A Passing

It finally happened to me. I was taking care of a woman in hospice and she died while on my shift. I have been on hospice shifts before but never had anyone die on me.She was a beautiful woman of 99. Lived a full life with two husbands and a bounty of children. I heard her son say as he was saying goodbye "You've had a full and wonderful life mom. You were one of the lucky ones." So I have to believe she did.Saturday night when I walked in her son, a minister, and his wife, were there. They had been camped out at the retirement village, in an apartment reserved for family, for the last couple of days. They were in with his mother sitting vigil. When the nurse came in I went into the bedroom with her. This lovely woman was catatonic at best. Her eyes were open, her mouth was open, she had a breathing hose in her nose. She was staring into space. One would have thought she had already died but her chest was heaving and she very much had a heart beat. Everyone said hello and the nurse and I turned her. Apparently she had gotten bed sores so we had to turn her every two hours. When a person gets that old and is near death their skin becomes very thin and therefore prone to staff infections. It is very important then to turn them every two hours. She hadn't had any solid food since wednesday so there was no bowel movement to clean. They had a colostomy bag attached to her so there was no diaper to change. She was already on morphine.The night went on as scheduled. We turned her every two hours and the nurse gave her morphine every four hours. The morphine helps to dull the pain of the body breaking down. Morning came and her regular care giver took over. She had been with her for several years. None of these regular care givers want to be there when the patient dies. At that point they've grown too attached and would prefer a phone call.I returned later that evening, sunday, at 8:00. Her son was out to dinner and was due back shortly. Nothing had changed. About 9:00 he did return and he and his wife and favored nephew, who had arrived earlier that day, all went in to sit vigil again. I sat in the living room. I then heard him reading the death prayer. The one that reads "yea though I walk through the shadows of the valley of death" or something. It was absolutely beautiful. I had heard that prayer before but never really paid attention to it. I never had to. This was the first person I knew who was dying before my very eyes. My 90+ year old grandmothers all died of old age in their own rooms either with other family around or no one. I was never a part of that process. It brought tears to my eyes.After he read that prayer they left, it was 9:30. I called the nurse back in at 10:00 because we had to turn her. Then at 10:30 she came back to administer more morphine. At 11:30 I checked on her, she was still breathing. At 12:04 I called the nurse to come in and turn her again. I went into the room by myself to get prepared and I noticed she wasn't breathing. I thought "wow, she's not breathing". I stared at her chest for what seemed like for ever and it wasn't moving. I realized she was dead? The nurse came in and looked at her. I was speechless. Then I said she's not breathing. No she's not said the nurse. She picked up her wrist to look for a pulse. She honestly couldn't tell if there was one. It seemed the heart was just stopping. I called her son immediately. He wanted to be notified of the slightest change. He came and we told him she had passed. I left the bedroom to give him privacy. He said a few more goodbyes. It was over.I was instructed to call the VNA nurse. Got the answering service who asked a lot questions I didn't have the answers to. They told me she couldn't get there until 3-4 hours later. At that time she would pronounce her dead and record that hour. It seemed stupid to me. Here she clearly died at midnight but they couldn't record it until 3-4 hours later? It seemed very undignified.Then I sat with her son who wanted to know every last detail of the past few hours.I'll have thoughts on all of this in my next post. There are many.