Monday

“Does he still wake up if you touch him?”

“He did last night. I have not tried since we all went to bed. I think he might be wet.”

Conversation is simple. The daughter reminisces about the life she had with her father.

“Has he had anything to eat or drink recently?”

“Not since Saturday night. Will you help me change him?”

I gather all the supplies needed. I put on some gloves and pull back the sheets. After a check of his disposable brief, I discover that he is soiled. Together, we put on a clean brief. He barely makes a sound during the procedure.

The daughter gives me a big hug before I leave.

“I don’t know how I could possibly do this without everyone’s help.”

“You are doing great. I’ll be back in the morning.”

Tuesday

“How was the night?”

“He moaned when we tried to change him last night. Did I hurt him? I was so scared that I was hurting him.”

“Sometimes, patients just don’t want to be moved much when they are dying. Right now, he looks comfortable to me.”

“Will you help me change him?

I gather all the supplies needed. I put on some gloves and pull back the sheets. After a check of his disposable brief, I discover that he is soiled. Together, we put on a clean brief.

The daughter gives me a big hug before I leave.

“I don’t know how I could possibly do this without everyone’s help.”

“You are doing great. I’ll be back in the morning.”

Wednesday

I visit before our normal team meeting, so it is early.

“How was the night?”

“James, I could not stay awake last night. I fell asleep in this chair. I’m so tired.”

“I know you are. I’m really proud of you. This isn’t easy.”

“Can you listen to him and tell me when he will die? I want to be right next to him when it happens.”

“I wish it worked that way. Nobody can predict an end of life event. I really need you to be careful when trying to decide to sign up for something so impossible. You will eventually need to go take a shower. You will need to use the restroom, or you will need to go pick up a family member to make a final visit. Don’t set yourself up to do something that is impossible. Be at peace with yourself if your father dies when you are not in the room.”

“Will you help me change him?

I gather all the supplies needed. I put on some gloves and pull back the sheets. After a check of his disposable brief, I discover that he is soiled. Together, we put on a clean brief.

The daughter gives me a big hug before I leave.

“I don’t know how I could possibly do this without everyone’s help.”

“You are doing great. I’ll be back in the morning.“

Thursday

“James, here is my granddaughter. Her mom had to drop her off this morning.”

The granddaughter looks at me with hesitation. She is probably about three years old. I smile at her and wave. She has a blank stare on her face and crawls into her grandmother’s arms. After a few minutes she is fast asleep even though it is nine in the morning.

“My son is here. He’s sleeping in the other room. He cried most of the evening. He spent every day of the week after school here when he was growing up. He loves his grandfather so much.”

“I’m glad he is here to help and support you. How was the night for your dad?”

“He doesn’t respond to anything. We changed him before everyone went to bed. I’ve been in this chair all night. I don’t know how much longer I can do this. I wake up every hour and check on him. I just want him to pass so this will all be over. Am I a terrible person?”

“You are not terrible. You are amazing. I wish all of my caregivers worked as hard as you do. You love your dad. You honor him with your presence and care.”

“Will you help me change him?

I gather all the supplies needed. I put on some gloves and pull back the sheets. After a check of his disposable brief, I discover that he is soiled. Together, we put on a clean brief.

The daughter gives me a big hug before I leave.

“I don’t know how I could possibly do this without everyone’s help.”

“You are doing great. I’ll be back in the morning.“

Friday

“Have I told you about my mother?”

“No, not really.”

She goes on to share some of her experiences with her mother. He has never discussed her mother before. At first I’m surprised. Her father is dying and now he wants to talk about her mother?

“She needs a break from reality,” I tell myself.

She pulls out her phone and shows me some YouTube videos and some Wikipedia pages. I discover that her mother is somewhat of a celebrity. Nobody fancy to the average American, but a really big deal to her. I look at the pictures and watch the videos.

After a few minutes she returns to her regular chair. After a few more moments she sits up.

“Will you help me change him?

I gather all the supplies needed. I put on some gloves and pull back the sheets. After a check of his disposable brief, I discover that he is soiled. Together, we put on a clean brief.

The daughter gives me a big hug before I leave.

“I don’t know how I could possibly do this without everyone’s help.”

“You are doing great. I’m putting you on the daily visit list for the weekend. They will take great care of you until I return Monday morning.”

Saturday & Sunday

On-Call staff makes visits over the weekend. The reports are almost identical to my visits. Encouragement and help with cares. Weekend staff tries to increase visits to twice daily. The daughter declines. She has this covered. She is amazing.

Monday

Both daughters are present for this visit. It’s a very tear filled visit. It has been a long seven days and they both report irritability when out in the public.

Their father’s respirations have slowed. He does not respond to sound or touch. The daughter providing most of the care struggles to stand without help. She grabs her cane for support and limps across the the room to the kitchen.

“I’m so worn out, James. I never imagined this would last so long. I lose track of time, and I forget to eat.”

“This is longer than most. Your father is going to cross over when he is good and ready.”

The sisters tell stories. I listen quietly. I am like an invisible observer at one point as they reminisce and have a few quiet laughs.

“Will you help me change him?

I gather all the supplies needed. I put on some gloves and pull back the sheets. After a check of his disposable brief, I discover that he is dry.

“He doesn’t need to be changed. I think his kidney’s have stopped working.”

“Will that cause pain?”

“No, not at all. Just keep doing what you are doing.”

The daughter gives me a big hug before I leave.

“I don’t know how I could possibly do this without everyone’s help.”

“You are doing great. I’ll be back in the morning.“

Tuesday

This was like any other morning. I checked the on-call report before leaving the house. There are no changes or updates. After about 10 minutes in the car I send my caregiver a text message.

“I’ll be there at eight-thirty.”

“I need you now,” is the reply I get back. I respond with, “Okay.”

I know what this means. I’ve been doing this for too long. Her father has either passed, or he is very close. Something has changed in a dramatic way.

I pull into the driveway, and most of the family is on the front porch. As soon has his daughter sees me she breaks out in tears. I step out of my car, grab my nurses bag and head for the front porch.

His daughter embraces me in the biggest hug I have ever received from a family member.

“He stopped breathing about five minutes after I sent you that text message,” she whispers into my ear.

Her hug feels like it will last forever. She is devastated.

“I’ll go in and make it official. Take your time out here. I am not going anywhere.”

It is obvious from the moment I enter the home that her father has passed from this world to the next. I listen to his heart for the full minute just like I was taught in nursing school. After sixty seconds of listening, I have my official time of death. I sit on the sofa and let things unfold naturally.

For the next thirty minutes I say nothing, and I do nothing. This is their time not mine. I need to become completely invisible.

The daughter gets out her phone and starts playing his favorite songs. I watch as everyone listens to the songs. There is crying, stories and laughter. The tension must be broken, and his daughter has all the right solutions.

Once the room returned to silence, his daughter looks at me and says, “Will you help me bathe him?“

I gather all the supplies needed. I put on some gloves and pull back the sheets. Together, we give him his last bath.