“My uncle has one week to live. I’m visiting him tomorrow. What am I supposed to say? What am I supposed to do?”
I was shocked to hear Michael Harkin’s voice when he answered the phone. I expected to hear his wife’s voice telling me the Grand KIA had passed on two years ago – when he was susposed to! I mean, we had three dress rehearsals for his pending demise after tripple bi-pass surgery. He was a gonner. Almost everyday we talked about the Grim Reaper. But, then came the Loyalty Checks while he was high on meds. Was I really a worthy friend after forty six years? Was I just kissing his ass so he will leave me in his Will? Of course I whipsered under my breath this o day 536 of the count down…..
“C’mon! C’mon! What’s keeping you? My best friend is mentally torturing me to death! He’s throwing me in the great void – meant for him! Help me, Mr. D!”
I have been googling pending deaths that don’t happen, and came up empty. How does one begin to discribe the extreme stress you suffered, and, those negative feeling that began to creep up on you after two years has gone by – and your stuck wearig black, or, putting it on when he calls!”
Well, all’s forgiven, because tommorrow most of us will be dead. All’s forgiven, because it looks like MKIA and I are going to die at the exact same time, after a 10,000 tom meteor strikes the earth.
Here are some thoughts and questions about “pending death”. It’s been good knowing you.
Oh, and Dollar Bill showed us an old un-cashed check for $5,000 dollars at Wendys.
And, all you students will have to honor your student loans after tommorow – guaranteed.
Spanky!
nding Death: Ways to Help Yourself and Your Family
How an anticipated death is different
Knowing that a loved one’s time is limited doesn’t necessarily make their passing any easier when it does happen. Somehow, we can never really be ready to say goodbye, and no matter how much we may realize in our minds that our loved one is no longer suffering or leading a life without enjoyment, our loss is a difficult and complicated situation to bear. But for many families, the chance to anticipate a death, and plan in advance—even if it is just a few days, can be a huge blessing. When you have time to prepare with family and friends, clergy and funeral professionals before the death, you are very much more likely to do so in a calmer frame of mind than at the time of death itself.
In the short video, Stuart K talks about ways to deal with the impending death of a loved one.
The sound of death rattle I: are relatives distressed by hearing this sound?
Wee BL, Coleman PG, Hillier R, Holgate SH.
Source
Bee L Wee Sir Michael Sobell House, Oxford Radcliffe Hospitals NHS Trust and University of Oxford, Oxford. bee.wee@hmc.ox.ac.uk
Abstract
BACKGROUND:
Death rattle is the noisy, rattling breathing that occurs in many dying patients. Health professionals intervene because the sound is said to distress attendant relatives. We found no formal study to confirm or refute relatives’ distress, so we decided to ask the relatives.
METHOD:
Face-to-face semi-structured interviews with 27 bereaved relatives to investigate their experience of terminal care and what their response had been to the sound of death rattle if this had occurred. Interview transcripts were subjected to thematic content analysis.
RESULTS:
We found that almost half of the 12 relatives who had heard the sound of death rattle had been distressed by it. The others were either neutral about the sound or found it a helpful signal of impending death.
CONCLUSION:
We confirmed that some relatives do find it distressing to hear the sound of death rattle. However, our expectation that relatives are universally disturbed by this sound was unfounded. There is no justification for a ‘blanket’ approach to therapeutic intervention when death rattle occurs. A better understanding is required of how relatives make sense of the sound of death rattle.
There isn’t any right answer to this. Follow your heart. Say hi. Smile. Tell him you love him and that you’ll miss him. Ask him if there is anything you can do.
posted by ian1977 at 7:01 PM on April 21, 2009
Tell him what you’ll remember most about him. When my dad was dying, he really enjoyed reminiscing with people (especially funny/silly stuff), and I think it comforted him to know he’d made an impact on people’s lives and that he would be remembered.
posted by amyms at 7:08 PM on April 21, 2009 [4 favorites]
My brother recently passed away similarly. I learned a lot from this page. Some of it may not apply if he’s not in a hospice.
posted by hootch at 7:09 PM on April 21, 2009 [2 favorites]
Don’t think you need to start off with serious and deep feelings – just hug him and tell him you love him, chat with him, spend time with him. Tell him a fun story or other memory that you have of him, or of you spending time with him. Be relaxed, easy, genuinely affectionate. Be real – above all, don’t be fake. If it’s natural for you to grab someone’s hand or lay your hand on their shoulder while you talk to them, don’t be afraid to do it (but be gentle in case he’s in pain). If you’ve been close to him, tell him you’re going to miss him but you’re so glad you got to know him.
posted by onemorething at 7:09 PM on April 21, 2009 [1 favorite]
Is he in good shape and accepting of it? Now may the time for taking some advice from (Queue cheesy pop-country music) Tim McGraw. That doesn’t mean be wreckless or inconsiderate – but now’s the time when he gets to do what he wants to do for the last few times. This is your chance to do some of those things with him.
