I have worked consistently in older adult’s services since I qualified. I’d say, at least until a few months ago anyway – when I seem to have accumulated a few people in their late 60s – that most of the people I see regularly are over 85. So it isn’t always surprising that we are confronted with users who die. It is a part of the process.
But however much ‘expected’ it might be, it can still come as a shock. Over the past two weeks, two people that I work with have died. Actually, they are the partners of people that I work with – the carers. Sometimes it happens that particularly with the more advanced dementia, I work as much if not more with carers at that point.
In fact, I came back from the weekend to the news that someone I had seen at home as recently as Thursday had been admitted into hospital on the Saturday and died apparently quite suddenly. There was no sign of anything untoward on the Thursday, in any case. In fact, we were discussing a move for the couple to sheltered housing.
She had been the carer for her husband – very reluctantly accepting services slowly to ease some of the strain that the years of managing alone had taken out.
The comfort is knowing that her family were around her at the time.
On a practical level, I arranged a respite placement for later in the week when some of the family need to return back to their homes. But while doing so, and considering a similar situation a couple of weeks ago, I was thinking about how we manage and approach death.
It is still a great taboo in a sense – we are not encouraged to talk about it widely – but you can build up very strong relationships in the short time that you do intervene, in fact, the therapeutic relationship is the key to change.
I try to offer as much support as is needed. Sometimes it is a matter of practicalities as in this situation. Mr G was reliant on his wife for support. We are therefore looking at a rapid move to residential placement – via a respite stay which has been set up for the immediate. I don’t think realistically that Mr G will be going back home but at least he has a few days with his children around him to be at home.
A couple of weeks ago it was a similar but different situation. Again, it was a spouse who died but more expected really. The children had made their way from other parts of the country to be near and some preparations were able to be made. Additional care was put in where necessary but although I try not to be pessimistic, I wouldn’t be surprised if the deterioration is more rapid now.
I wonder how much we take on the grief of people who, as they get older, lose not only spouses which we can all relate to, but all the people around them. Friends, colleagues, siblings, neighbours. Repeated grieving over and over again – perhaps sometimes with little time to absorb the information in between.
There are no answers really. That’s the thing about death – expect providing support as needed and a space to either talk or not talk.