Journal of Gerontological Nursing

Lessons from Mom's friends

Linda B Rahilly, MS, RN, C, CHPN

Abstract

I have been a nurse for many years. I cannot count the wonderful experiences I have had and the number of patients, family members, and co-workers whose lives have enriched mine. Recently, however, I had a particularly moving experience that touched me in a way I have never before been touched. The difference with this experience was that it was personal. My mother was dying in the continuing care retirement community where she and my stepfather lived for 3 years.

I have always worked primarily with the elderly population and most recendy I have been working as hospice nurse. I have spent a good deal of time in nursing homes, acute care settings, or assisted living facilities where most of the elderly adults are either very acutely ill, chronically Hl, or very frail and dying. Obviously, many of these individuals are functioning at a minimal level and require a significant amount of care. When this group of elderly adults is the focus of one's care, one's feelings, thoughts, and impressions about elderly adults become distorted. It is easy to forget that for each of these frail elderly adults, there are lots of very healthy elderly adults functioning independently and leading very active lives in their communities.

The elderly adults in my parents' community, showed me a world view far different from that which I have experienced in my professional career. Now, I pause and reflect on the amazing strength of those elderly adults whom I suspect are more representative of the elderly population as a whole than those whom I have seen in the health care setting.

When my parents first moved to this community, I had an opportunity to meet several residents during my periodic visits from another state. After my mother was on hospice, I lived approximately an hour away from her and my visits increased from once a week to three times a week, and eventually to daily visits as she declined. My visits were usually in the middle of the day, so I ate lunch with my parents and other residents in the main dining room. Right away, I became acquainted with many of the residents. I enjoyed listening to the wonderful stories of their lives, learning about upcoming visits with children and grandchildren, how they would celebrate upcoming holidays, who had been hospitalized, who just moved in, and so forth. Before long, everyone knew "Virginia's daughter the hospice nurse," and they were interested in my family's events, such as the new home we were building, and my son's upcoming wedding. They became my extended family.

As my mother became more ill and less mobile, the residents continued to include her in the community's life. Probably the most powerful aspect of this whole experience was the way these elderly adults remained attentive to my mother throughout the months before she died. I never worried that she would be stuck at the end of a hall with no visitors, ignored by staff and residents. Every day one or more of her friends came to visit het, even after she moved from her independent apartment into the assisted living unit, even as she lay actively dying.

With each visit, even though she was failing, the residents reminded me that my mother was a strong, special lady with a beautiful smile. Everyone from the nurse in charge, staff nurses, and CNAs to the maintenance and housekeeping staff and residents inquired about my mother's and our family's well being. Her friends brought her pansies, her favorite flower, cut lovingly from a garden. They sat in silence with us, even when…

I have been a nurse for many years. I cannot count the wonderful experiences I have had and the number of patients, family members, and co-workers whose lives have enriched mine. Recently, however, I had a particularly moving experience that touched me in a way I have never before been touched. The difference with this experience was that it was personal. My mother was dying in the continuing care retirement community where she and my stepfather lived for 3 years.

I have always worked primarily with the elderly population and most recendy I have been working as hospice nurse. I have spent a good deal of time in nursing homes, acute care settings, or assisted living facilities where most of the elderly adults are either very acutely ill, chronically Hl, or very frail and dying. Obviously, many of these individuals are functioning at a minimal level and require a significant amount of care. When this group of elderly adults is the focus of one's care, one's feelings, thoughts, and impressions about elderly adults become distorted. It is easy to forget that for each of these frail elderly adults, there are lots of very healthy elderly adults functioning independently and leading very active lives in their communities.

The elderly adults in my parents' community, showed me a world view far different from that which I have experienced in my professional career. Now, I pause and reflect on the amazing strength of those elderly adults whom I suspect are more representative of the elderly population as a whole than those whom I have seen in the health care setting.

When my parents first moved to this community, I had an opportunity to meet several residents during my periodic visits from another state. After my mother was on hospice, I lived approximately an hour away from her and my visits increased from once a week to three times a week, and eventually to daily visits as she declined. My visits were usually in the middle of the day, so I ate lunch with my parents and other residents in the main dining room. Right away, I became acquainted with many of the residents. I enjoyed listening to the wonderful stories of their lives, learning about upcoming visits with children and grandchildren, how they would celebrate upcoming holidays, who had been hospitalized, who just moved in, and so forth. Before long, everyone knew "Virginia's daughter the hospice nurse," and they were interested in my family's events, such as the new home we were building, and my son's upcoming wedding. They became my extended family.

