After spending hours at the bedside of my precious Grandma Daisy, I stepped out of her room to make a brief telephone call. At that moment, Grandma Daisy died.
For years thereafter, guilt nagged at me that I had abandoned her to die alone. When I began working in hospice, I witnessed similar experiences as family members took a quick coffee break or stepped outside for fresh air and returned minutes later to find that death had arrived.
My perspective changed after I had a conversation with a veteran hospice nurse who suggested that many dying people seem to choose the moment of their death to coincide with their loved ones leaving the room.
Private people often die privately. Perhaps they want to spare their loved ones the pain of witnessing the moment of death. "Or," she added, "maybe the person was saying, 'I've moved on; you move on, too, until we meet again."
After nearly two decades of working in hospice, I have come to believe two important things: First, many dying people appear to choose the moment of death. I truly believe that was the lesson Grandma Daisy taught me. Second, I believe no one really dies alone. People who are close to death and cannot talk will often focus on a corner of the room as if looking at a presence. Many raise their arms, reach out, smile, and try to speak by mouthing words. Those who are very near death and can communicate often report a sense of peace and joy as they are visited by deceased loved ones, pets or angels. That was Leesha's experience in hospice.
Death held traumatic memories for Leesha, whose father died when she was an infant. When she was 10, Leesha returned from school to find her mother, who had been seriously ill for months, was gone. All Leesha recalled from the funeral was the shiny "brown box" that supposedly held her mother's body (her grandmother decided a closed casket was best) and the overwhelming odor of flowers and damp winter coats.
Decades later, when Leesha was dying of colon cancer, thoughts of her mother consumed her. Growing up, she'd asked questions of her grandmother who raised her, but those queries only brought tears.
A hospice nurse visited several times a week, supervising her care and adjusting pain medications. As often happens, the two women became close.
"You never told me that dying would take so long or be such hard work," Leesha complained one day. Then she admitted what was really bothering her: anger at her mother for leaving her. "I've never gotten over her death. I know she didn't want to die and leave me, but I've never been able to get past my anger. I believe we will see each other again, but I'm scared of what will happen because I'm still so mad at her."
The nurse listened as Leesha poured out her feelings of how much she loved and missed her mother. "There's even a part of me that believes she isn't dead and that she will come back to me. I never talk about these things because I'm afraid people will think I'm crazy."
"I don't think you're crazy," the nurse reassured her. "You were a frightened little girl who couldn't understand why she never had a chance to say good-bye."
The two women talked for a long time that Friday afternoon about the ties between mothers and daughters, and the emotions that consumed Leesha, especially her anger.
When the nurse returned on Monday, Leesha greeted her with a smile. "I had visitors over the weekend." Then, as if she was savoring a secret, she shared: "my mother and a friend -- Martin Luther King, Jr. were here."
A picture of Dr. King had been displayed in her home throughout her childhood, and Leesha's mother had told her stories of his courage and mission for equal rights. "My mother and Dr. King told me everything would be all right. That big lump of fury and fear I've been carrying just melted away."
Over the next week, Leesha reported that her mother and Dr. King returned two more times. Then her mother appeared alone for a final visit, explaining the fatal disease that had taken her away so many years before. Her mother told Leesha she had watched over her every day and soon they would reunite.
When the nurse left that day, she told Leesha she would see her on Monday.
"I won't be here," Leesha replied. "Thank you for everything."
Leesha died on Sunday.
The stories of Grandma Daisy and Leesha may offer comfort to those who are wondering about their loved ones' experiences at the moment of death. By sharing these stories you may find that they are far more common than you once believed.
(To learn more about planning and preparing for excellent end-of-life care, visit the National Healthcare Decisions Day website at http://www.nhdd.org and the National Hospice and Palliative Care Organization's website at http://www.caringinfo.org.)