A Hospice Story - Cecil

This morning I find myself wondering if Cecil has made it through the night. Last night, when I sat with him, he was in the process of dying, and it was progressing as active dying does.

I met Cecil last night, when I was asked to provide a couple of hours of respite care so his daughter could get a couple of things done. He was in a recliner when I got there, deceptively sitting up as if ready to get up and go somewhere, but when I took his hand in mine it was slack, and he didn’t seem to know I, or anyone else, was there. His breathing had already become more shallow and pained, the “death rattle” present.

His daughter and I talked while we waited for her brother to make a couple of phone calls, and she briefed me on his condition. Just several days ago he was ambulatory and verbal, old but not dying, and then he suddenly declined. That was when hospice got involved. She had moved here less than two months ago to be close to him, since there was no other family in the area. She’d been in the habit of picking him up at the assisted living facility every day and taking him to her house, where she’d make him lunch. On Sundays they went to church. Cecil was Salvation Army, she told me.

Cecil sat in the middle of the small living room in his recliner, his daughter in a chair on one side of the room, I on a couch on another side, and I kept glancing at him to make sure he was comfortable, at least as far as I could tell. She told me that he’d started becoming more affectionate in the past few days, suddenly going in for hugging and such, which had never been the case with him before. A couple of days ago he’d brushed his daughter’s face with his hand and said, “I love you,” something he’d never said to her before, not in over 60 years.

She told me that if the other brother, Cecil Jr., came back, not to let him in. He’d been volatile earlier, and he had some issues. He’d never fully recovered from Vietnam either. I told her I would lock the door and keep Cecil’s environment calm.

It’s difficult to know a person who’s in the process of dying. Cecil wasn’t speaking, or tracking, and all I had to go on was what his daughter told me. We talked about death and dying and how difficult it is, whether or not one’s ready. It doesn’t matter, because you can never be quite ready for it. Cecil had asked her, back when he was voicing these things, for an overdose of something so he could get it over with. He was ready to go. But of course that’s illegal. Sometimes they’re ready to go but don’t know how.

His daughter warned me that while they were gone Cecil may want to move to the hospital bed in the living room, or that he may even want to move to the bed in the bedroom. He might want to take off his clothes, which consisted of shorts and a shirt, and that the shorts stay on. If he gets into the hospital bed without his shirt, keep the blanket from touching his skin by hanging it from the metal bars that keep him from falling out. An attendant brought his dinner. If he wanted to eat, he’d probably want the fruit. He’d had all his meds for the time being. I looked at Cecil. He hadn’t moved since I’d gotten there, hadn’t uttered a word, and I couldn’t, for the life of me, imagine him doing any of the things she said he might do.

We waited for the hospice nurse. She was bringing more meds and coming to check on his condition. By the time Eileen’s brother returned, ready to go, she still hadn’t arrived, and I told them to go ahead, and to take their time. “What if we get back after 8?” Eileen asked me, as if I’d suddenly disappear at the appointed time. “I’ll still be here,” I told them, “I have nowhere else to go tonight, so take your time, get some dinner. “

Her brother told me he’d talked to Cecil Jr., and he’d calmed down, and it was okay to let him in if he came back, and to please stay close by, but not necessarily too close. They left then, taking Zach, the Welsh corgi who’d been sleeping at my feet. I love assisted living facilities that let dogs in. Cecil’s previous one, the Waterford, hadn’t been as generous.

They left, and I turned on the television to the Blazers game just in case Cecil wanted to see it. It was the only thing he would want to see, if he were to want to see anything at all. I sat on the couch with my book and my journal, and I watched Cecil to see if he showed any signs of getting up and taking off his clothes. He showed no signs at all, just the slow hitched breathing.

The nurse arrived, apologetic and upset that she was so late, but she’d had a difficult intake earlier that had put her behind. I reassured her, with all my lowly volunteer authority, that it was quite all right. She wasn’t convinced, but she accepted my gesture in the spirit in which it was intended. She checked Cecil’s vital signs, which were showing signs that he was indeed dying, and she took off his socks to check his feet, which were indeed cold.

She asked me how I was. I told her I was fine. I have no fear of the dying. I can’t disappoint them, and if I do happen to do so, it’s not a lingering disappointment. I’m calm when I’m with the dying because they have enough going on inside of themselves as it is. I think of dying, in these cases, as a release, which is then not a bad thing. I suppose it’s surprising that I’m not scared of the dying because I’m scared of so many other things, but there it is.

The nurse gave Cecil Ativan to calm him, just in case he needed to be calmed. She watched him for a bit. She asked if I’d be okay if he died while I was alone with him. I told her I’d be fine. If he died, I knew who to call, and I’d sit with him while I waited for the professionals. It’s not a difficult job. She left then, after we hugged. I think she needed a hug.

A little bit later Cecil Jr came to the door, and after I introduced myself he sat down on the floor next to his father’s chair silently, saying nothing. I moved away so they’d have some privacy, but kept watching Cecil. It looked like his head was starting to slump forward, so I asked Cecil Jr to help me recline the chair a bit so he’d be more comfortable. We did, and it did look more comfortable, though Cecil was still not letting us know one way or the other.

The other brother returned after a bit, sans Eileen and Zach, who would be following along shortly. I told him about the Ativan, and that things were progressing as expected, and to feel free to call hospice at any time, and that hospice would be checking back with him of course.

Eileen called me later, after I’d gotten home, and wanted to know what the nurse had said. I told her everything I could, and when she asked if the nurse had said how long, I told her no, that he was actively dying, but no one knows how long it will take. No one knows. The nurse wanted to stop back in the morning, but then wasn’t sure if he’d last that long. I didn’t tell Eileen that, she knew. I was out of my depth, so I reassured her that things were progressing as they should, and to call hospice at any time and they would get right back to her. I told her to call me if she needed more respite or if there was anything else I could help with, and we made tentative arrangements for me to come back on Sunday afternoon for a couple of hours. The need for this seemed unlikely, but, like I said, no one knows, so I told her that I would be there if I was needed, and if she needed anything sooner, to let me know.

So now I wonder where Cecil is at. Is he here still, or is he there? I’m not entirely sure he was even here last night as it is, though physically he was. Perhaps he’s just a bit closer now. Or perhaps he’s gotten ambitious enough to get up and take off his clothes.