If its bad – go for longest ice cream headaches.
If he’s mobile – go for a skydive.
This is you chance to tell him what your relationship has meant to you, to validate his impact on you, and to let him decide what final memories he wants to take with him.
I’m sorry for your loss.
posted by Nanukthedog at 7:10 PM on April 21, 2009
Bring a video camera, and interview hm. Ask him about the high points of his life, about his family and his childhood memories. His memories of significant points of history – “Where were you when you first heard that Kennedy was shot?” kind of stuff. Let him tell his own story that can be shared with his family; spend your time on getting to know him, and not worrying about the future.
Put it on a DVD, and at some point after – I can’t really answer when this might be appropriate – but share it with family, and by this I don’t mean having a family viewing… offer copies to people who can then watch it on their own time when they feel they are ready.
posted by SquidLips at 7:16 PM on April 21, 2009
My uncle has one week to live. I’m visiting him tomorrow. What am I supposed to say?
Tell him you love him.
What am I supposed to do?
Cry.
Just focus being as human as you can.
posted by Ironmouth at 7:24 PM on April 21, 2009 [4 favorites]
Had a similar situation, here’s a few suggestions.
posted by Brandon Blatcher at 7:31 PM on April 21, 2009 [1 favorite]
Just being there is more important than what you say or do.
posted by malocchio at 7:35 PM on April 21, 2009 [3 favorites]
If I were to die I probably would read Marcus Aurelius “Meditations”.
posted by yoyo_nyc at 7:37 PM on April 21, 2009
Make preparations to deal with your grief. But when you visit him, don’t make that grief the focus of your time together. He knows he’s dying. Send him off with something better than the same thoughts that echo in his quiet mind.
posted by jefficator at 8:04 PM on April 21, 2009
I visited my mother knowing it was the last time we’d see each other. What did we do? For most of the time, we did the same stuff we always did. We talked about our crazy family. We told funny stories. I told her about school. She told me about her garden. She complained about not being healthy. We made jokes about it. Raunchy, awful, deviant jokes.
And then it all sort of came to a head, and we sat for a long, long time, and she told me who she wanted me to be, where she wanted me to go, and she said she was sorry that she wouldn’t be around for it. That was hard.
Being there is the important thing. Sit and talk, or don’t. Whatever you and your uncle need to do. Maybe it’ll be like any other family visit, as weird and awkward or joyous and uplifting as those can be. Or maybe it will be a profound experience. You won’t know until you’re there, and you might not know until long after you leave.
The hardest part, I think, is treating a person in this situation as a person, still alive, still full of life (unless he has a debilitating illness that will make communication difficult, of course, but even then, look at Stephen Hawking).
So I’d say to be you, and let him be him. And be glad for the opportunity.
Very sorry for your family’s loss.
posted by socratic at 8:10 PM on April 21, 2009 [22 favorites]
It may seem odd but he’s probably most concerned about his loved ones – you. Dying is a small sort of letting those around you down, where you aren’t able to watch out for them anymore. Without details or knowing him, I’ll venture that he’s ready and accepting the end of his life coming up – it’s leaving those around you behind that’s the hard part. Tell him about your plans, your hopes, your dreams.
posted by kcm at 8:11 PM on April 21, 2009
You didn’t mention if he is mobile or not, but, if he likes the outdoors take him for a walk. I went on a walk with my Aunt shortly before she died and that walk meant so much to both of us.
Try to relax as much as possible and let him take the lead.
posted by a22lamia at 8:13 PM on April 21, 2009
When my grandfather was dying I couldn’t do much more than hold his hand and kiss him on the forehead….but he told me at one point that he was glad I was there.
posted by brujita at 10:40 PM on April 21, 2009
Bring a video camera, and interview him.
Unless he specifically requests this, for God’s sake fuck no!
You know what’s happening. He knows what’s happening. Unless you have any deep issues that require the giving or accepting of forgiveness, just talk to him like you normally would.