As my mother became more ill and less mobile, the residents continued to include her in the community's life. Probably the most powerful aspect of this whole experience was the way these elderly adults remained attentive to my mother throughout the months before she died. I never worried that she would be stuck at the end of a hall with no visitors, ignored by staff and residents. Every day one or more of her friends came to visit het, even after she moved from her independent apartment into the assisted living unit, even as she lay actively dying.

With each visit, even though she was failing, the residents reminded me that my mother was a strong, special lady with a beautiful smile. Everyone from the nurse in charge, staff nurses, and CNAs to the maintenance and housekeeping staff and residents inquired about my mother's and our family's well being. Her friends brought her pansies, her favorite flower, cut lovingly from a garden. They sat in silence with us, even when mom no longer spoke.

They greeted me as I entered and left the community, asking me how I was doing and were quick to give me a reassuring hug or words of encouragement. They spoke matter of factly about death and dying and told me when they lost a member of their community.

Several women shared with me their feelings about the reality of being a part of an age group where death was so commonplace. I never took offense to this matter-o f-fact attitude because I knew how much the residents cared about my mother and one another. They also kept telling me they hoped my mother would not suffer, that she would die peacefully. No one had to tell these residents when someone was dying, it was something they just knew because they saw the subtleties of change occurring in each other.

Life in this retirement community was vigorous and entertaining. Sometimes we all joked about how rich they got in the latest Bingo game, and we laughed together as they described how forgetful they were becoming. Humor was a wonderful coping mechanism. I especially remember one day how a group of us, including my mother, were hysterical with laughter when a new, confused resident thought I was also a resident and wanted to know which apartment was mine.

The residents also shared with me their worries over aging and their plans for the future, taking trips, seeing plays, or attending other events. We reminisced over memories and shared family stories. We sat together in the facility's beauty salon while my mother and other women continued the time-honored tradition of beautifying themselves. The gossip flowed freely, as it does in any beauty salon and the hairdressers lovingly and tenderly made each woman feel special and beautiful.

When my mother died, the residents and staff comforted me while I cried. As I cleaned out her room over the next couple of days they made a point of giving me the space I needed to do this unpleasant task. Yet, as I walked through the halls, residents and staff put their arms around me, offering me support. They all stroked my ego by telling me what a good daughter and caregiver I had been and how proud my mother was that I was "the best nurse in the world."

At my mother's memorial service, several residents who were part of the community choral group sang my mother's favorite hymn, "The Old Rugged Cross." Many residents stood and shared their memories of times spent with my mother. They loved the eulogy I read with difficulty, in which I shared early memories of my mother. They expressed their hope that I would continue to visit them and not "be a stranger."

During a recent visit to see my stepfather, I shared with many of the residents that I will soon be a grandmother. The cycle of life continues. My daughter-in-law found out she was pregnant just before my family and I buried my mom's cremains. My future granddaughter's name will be Virginia Hope, after mom. The residents made me promise to bring my granddaughter to see them and told me to make sure it was at noon, in the dining room, so everyone could share the joy of seeing Virginia's great-granddaughter. I cannot wait for that very special day.

Caring for my mother while she was dying was one of the greatest privileges and honors I have experienced. I believe things happen for a reason, and that each experience is a learning opportunity. What I learned from this experience was something that cannot be put in a nursing textbook, and in fact, is even hard to describe on paper. As I wrote this, I struggled with the ability to truly express how profound this experience was. I do know that it was enriched by the residents who were my mother's friends and companions - a special group of older adults who were strong, compassionate, funny, caring, realistic, hopeful, and resourceful. They have reinforced in me the notion that elderly adults are indeed wise sages. They have made me proud that I have devoted most of my career to working with the elderly population.

"Endnotes* features personal stories, anecdotes, fiction pieces, cartoons, or any other submissions regarding the elderly written by our readers. Please submit your "Endnotes" to: Managing Editor, 6900 Grove Road, Thorofare, NJ 08086, or fax (609) 853-5991, or e-mail: http://www.slackinc.com.

10.3928/0098-9134-20021201-09

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