Death and the Lady

As some of you may know, one of my day jobs is helping older folks manage their bills and balance their checkbooks. It’s extremely satisfying work, one of those rare instances where you can actually see your actions affecting someone’s life for the better.

But my clients are elderly. They’re entering the twilight of life. It means sometimes I lose them.

My favorite client, Mrs. Z., is currently in hospice care. She’s an opinionated, 97-year-old spitfire from West Virginia with a pretty rich fantasy life.  She’s at home, which is good, and her bed is now in the living room which is bright and lets her have visitors. If you can catch her eye, she gets an impish look and begins telling you about how she’s going to be going to Leningrad next week.  She still likes her brownies and her Vermont Country Store catalogs, though the New Yorker is a bit beyond her now.  The point is, she’s alive.

I once heard a hospice nurse say that people are never really “dying,” they’re either alive or they’re dead.  Don’t treat a live person as deceased until it actually happens. And yet the palliative care Mrs. Z is receiving falls so far short of that. Yes, she’s bed-ridden. Yes, she has a catheter. That doesn’t make her less of a person, less alive. She’s having pretty bad dizziness or vertigo, and claws at the air looking for something to steady her. All it takes is someone to hold her hands and she calms down. That’s it. Simple, human touch.  One of her aides was dismissive of Mrs. Z’s agitation, saying, “Oh, she’s just confused.”  While that may be true, it doesn’t make it any less terrifying for her. To her, it is real.  She’s dying, she’s scared, and if someone just sits and holds her hand, it’s all ok.

Mrs. Z isn’t my first dying client.  That would be K., whom I watched fade for over four months after she had fallen out of her bed in the nursing home and broke several bones.  She had memory problems, but always smiled when she had visitors.  Pretty new to the job, I didn’t really know how to interact with her, what to do. I’d run in, take care of her bills and filing, and run out again, counting myself lucky if she weren’t in her room. I found myself avoiding her, ashamed at my cowardice, but not certain how to push through it. I’d say, “Next week. Next week I’ll have some time. Next week I can be braver.”

And then she died.

I regret that I ran. I regret that I couldn’t have made that extra effort just to sit with her for a little bit as she watched the resident cockatiels from her wheelchair. And that’s the thing. It takes so little to do right by someone when they’re dying, so precious little. I didn’t need to wait for a divine thunderbolt or new research study to tell me what to do–I just needed to hold her hand.

I don’t know if I’ll get it right with Mrs. Z this time. But I do know that this time I’m not running, and I’ll be there when she needs me. I think that will be enough.