On Death and Grace

It wasn’t long ago that the death of a family member was a natural part of family life. People passed at home in their beds cared for by their family. Although over 80% of people express the wish to die at home, only around 30% actually do.  Another 30% pass in hospitals while approximately 20+% of senior-aged people die in skilled nursing facilities at their senior communities. 

This blog post is a personal story of how our family cared for my mother at home during her last journey. I’m writing it in hopes that any of the things that helped us care for her will be of help to any of you going through releasing your loved one into the arms of death.

Gigi's premonition of death 

My 100 year old mother, who we all called affectionally “Gigi” for Granny Gloria, began telling everyone that she was ready to die and that she felt complete with her life. She never wanted to be a burden and she was fiercely independent. Yet she was still quite active. She rode her gym’s stationary bicycle daily for a half hour or so. She woke up early three times a week to do aqua aerobics in the pool at her senior community where she lived independently.  She got down on the floor to practice Pilates and she climbed the stairs outside of her apartment several times a day. 

I really didn’t take her warnings seriously. I thought she’d live for another few years at least. But she moaned about her failing eyesight and was frustrated with not being able to do enough for herself since she couldn’t see much anymore. We hired an aide for 4 hours a day to help her navigate the morning hours and lunch. She could no longer operate the microwave to heat up a meal by herself because she couldn’t see how long she had put it on for.

Respecting a loved one’s wishes for death

One morning, Gigi couldn’t wake up. Unfortunately, I wasn’t just 10 minutes away per usual. In the 9 years that Gigi has lived in Santa Barbara, I’ve only left her here alone twice, both times to go to events in the East coast. The first time, Gigi had a gallbladder attack and I had to manage from afar with the help of my sons to get her gallbladder removed.

The second time happened now on the day we couldn’t awaken her. She had insisted I attend the engagement party of my cousin’s daughter in Pennsylvania. Her plan was to go stay with my handicapped husband and help take care of him over the weekend while I was away. 

Fortunately, I knew something was wrong because I had had a report from her senior care facility that she had burnt up her microwave by leaving it on for too long the day before. The smell had alerted her neighbors but she didn’t tell me about it. I started calling her that evening but couldn’t get an answer. I sent my son over to check on her and she seemed peacefully asleep in her bed. The next morning though her aide couldn’t get her to wake up. 

I called her doctor and he sent an ambulance to take her to the hospital. At the emergency room. she was able to open her eyes for a bit at a time but when asked what year it was, she said 1924, the year of her birth.

My mother frequently ran into what she called “old age prejudice”. The hospital staff didn’t think it that unusual for a 100 year old not to wake up. After a few tests including a CAT scan of her brain, the ER doctor discharged her to go home. They couldn’t find anything wrong even though she could barely maintain enough alertness to talk and she could only walk at a slow shuffle with a walker. Who would have believed that she could have been so active just a day before?

My 2 grown sons and their partners valiantly cared for Gigi at my home that weekend where we fortunately had a lot of pads and briefs that helped them keep her clean. She would sleep unless they awoke her to eat. She had difficulty swallowing before dosing off again but the few words she spoke made it clear that she was mentally all there, just unable to express herself well. 

I flew home and got her readmitted to the ER. Finally with an MRI, they found she had had a stroke in the central part of her brain which is the command center that affects the ability to wake up and also compromises the tongue’s movement making it hard to swallow.

That was the beginning of 4 days of hospital tests for all kinds of other measurements to determine whether she should go to rehab or be allowed to die. I had no doubt of what she wanted. But a young neurologist was determined she should go to rehab where he said she could live for a few more years despite her clearly failing more and more every day. 

By day 3 in the hospital, she was no longer feeding herself or able to walk with the walker. Despite the administration of IV stimulant drugs, she still couldn’t stay awake. After her primary care doctor told me the neurologist had said she was going to make a “full recovery”, I demanded a second opinion. 

Thankfully, the 2nd neurologist, who had many more years of experience, recognized she was failing. He told me, “I hear from many 100 year olds that they’ve had a good life and that they are done. But it is unusual for the family to agree to let them die. So many suffer from too many tests or procedures to keep them alive when what they want to do is die.” 

I knew what my mother would choose without a doubt. I requested that he admit her to hospice care.

