“Do You Really Think She Can Hear Me?”

About a month ago I had the privilege of being at a patient’s bedside as she experienced a peaceful death. I am a Hospice Admissions Nurse and had been asked to admit a woman who lived in a nearby nursing home into our program. Normally these visits are rather routine, as Nursing Home patients have plenty of nursing support. Much of our job as Hospice providers to patients in Nursing Homes is to add expert comfort and pain relief support and end-of-life teaching for the patient and their family.

This situation was a bit different, because the eldest daughter was so distraught about her mother’s rapid physical decline, that she was emotionally raw and verbally lashing out at everyone around her. The time surrounding death is already filled with anxiety and tension, but this caregiver was making everyone around her so upset that she had successfully alienated herself and the patient from the staff. Our Hospice Care Consultant staff member who had taken the referral for this patient was a very sensitive woman and had taken the time to carefully communicate the stressful circumstances to me, so that I knew that I was walking into a challenging situation.

I met the patient and her eldest daughter and did a physical assessment, quickly realizing that the patient, an 86 year old blind woman, was in the final minutes before death. I could tell that the daughter was unaware of the imminency of her mother’s death.

I carefully brought her out into the corridor and explained that her mother was dying. She said she knew, but then I explained that she was actually actively dying and would likely die within a couple of hours. She just looked at me and then burst out sobbing. I held her for a few minutes until she calmed down and then she said, perfectly calmly, “I knew it had to be close when I saw her this morning – something had changed and I just knew it.” She cried for a bit more as I carefully explained the physical symptoms of the dying process.

I stressed the need to touch and hold her mother and to speak clearly and calmly to her, as she was blind and couldn’t see people around her.

The daughter called her sister and brother on her cell phone and they were able to come to the nursing home and gather around their dying mother. It was so good to see them all holding her and telling her it was okay to let go and to go home and be with “Pop-Pop,” her previously deceased husband. They shed tears freely and cried and held her and each other.

The patient was quickly transitioning, and her terminal agitation and restlessness ceased after her three children came to be with her. They stayed by her side for the next hour and I encouraged them to share stories about their mom. I learned so much – about how she had been a nurse and had taken care of senators down on Capitol Hill back in the 1950’s. I learned about how one of her sons, Mark, had predeceased her and about how hard that had been for everyone. We fell into a pattern of sharing stories and the whole time we touched the patient, held her hand, stroked her arms.

As things were drawing to a close the eldest daughter said to me, “Do you think she can see me?”

I explained, very quietly, that she had been blind for a few years and that our presence was more likely felt by her by our touch and voice. Then she said, very softly, “Do you really think she can hear me?”

I didn’t have to answer that question – as I looked down at the frail woman, breathing her very last breath, I saw a solitary huge tear come out of her eye and roll down her cheek.

Now I know for sure what I have always told my families at the death bed – no matter how quiet our patients are, no matter how devastated their bodies are from disease, they can hear us and feel us, and it means the world to them.

About the Author: Chris Schaeffer is an RN and Certified Hospice and Palliative Nurse at AccentCare Hospice of Maryland.