You can say everything you need to with your last hug or kiss before you leave.
posted by Cyrano at 11:11 PM on April 21, 2009 [1 favorite]
You don’t go into specifics, so I am
going to go out on a limb here.
Sometimes when people only have
a week to live, they are in palliative care.
Sometimes some parts of them have
shut down already. When they are that
close to death, some parts of them aren’t
always responsive or very alert.
I would suggest that you touch him.
Hold his hand, rub his arms, maybe even
hang out beside him in bed.
Even if he’s aphasic and has trouble
understanding speech, the sense of touch
is generally recognized as the last sense
to go. So when you see him, touch him.
It will comfort him. Esp. since when people
see sick people, they aren’t always eager
to touch them. But it’s the most direct
and sure way of telling someone you
love them, esp. if when you tell them
you love them, sometimes it’s not understood
because of aphasia or other damage.
Good luck.
Impending Death: Ways to Help Yourself and Your Family
How an anticipated death is different
Knowing that a loved one’s time is limited doesn’t necessarily make their passing any easier when it does happen. Somehow, we can never really be ready to say goodbye, and no matter how much we may realize in our minds that our loved one is no longer suffering or leading a life without enjoyment, our loss is a difficult and complicated situation to bear. But for many families, the chance to anticipate a death, and plan in advance—even if it is just a few days, can be a huge blessing. When you have time to prepare with family and friends, clergy and funeral professionals before the death, you are very much more likely to do so in a calmer frame of mind than at the time of death itself.
In the short video, Stuart K talks about ways to deal with the impending death of a loved one.
Additionally, anticipated deaths often take place while your loved one is under close medical supervision, and so legal issues of pronouncing and reporting the death are usually very straightforward. This removes one additional burden from your responsibility and again makes it easier for you and your family to start the grieving process. If your loved one is an inpatient at a hospital, nursing home or inpatient hospice facility, staff and procedures are in place to comply with initial legal requirements, and often to notify the funeral service provider of choice that the death has taken place. When a person dies at home while under the care of a hospice organization, a call to the hospice nurse will start the process of completing initial legal requirements.
Having advance warning of an impending death can allow for discussions of final wishes and planning, but many of us are reluctant to face up to these eventualities, or are too overwhelmed by care-giving activities to plan or think about services. But overwhelmingly, families who take this step to plan in advance say it was the most important thing they did to make a difficult situation more bearable.
Step One: Orient yourself to the process.
One of the reasons end of life is so stressful for many families, is that we just don’t know what to expect. Getting an orientation to the process before the death occurs has proved invaluable to many families. Because death is a difficult subject to bring up, it is often easier to gain information in the privacy of your home. To give yourself an overview of what is to come, you may find it helpful to watch the short video: The Remembrance Process℠.
Also this would be a good time to review 3 Myths About Funerals, and 5 Things Many Families Don’t Know About Cremation.
With these two overviews as background, you will likely want to reach out to your clergy and hospice / medical advisors and ultimately to a funeral professional, who is the caregiver who will help once the death has occurred.
Step Two: Reach out for professional and family help in advance.
Your clergy and hospice professionals will provide tremendous spiritual and emotional support, but ultimately, the advice from a funeral professional can make sure you have the information and choices you will want once the death occurs. Reaching out to them in advance, lets you prepare better, and allows the funeral home to prepare as well. They can show you all your choices, document your wishes, and prepare necessary documents in advance, all of which will reduce the stress on you and your family when the actual death occurs.
There are many benefits to addressing the funeral in advance. Just some of them are:
•You will gain information when you are calmer, and better able to absorb information and choices.
•You will be able to share that information with family and friends, so they can provide input and suggestions on how best to say goodbye to your loved one.
•It allows you to think about the full Remembrance Process℠ and all the ways you can move from grieving to remembrance.
•Your funeral home can prepare documents and a list of your wishes in advance—so there is far less stress on you and your family to make decisions when the death occurs.
•Importantly, an Authorized Remembrance Provider℠ will help you plan, document your wishes, and explain all your choices, at no cost to you, and with no obligation.
Step Three: Taking care of yourself and family when the death occurs.
One of the biggest differences in an anticipated death versus a sudden or unexpected death is that you will be in a hospital or hospice situation, and they will take care of many of the immediate and necessary tasks, such as verifying the death automatically. You will have to reach out to your funeral home at this time however, and if you have planned with them, they will be able to move promptly to meet your needs.
