A gentle goodnight

Witnessing a hospice death taught this young doctor about family and compassion.

By Matthew Hom, MD
Internist/San Diego

The night was cool, but there was plenty of warmth and love in East Wing room 112. Gathered around the bed where the 67-year-old woman lay were her husband, their five daughters, a son, and their families. Brilliantly colored flowers and tropical plants filled the room, and Hawaiian folk music—the music of the woman's birthplace—played softly in the background.

Some of the daughters shared an occasional laugh over a memory of their mother. One, however, was more solemn and preferred to sit on the couch alone. Several family members were noticeably worn out by stress.

The mother slept soundly while one daughter combed her hair methodically. The father stood silently beside his wife, holding her hand and managing a small smile at all the affection embracing her and those in the room.

The woman passed away that evening. The family was sorrowful, but not dispirited. As one daughter said, "This is the way Mother would have wanted it. She was strong in her faith." A younger daughter added, "Mom went to a better place. The situation was peaceful, dignified, and comfortable."

That night I was neither physician nor healer. The woman was my aunt; I was family, and saw firsthand the positive effects of hospice care. From the initial diagnosis of metastatic cancer to my aunt's final breaths only three weeks later, the hospice workers continually impressed us with their tireless efforts, compassion, and guidance.

"The home hospice people got involved the day of Mother's diagnosis," one daughter said. "The hospice nurse was very patient with Mom and the family. She ordered medications and arranged for the hospital bed. She was very thorough, explaining the medications and the paperwork that had to be filled out."

After two weeks of at-home care, my aunt had to be transferred to an inpatient hospice unit because of the ravages of her cancer. There the hospice workers guided the family and patient through the dying process, always with compassion and patience. "The nurse told us that final night that Mother was still holding on, as if she were waiting for someone," one daughter remembered. "We hadn't been able to contact our brother, and she suggested that we continue to try so that he would have closure on Mom's death." He did make it to her bedside before she died.

Another nurse had the sensitivity to request a family meeting away from my now-unresponsive aunt's bedside to discuss her declining physical status. My uncle recalled, "She was most concerned that Mother was resting comfortably and that the family was comfortable as well." Besides being impressed with the sympathetic and helpful hospice staff, my family appreciated the acupuncture and massage my aunt received. Family members were also offered massage to help reduce their tension.

Clearly the support and services provided by hospice allowed my aunt to die with peace and dignity. The beautiful setting and compassionate care allowed my cousins and my uncle to focus on what was important to my aunt and to them—being a family.

 

Matthew Hom. A gentle goodnight. Medical Economics 2002;5:46.