar stories to what I heard from other nurses at the hospice in which my friend’s mother died.

At this point in my patient's journey she was rejecting hydration and sustenance.  I texted the Caregiver after I left and told her I had visited her cousin.   A couple days later we decided I would meet her at hospice the next night at 9:00 pm.  That is when my patient was most restless and needed visits.  This is called “terminal restlessness” as the patient is now in the dying process.

When I arrived, she was awake.  Her eyes were open a small sliver, but she smiled when the caregiver told her I was there. It sent a warm flush through my entire body. The caregiver told me the patient really liked me after my in-home visits and wanted me to keep coming.  We got along well together. She was a feisty lady.

15 minutes into the visit she reached for the ceiling.  The caregiver told me she was doing this a lot, that she was talking to her grandmother, her mother and her brothers. I was seeing this for myself.  Both the caregiver and I were mesmerized by this activity. She would reach her hands up and speak in mumbled words, she would smile, laugh and reach.   After a while she would come back to present and attempt to talk to us. Most of the time it was unclear what she said.

She would rest.  Then it happened again. This time she looked at the wall with her eyes wide open. She clearly said, “Can you take me?”   Followed by “Huh?”  That was followed by another "take me, I am dying."  She was clearly speaking to someone we could not see.  We asked who she was talking to and she said her brother by his name. We asked her where she was going, and she said Home.   Two hours into the visit she told us someone was sitting in the chair. I immediately thought it’s the greeter.   It was an experience full of wonder.

At one point she became agitated. The male nurse, an older man, came in placed his hand on her forehead and began singing Amazing Grace.  He told her she was loved, she embodied love and always throughout her life had the seed of unconditional love in her. It was beautiful.

At midnight we decided to leave. I reached over my patient,  put my fingers in her hand and she wrapped her hand around mine. She took both of my hands in hers and she slowly lifted them to her lips. She held them there attempting to kiss them although she was unable.  It moved my being.    My eyes watered with gratitude that I was having this experience that I too was loved.  I thanked her for allowing me to be present in her process.  I wished her Godspeed on her journey. 

Two days later she was still with us.  I told the caregiver I would be down on the 17th to visit.  I was alone for this visit.  I had the privilege, the honor of being present with her as she was actively dying.  I went into the room mid-morning to the sound of the death rattles. This means the patient can no longer swallow and becomes congested with body fluids. I quickly asked the nurse to come in and turn her so breathing would be easier.  She calmed a bit. The first hour was rough for me as the sound is unsettling. I played the old gospel tune “Swing Low Sweet Chariot” from the soothing album “Graceful Passages” by Gary Malkin & Michael Stillwater. (For which this blog was titled)

The second hour was again full of wonder with her hands reaching for the ceiling mumbling in constant conversation with someone.  The third hour she held my finger as she mumbled nonstop to someone she was clearly seeing. Then three times she put her hands under her back and arched forward, eyes looking up wide open as if stretching for another place. This was followed by a relaxation and the rattle became much lighter and almost ceased.

At this point, I had to decide if I should stay or go. I chose to go because I did not know how long it would be. It was during the the next hour and 20 minutes she transitioned.  It could have been five minutes after I left. I will never know. I just know the nurses make their walk through every one-two hours and when checked on, she was dead. She transitioned on March 17th, 2018.  It was a Graceful passage.  She was about a month shy of her 108th birthday. 

I was at a late lunch when I looked at my phone and saw the text, the missed call that she has passed. I cried because she was such a gift to my heart. The opportunity to meet a woman one month shy of her 108 birthday.  To have the privilege of sharing in her Eleventh hour. She showed me all I desired to see.  I was a welcomed volunteer by the Caregiver whom I appreciate so much and I participated in her Graceful passage. 

I know one thing for sure, we do not die alone.  We are surrounded by the Spirit world. These are not visions of the brain losing oxygen, or morphine related incidents-these are real interactions.  My patient died of old age, she was not in pain. In the end the only drug she took was for anxiety. I witnessed this first hand. I was there in her Eleventh hour.

Elisabeth Kubler-Ross, the psychiatrist who had a near death experience, and spent most of her life working with the dying said:

“Look forward to your transition. It's the first time you will experience unconditional love.  It will be all peace and love and all the nightmares and turmoil you went through in your life will be like nothing.  When you make your transition you are asked two things basically.  How much love were you able to give and receive and how much service you have rendered. "

She also said: 

"We need to teach the next generation of children from day one, that they are responsible for their lives.  Mankind's greatest gift, also its greatest curse, is that we have free choice.  We can make our choices built from love or from fear."

It matters how we love. How we love ourselves and others.

I have a lot to learn. I am grateful for the lessons.

Until next time,

Sat nam.