Getting help at home to care for a dying loved one

Since Congress authorized Medicare to cover hospice care for seniors around 45 years ago, more than half of seniors now who die are enrolled in hospice. Although some people need more pain management that is easier to administer in a hospital or skilled nursing facility, hospice provides the nursing support to help families care for their loved ones at home. If you’re doing it for the first time, it really helps to have the advice of professionals who have seen the process of death many times before. Hospice brings a supporting an array of professionals for physical, emotional and spiritual support.

Hospice delivered a hospital bed the very next morning. I had had my sons move furniture out of the bedroom Gigi always stayed in at our house. With warm summer days, we could open the French doors that look out on a beautiful garden terrace. More supplies arrived with the hospice nurse along with a comprehensive booklet on caring for a dying person.

Gigi arrived by ambulance at noon and our vigil began.

The deathwatch

The deathwatch is the vigil that is held while someone is dying and for some time after they have passed. So often what you are doing is watching your loved one breathe. Keeping them clean and comfortable becomes your preoccupation.

If that sounds tedious, it isn’t. Even with my mother sleeping so much of the time, the next 4 days until she died were filled with invaluable precious moments. The atmosphere surrounding a dying person is heightened and vibrates at a different frequency than everyday life. It reminded me of the atmosphere surrounding a woman giving birth. It just is truly special.

Here are some of the things we did during those four days at home until Gigi passed over that made her last moments full of love and created good memories for our family:

Music: 

They say the last sense to depart is hearing so we made sure that Gigi’s hearing aids were charged up and inserted correctly. We moved an extra speaker into her room and played her all kinds of music depending on the mood. Music was probably the most important thing we did for Gigi besides surrounding her with our love.

Some soft celestial music from Kitaro was great when she seemed deep asleep. Sail Away and other songs from Enya would get Gigi moving her arms or tapping her fingers.  When Gigi awoke in the early evening and could stay awake for longer, we played her beloved Big Band music from the ‘40’s. After giving her a long stem rose to smell, she started waving it like a conductor with an orchestra to the beat of Benny Goodman and Glen Miller.

In her final hours, we played Ave Maria by Ashana, an incredibly moving rendition that lifts hearts as it brings tears to your eyes. Finally we found choral music from an A Capella choir in England. She loved church music from her many years as an Episcopalian and both my sons had sung choral music in an A Capella choir in high school. These songs with their amazing harmonies soothed her final hours and set a mood of reverence to surround her as she breathed her last breaths.

Family and Friends:

I welcomed everyone who wanted to come to be part of our vigil. Sometimes the room was so filled with life, I wondered if it was too much. But Gigi, always one for a party, loved being with everyone even when she wasn’t fully awake. From baby Huxley, who stared at his great grandmother realizing that he was seeing something very different about her, to my oldest son’s puppy who licked her hands, our family gathered around her. We talked to her knowing that she could hear and understand us even if she couldn’t respond. 

Close friends came by for their last moments with her. One brought a guitar and played her songs about journeying into the beyond. Others massaged her feet and shoulders, held her hands, brushed her hair. We teased her one evening as three of us worked on her that we were giving her a spa day. 

Prayers & blessings:

On Sunday morning, some friends joined me in creating a service for Gigi. We made an altar at her bedside with a Celtic cross and 2 candelabras that held 3 candles each. In an incense burner, we burnt frankincense and myrrh that helped create a church-like atmosphere while filling the room with sacred smoke. 

I read the 23^rd Psalm in the King James version because Gigi loved this prayer in the ancient English. We spoke personal prayers and blessings, thanking her for all she gave to us and everyone she met during her lifetime. 

Though Gigi wasn’t fully awake during our circle around her bed, we could tell she was listening. Closing my eyes, I selected a card from Alana Fairchild’s White Light Oracle deck. My heart nearly stopped when I saw I had picked “Sacrament of Extreme Unction”, the ritual that is performed in the Catholic church at the time of death to allow the soul to leave the body gracefully. I read to her”

“Your heart knows how to let go so you can find peace. It is time for you to experience spiritual closure. A beautiful new reality is opening up for you. Entering it requires you to release your attachment to the past. You have been inwardly preparing for a powerful rebirth. Now is the time to trust in what is meant for you and move towards it with an open, trusting heart and peaceful mind” © 2020 Alana Fairchild

Food and drink:

We were advised to give her soft foods when she wanted to eat since she had difficulty swallowing. She didn’t ask for food but If I asked her if she was hungry, she would nod yes or no. I would scurry to get something tasty when she was in the mood to eat. Ice cream was her favorite dessert and we fed it to her one night for dinner with a Tylenol capsule broken up in it as she had complained of a headache. 

