Mixed feelings are not unusual when a patient dies. That is what I had when I received word that my patient, Mr. J. died. I knew him for over a year as his palliative care case manager. My job was to support what he wanted for his healthcare journey.
During his final hospitalization, I visited him a couple of times. The last time was a few days before his discharge to home with hospice. He had known all along that his cancer was not curable. On that final visit, I asked him how he was doing. He looked at me and he told me, “I think I am dying.” I replied that if that was the case, there were a few things we needed to talk about.
I told him that in relationships, there were four things that mattered most. They were to say, “Please forgive me,” “I forgive you,” “Thank you” and “I love you.” I inquired if there was anyone he would like to see or talk to. He told me that he had two siblings, his best friend, and his wife’s family that he would like to see. We also discussed the whereabouts of important papers. He told me exactly where they were located in his home. The patient thanked me for my help and told me that I was near to his heart.
I knew the information I had just received was important to pass on to his adult children, in hopes that he could be helped to have closure to these relationships. I phoned his son and had a long talk about what I had discussed with his Dad. I relayed the details of our discussion, including the four things, people he wanted to see or speak to, and the location of the important papers that they would need. He went home with hospice support.
A few days after Christmas the son called me to inquire further about the important papers. He related to me that he had a wonderful, deep, meaningful conversation with his father the same evening of the day I had talked with his Dad. I expressed how wonderful it was that his father was able to do that. What a gift! He also told me that when his Dad got home from the hospital, he was able to eat Christmas dinner with them, even feeding himself. The next day, the patient declined. The wife’s family came. All the other important people made contact. He told me that the priest had also been in to give blessings.
My patient died, surrounded by loving family, supported by hospice, faith and friends.
It is always sad when a person dies, but there is greater peace when the patient has had time to complete relationships, symptoms are well-managed, and families aren’t left with the feeling that there was more that they should have done or said. I am proud to have been a small part of his healthcare journey.
