BEYOND STATISTICS: When They Do Not Go Softly Into the Night

I have had the honor of being with so many as they ‘transition’ to the other side. Many have been of the movie scenario quality with loved ones around the bed sharing stories, singing favorite songs, lovingly giving permission for their Mother/Father/child/spouse/dear one to go.

It doesn’t always happen that way. Sometimes that dear one is mad, bitter, hostile, hateful in moments, blasting tired relatives and friends with cursing, and daring a minister to step inside.

One acquaintance called me one day. “What in the Sam hill am I supposed to do with Daddy? He is cussing at my siblings and my poor tired Mom and acts like he might fist fight with the nurses. This isn’t him. Will he stay mad until the end? Because if you think he will, I’m outta here! And I’m taking Mama with me!”

When I do an assessment of ‘the big picture’ there are hints along the way for this behavior. Sometimes it has to do with a change in brain chemistry due to metastatic disease, drugs to help with pain or anxiety, or they are just plain angry. Why? Especially with men I’ve heard them tell me they don’t like losing their independence. They do not always do well with someone strange entering their private home and suggesting they consider a hospital bed or cutting back on their salt intake, or trying to give their pain meds the consideration of routine dosing around the clock to keep the blood level even to avoid playing ‘├žatch up’ if doses are missed. It comes down to thinking they have lost control of their lives. They feel like they are no longer in charage. Who are they going to yell at? Often it’s the ones closest to them: spouse, child, parent, partner, doctor, nurse, dog…

When the weary family members try to take it all in stride along with their physical stress, prepatory grieving process, lack of sleep, they are tempted to walk out the front door and not return. It is tempting!!

Loss of a loved one is hard enough when everyone is supporting one another and the patient is comfortable, at peace with the process, and tenderly expressing thanks for each one there. BUT the reality of life is there are times when we call in the Hospice team and say, “Can you help me out here? Can you look with fresh eyes at this and point me to where and how I sit with this anger and not take it personally? Do you have a volunteer who can objectively sit here while I walk around the block or drive a few miles south of town to a park?”

And that is a great idea! Move away from the scene for a while if at all possible. Breathe and then remind yourself you may not be able to ‘make it all ok’ no matter what you say or do. It is what it is. Sit with your grief, your heartache, your sadness and honor those feelings. Then give yourself permission to return with full understanding that Mom might move into a different space before this is all done and wrap her arms around you. Or Mom may go into a coma and you will sit in peace and quiet a few hours or a few days before her vital organs stop. Or Mom could very well be angry to the bitter end.

These are questions in many hearts of patients that often aren’t voiced. “Can you sit with me in my pain? In my anger? In my fear?”
“Will you see past my outburst? Will you forgive me? Will you still love me?”

One sibling pulled me into an empty hallway while his Dad was ranting and raving. His sister refused to leave Dad alone. She ignored his ‘spells’ and would hum or do needlepoint or rock in the padded bedside rocker seemingly untouched.

Paul was wringing his hands, “I can’t sit in there. Does that make me the ‘bad’ child? I don’t know what to say. I can’t ignore him when he is saying those horrible things. My sister acts like she can’t hear it. They are both making me nuts!!”

Be honest with where you are. One sibling may stay in the kitchen fixing supper for evreyone. One sibling may do outside yard work or care for livestock. One may work on financial and insurance papers. And one may sit at the bedside. No one is more worthy. All are worthy! Don’t judge where you are or where they are. Thank one another for whatever they are doing and don’t try to make them fit a mold they don’t fit into.

Unconditional love, genuine forgiveness, and respect go a long way. Talk to your priests, your minister, your best friend, your grief group, your counselor, or your pet, and especially your God….or write about it. No one escapes this. One day it will be us.

5 replies on “BEYOND STATISTICS: When They Do Not Go Softly Into the Night”

  1. Dia Osborn says:

    This is so important to understand Becki! And a great reminder for me. Now that I’ve been away from hospice work for a couple years I find myself selectively remembering the beautiful parts and conveniently forgetting the rough. There was an elderly man I once worked with who’d had a stroke years earlier and had difficulty controlling what came out of his mouth. He had all of us on the team in tears at one point or another, he could cut to the quick with a few brief words, but afterwards he tried to apologize to me in his own way. (He was not a naturally apologetic kind of man.) :-) It was a revelation and a gift to me to see how miserable he felt about inflicting so much pain on the people trying to help him, and made it a little easier to shrug it off thereafter. Thanks!

    • Nurse Becki says:

      Thank you Dia!! I hope to share this with many more. Thank you for all your beautiful wisdom writing in your blog!! Blessings to you dear Dia!!

  2. Dia Osborn says:

    p.s. thanks for the email and link! I read this as soon as you sent it but wanted to wait until I could get over here to your blog to comment. Dxxx

  3. Dia Osborn says:

    The book arrived!! I love the way you’ve laid it out, with lots of short stories easy to read one at a time then sit with and digest for a while before moving on to the next. I think this subject matter in particular really lends itself to shorter nibbles. The stories I’ve read so far are beautiful and really take me back to what it was like in those rooms…the incredible gift of seeing deep into the lives of such a profoundly diverse community of people. I really love it, Becki. Thank you so very, very much!

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