One evening with friends, we celebrated happy hour by toasting her with her favorite cocktail. She took delight in sipping it through a straw and arched her eyebrows while seemingly saying  “Ooooo” with her mouth in an o shape when I told her I had given her a full shot! 

The night before she passed, she actually said, “I’m hungry!” with a lot of force. I hurried to get her something right away while she was awake. She ate chicken salad, her favorite lunch dish, and TeeChia cereal with berries and yogurt, her favorite breakfast. She didn’t find it at all odd to mix the two in one meal and ate with a relish. I’ve read that dying people will often eat a last meal with enthusiasm just before they pass. Though I didn’t know it as the time, she was doing just that.

Hydration:

Gigi could drink through a straw in the beginning but that ability went away as her death grew near. Keeping a person’s lips and tongue moist is so essential when they are breathing through their mouth all day long. We gave Gigi ice chips made from juice or filtered water that she could dissolve in her mouth without choking on too much liquid. We moistened her lips with a liquid lip butter by Weleda that kept them supple. 

Hospice gave us ‘lollipop’ sticks with sponges at their end that we soaked in water for Gigi to suck on. They also had moisturizing lotion that we could put on her tongue and inner cheeks. Doing all this frequently was key to her comfort.

Physical care:

I was fortunate to have an aide help me to keep Gigi clean and bathed, change her briefs and nighties and turn her every few hours so she didn’t develop bed sores. Not being experienced in caring for an adult, it was great to have someone advise me on how to physically care for her. It worked best if 2 of us could handle this part of her care to help roll her on her side and change her bedding or briefs. The Hospice nurses can also teach these skills.

Medication:

We were fortunate that Gigi didn’t experience much pain but Hospice had warned me that she might experience anxiety as it became more difficult to breath. The morning of her passing, Gigi looked anxious and indicated she was having a hard time breathing. Under the hospice nurse’s care, we administered some oral Atavin to ease her anxiety and a minute dose of morphine to ease her ability to breathe. For 7 consecutive hours, I gave her the small oral dose of morphine that the nurse had prescribed. However, by the evening, Gigi seemed at peace and no longer showed signs of anxiety. I stopped the medication which was quick acting but short lived. By the time Gigi passed over, none was left active in her body. I was so grateful that she didn’t need to be drugged heavily and could pass over in her undrugged state of mind.

Shared Crossing

A number of years ago, I took a workshop on how people can accompany a loved one part way when they are dying. The psychologist who ran the program calls it “Shared Crossing”. There were wonderful stories from other participants on experiences they had, each one unique and very personal. I hadn’t experienced one myself and had no projection as to when and if one would happen for me with Gigi.

They say that dying people will warn their loved ones that they are getting ready to pass and Gigi certainly did so for me. Her last night in the hospital, I went there late hoping that Gigi would wake up. Sure enough her eyes opened and she said “Weird.”

I asked her what’s weird. “The ceiling," she exclaimed, “I’ve never seen anything like it.” Her eyes roamed across the hospital ceiling. Clearly she was seeing something that wasn’t normal. Then she said, “I can’t find the exit!” and looked anxious. 

I knew intuitively that she was trying to find the way out of her body. I asked her if she trusted me. She nodded yes, looking into my eyes. I assured her that I would help her find the exit and that she would be safe and cared for at home starting the next day.

On her final evening five days later, after listening to her breath for many hours, I positioned myself at her head, leaning against the top of her bed with my hands on her heart. I remember thinking, this is so comfortable, I could stand here for hours. An hour or two must have passed as one of my sons left to care for his baby while my oldest son sat vigil beside her bed with me. 

Gigi’s breathing had become more shallow and her extremities had turned bluish which I knew was a sign that death was near. Previously she had been hot to the touch, but now she grew cool and clammy. 

Without any indication or change in her breathing to warn me, I closed my eyes and went into a meditative inner vision. I saw myself accompanying Gigi up what can only be described as a celestial, pearly white staircase glowing with light. At a certain point, I turned to her and said, “this is as far as I can go with you. Now you must go on by yourself”

Gigi faced me and a blaze of light surrounded her. She had a glorious smile, the same smile that had inspired her mother to name her Gloria as a baby. Radiant in white light, she ascended the celestial staircase. It was exactly the Christian image of heaven that her faith in God had always sustained in her.

