Monday, March 23, 2009

Saying goodbye to Sean

My dear patient Sean died around 4:30 pm on Friday. When I came to the assisted living facility earlier that afternoon, it was very evident that he was getting very close to the end. His hands were cold and clammy, his feet were mottling, and he was starting to have apnea. His 18 year old daughter K had decided to go back to school for the day. We thought maybe Sean was waiting for K to get there. Sharon and his other daughter L were there, along with Sharon's sister. Sharon said they had said goodbye as a family last night, thinking he would not make it through the night. But here we were for another day. K came over straight from school and spent some time holding her dad's hand but it didn't seem to spur things along. Looking at Sean I knew he would either go any minute or last another night. There was one other patient I really needed to touch base with so at 4 pm I told RN Beth to call me if anything happened and headed to the town over. I was with the patient for about 15 minutes when Beth called to say that Sean was gone. I promptly wrapped things up with this patient (who, incidentally, was very understanding) and headed back to the facility, calling a friend to push back our evening plans along the way. When I got there, the family was doing OK but one of the ALF care managers Chris was having a really hard time. I sat with him for a while, talking when necessary but mostly listening as he processed his feelings. Sean was the first resident that he lost and he was surprised by the depth of emotion. I asked Chris what he thought Sean would say to him right now. He started to chuckle and then said, "He would dance." My thoughts exactly! Sean had never been a dancer, according to Sharon, but when he was still ambulatory he would wiggle to his own beat with the happiest look on his face. I think we will all cherish the memories of Sean dancing! Chris became calmer as we reminisced. Then I suggested he spend a few minutes alone with Sean to say his goodbyes.

As we were waiting for the funeral home, Sharon shared a story that you may or may not believe. One of the care managers told her this morning and it was very comforting to the family. She said that after she, K, and L said their goodbyes to Sean, they left the facility for the night. She said the care managers were eating dinner in the common area which was also across from Sean's room. One of the workers, "Jacinda" got a strange look on her face all of a sudden. When her coworkers asked her what was wrong, she said "I just saw Sean walking down the hall after Chris and he was healthy, young, and handsome." They looked down the hall but they didn't see anything. Chris later said that when he was walking down the hall he felt someone was watching him but he didn't see anyone. Chris joined everyone eating dinner. A few minutes later Jacinda started to cry. When questioned, she said, "Sean is standing behind Chris with his arms crossed and he's nodding in approval." Sharon thinks that maybe Sean's spirit had left his body since they had all said goodbye to him but for some reason he held on for another day.

The other eerie coincidence occurred after Sean's death. Sharon called Sean's sister Kara to let her know that he had passed. She did not say what time it had happened, only that he had died. Kara asked Sharon if it had happened 5 minutes ago. When Sharon said yes, Kara shared the following. Kara had been sitting with her husband John, who has frontal lobe dementia and is nonverbal, flat affect, he does not respond to anything. All of a sudden he started crying. Kara could not believe what she was seeing and started to worry that John was going to die because it was so unusual and this is when Sharon called her. They wonder if maybe Sean visited John and that John was grieving because he knew his friend and brother-in-law was dead.

For my part, I was sad to say goodbye to such an interesting and inspiring patient. I know it was his time and that he is no longer suffering. The whole time I was driving back to the facility, I instructed myself to stay strong. I knew what I would have to do for the family. They knew that I cared about him and about them but this was not about me and how I felt about Sean. This was about helping them grieve and giving them the support that they needed. After the funeral home came, after saying goodbye to the family, after I was settled in my car, I let myself cry a bit and then I headed to my friend's place for some much needed distraction.

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