I always use the title from that 2000 classic starring George Clooney to describe the series of events that line up just right for the perfect outcome. And so it was for my first attended death. Like most of us in the hospice world our main focus is to comfort those dying but for the vigil volunteer I have always felt the greatest accomplishment is to be there when the patient actually dies. It isn't to satisfy some morbid curiosity or to put another checkmark on a statistics sheet. It is to place a period at the end of a person's life story. If you are a vigil volunteer, I don't have to explain this to you.
I started my work with hospice in July 2009 and it was only last week that I actually experienced my first attended death. That alone would have been an incredible experience, but I also had the patient's daughter in the room with me. As I often find with family members, the daughter was anxious and afraid to be alone at the actual moment of death. Upon my arrival I noticed that her mother was unresponsive to my voice and to my touch. She would remain that way for the remainder of my vigil visitation.
Her respirations were shallow, not labored and no hint of pain or discomfort. I sat with her daughter and explained the process (obviously in gentle terms) of what was happening to her mother. About 2 1/2 hours nto my vigil her mother stopped breathing. I told the daughter to wait a moment as many times a patient will experience apnea. After a good minute and a half I decided I needed to step outside to summon the RN on duty at the nursing home. When we walked back into the room we found the patient breathing again.
About five minutes later the staff left us to be alone. I explained to her daughter that it was difficult to predict a time when someone would pass but that she was probably very close. I had noticed early on during my visit that she was reluctant, or maybe just unsure, as to what she should be doing. I decided it was time to coach her and so we moved the chair next to the bed. I suggested that she hold her mother's hand and that she speak to her. Less than a minute later her mother took her last breath.
I wasn't sure how the daughter would react, but she was calm, at peace with what had just happened and thankful to have someone there to help her through this process. I explained to her that as difficult as this was, there would be a time in the future that she would be so thankful to have this moment. I then allowed her time to be alone with her mother while I stepped out to make sure all the proper notifications were being made.
If I had to write this script I could not have done it any better. All the pieces fell into place. I had waited a long time for this moment. There were plenty of prayers asking for strength and courage for myself, and the countless number of patients I sat with. I didn't know how I was going to react emotionally, physically and spiritually. Thankfully, God gave me the strength and a gentle death for my patient. I relied on my training to provide the answers and my heart to provide the compassion.
In the end this was a “Perfect Storm”.
Jeff Hoffman
Vigil Volunteer
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