I returned to the room and opened my eyes. I looked down on my mother’s body, her still strong arms stretched out beside her. I realized she had taken her last breath and felt for her pulse. It was gone. Gigi had left us and crossed over into the light.

The aftermath 

What happened next wasn’t planned and surprised me as much as anyone. 

I was filled with joy. I had the urge to dance. 

Dance is very strong in our family. Gigi danced at her 100^th birthday party just 4 months before. We are all dancers and my sister and daughter-in-law made dance their profession. I asked my son to put on Pachelbel’s Canon. Many years ago, I learned to take part in circle dances to this moving composition by the German composer, Johann Pachelbel.  

The music moved me to express this full choir of feelings that was coursing through me. I danced around my mother, waving my arms over her body, twirling on my toes, and giving over to the radiance and joy I saw her experiencing when I shared her crossing over.

Grief comes in waves now but then, I could only feel her joy. She had completed her very full life and the only sorrow is felt by those of us left behind who miss her dearly.

Calling on a death doula

A woman I’ve known in the Santa Barbara was trained as a death doula. When Gigi first had the stroke, I called on Arlene to give me advice. That night, after the hospice nurse had pronounced Gigi dead, Arlene came with roses, soft cloths and prayers.

My youngest son and his wife with their baby sleeping nearby joined me in washing Gigi using the soft cloths and anointing her body with the essential oil of spikenard mixed into almond oil. According to a friend of mine, who is an essential oil expert, spikenard was used to anoint Jesus’s body. Several places in the bible, both Jesus’s head and feet are anointed with ‘nard’ short for spikenard, a pungent aromatic plant that grows in the Himalayas.

We blessed and anointed Gigi from head to foot, rolling her over to bless her backbone too that held her erect for 100 years. I also sprayed an essential oil of rose mist over her body as it is supposed to help the soul in the liminal space separate from the body.

We dressed her in a lavender formal outfit that she had worn to my son’s wedding. It was the perfect celestial color to compliment her white hair and now alabaster skin.

Finally we took the roses, broke them into petals in a bowl and then strew them around her body as we expressed our love for her. She looked so at peace with the rose petals adorning her head and body. 

My Final Vigil

It was around 11 PM now and I decided to spend the night with Gigi, still holding vigil beside her. There are so many different traditions as to how long it takes for the soul to fully separate from the body. It seems though that, depending on the climate of where death occurs, people either get buried quickly or lie is state for 3 days. 

I chose what seemed best for us. I spent the night writing, remembering, crying, and gazing at my mother for those final hours. In the morning, I called the mortuary. My cats were going crazy and although I didn’t smell anything other than the essential oils, it was going to be a warm day.

The mortuary attendants helped me wrap Gigi in a shroud I had chosen the night before. It was a white and blue woven blanket, her favorite colors, that I had bought many years ago in Greece. They placed her in a stretcher, covered her in a fuzzy purple blue blanket they had brought and carried her out the door as we strew the rose petals on the path she traveled to their waiting van.

Gigi’s final journey was almost over.

This Friday, I am going to accompany her body to the crematorium in Lompoc, a town about an hour north of Santa Barbara. There I will see her for the last time as I put her in the furnace to turn her body to ashes. I would have preferred to compost her to avoid the release of carbon dioxide as you can do now in Oregon and Washington, but that law won’t come into being in California until 2027. Soon we will be able to choose different types of “green burials” as the movement to end the use of fossil fuels and embalming chemicals. For now, this is the way Gigi’s body will be able to go back to New Canaan, Connecticut to her former church where a columbarium awaits her nearby her two deceased husbands. 

I plan to keep a little in an urn to take into the hills above Santa Barbara where she loved to gaze out across the land to the ocean. Ashes are wonderful because they can be put in more than one place. Gigi’s ashes will go to several places she loved, giving me the opportunity to say goodbye and feel my love for her at each occasion. 

If you have made it to the end of this blog post, I thank you from my heart for listening to the story of my mother’s passing. I truly hope you find some value in it for your own life and the lives of your loved ones. May you be uplifted as I have been. I’ll leave you with this quote from the artist, Laurie Anderson:

“I believe the purpose of death is the release of love.”