Having anticipated a death, we may fall into an autopilot mode and systematically follow a list of tasks. We may have planned it all out only to find that we are still confused and can’t remember what to do next. In any case, and in each succeeding step, make sure that your emotional needs and those of your family are taken care of, even if this means changing your plans.
Your most immediate need may be to call your pastor, or for loved ones to gather around you. Taking care of your emotional needs and those of your family should be your first priority. All else can wait for a few hours, if necessary. Here are some key points to consider:
•Don’t rush yourself through decisions and procedures, or miss out on your opportunities to say your goodbyes.
•Nearly every decision can wait for a few hours, so be sure to take care of yourself and your family first.
•Are there family members who will need to come right away?
•Would the support of a friend help you get through this? If you feel it would help, make those calls whenever you are ready to do so.
•If you haven’t done so yet, a good way to gain an overall perspective of what will happen is to watch The Remembrance Process℠ Video.
Step Four: Consider both the needs of your family and the wishes of the deceased.
Even if we have thought out and agreed to a course for action prior to our loved one’s death, we may find that unforeseen realities cause us to question our plans. We may be torn between promises made to our loved one and the very real needs of our family. Often, the dying person doesn’t want to burden their survivors with the expense of funeral services, or would prefer to think of them rejoicing in life rather than gathered in sadness.
No one wants their legacy to be one of sorrow, but unless we work through our grief following a loss, we may have difficulty moving forward back into life. For most people, having some sort of funeral or memorial service is a positive way to work through and deal with these issues. Services can be traditional, casual, religious or secular. What is most important is that family and friends can come together to share the burden of the loss and acknowledge the importance of your loved one’s life.
Step Five: Ways of saying goodbye.
Provider —- select —- Cemeteries Funeral Homes
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Again, every decision you’ll need to make does not have to be rushed, so if you are really unsure about what kind of ceremony would be appropriate, or whether you would prefer burial or cremation, explore your options. The funeral home will need to know whether you want them to prepare your loved one for a family and friends goodbye. In this case, they will need your permission before beginning embalming preparations. But with that said, if you are unsure about your choices, you can wait until the next day to make your decision.
Your funeral home will make an appointment to meet with you and explain your options. Years ago, most services were very similar. Today, it is customary for services to be adapted and arranged to fit your specific needs and wishes. There are many choices for services such as a private family goodbye, friends and family goodbye, or community gathering, whether burial or cremation. There are also highly personal choices for a permanent remembrance, which many families find extremely comforting. Give serious thought to what you need from the service, and to what other family members, friends and members of the community need to say goodbye to your loved one.
You may be surprised to learn all that is possible and all the different ways that these aspects of funeral ceremonies can be made more meaningful through planning and family participation. And in most cases, your friends and family will want to help. At this time, and in years to come, memories of the support family and friends provided will be a key part of moving to remembrance of the loved one. At RemembranceProcess.com we have more information on the types of funeral and memorial services families are using today and other information on choices available to you.
If you have planned with a funeral home in advance, then you will be able to focus more on helping yourself and your family with the grieving process. We have learned from the experience of thousands of families that working through the time-tested steps in the Remembrance Process℠ helps in moving from grieving to remembrance. Saying Goodbye to Your Loved One with the support of your friends and family can be a huge part of this process, and we strongly suggest that you and your family explore the choices that most appeal to you. The memories shared, the stories told at these “goodbye” services will be remembered and valued forever. What many families don’t realize is how personal and creative saying goodbye can be. Eulogies and obituaries can also be a key part of remembering your loved ones, and reviewing the sections on this website can give you the information you need on how to prepare a eulogy or obituary so they can be most meaningful. Friends and family are often eager to help here, and often, some of the most memorable parts of the service are the words said about the loved one.
Step Six: Permanent Remembrance.
Lastly, many families find that permanent remembrances like cemetery monuments and grave memorials can be especially valuable for now and for decades to come. But many families don’t know they can have these remembrances even when they choose cremation.
Having a permanent place to remember your loved ones is another time-tested way of helping move through grief. For families who choose traditional burial, a cemetery is the clear choice.
But many families who choose cremation don’t realize they have even broader choices for permanent remembrance. These choices can include special sections in cemeteries, cremation gardens, cremation niches, columabariums, and even highly personal locations.
All of these choices allow a family to choose a headstone, monument, grave memorial or other permanent tribute. View this video to learn more about the ways other families have remembered their loved ones and the many choices you have for permanent remembrance.
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