I remember back when my dad was dying, and at this point unresponsive, to a time when our hospice nurse came to the house for a visit. We were all gathered in my father’s bedroom and watched as the nurse did her physical assessment. Being new at this point, to the whole dying experience, I turned and asked the nurse how long she thought this would all go on. My father had been unresponsive for many hours, and had eaten little if anything over the course of the past few days. “He can hear everything you are saying, you know” replied the nurse. I was horrified, and embarrassed, and immediately thought what a terrible thing to have said in front of your dying father. My sister, God love her, turned to me and seeing the look of horror upon my face, rubbed my back and said “Don’t worry, I’m sure he’s wondering the same thing.” And that was my first introduction to the idea, among dying experts, that hearing is thought to be the last sense to go in the dying person. Just a few hours later I would be witness to its truth, as I saw my dad’s reaction to stories being shared around his bedside, a slight squeeze of my mother’s hand, a lopsided grin, which I wrote about in my post My Favorite Memory.
I had a family member once come up to me and ask, however, where is the proof? How do you know that the person can still hear us? Where is the scientific data? To be honest, there isn’t any hard scientific proof to back it up, no research to point to that says this is a fact….and yet…ask any hospice nurse, or hospice aide or hospice doctor and they will tell you that, from their own experience, they have found this to be true. As I said, I personally witnessed small reactions from my own dad to hearing all of our voices while he had been unresponsive. But I also have had many other experiences which supports the idea of the dying person being able to hear. I was with a family once, waiting at a respectful distance in the corner of the room, expecting my patient to pass at any moment, when the man’s wife pleaded with him as his breathing became almost nonexistent ” Please, please, don’t leave me, don’t leave me, I’m not ready for this!” And by some power, this man slowly regained a steady breathing pattern and came back from the brink. A couple hours later when he did die, his spouse was ready, and accepting. There have been other times, on many more than one occasion, when very imminent patients were told by family to hold on because so and so was on their way, and many times they did hold on, to later pass not long after the person had arrived. I direct you then, to hold the phone close to your loved one’s ear so they can hear the messages of ‘I love you’ or ‘hold on, wait for me if you can’.
What is exactly happening at this stage when a person is unresponsive? I don’t know for sure. Do they have one foot in this world and one in the next? Perhaps. I tend to think so. It doesn’t happen one hundred percent of the time, but it does more often than not. And when the dying person does pass before someone can get there, I can’t but help to think that perhaps there are also times when the dying choose not to die with their loved ones present, that maybe on some level they wish to spare them. Ultimately though, I do personally believe that the dying person can hear us, and I encourage all of my families to act as if they can hear everything you are saying in the room. Take all arguments and negativity outside the room. This is not the time. Do play the music they enjoyed and bring in those CDs to the hospital or nursing home or hospice care center so that we can play their music when visitors have gone home. Some people told me their loved ones always had the television set on twenty four hours a day, so you can be sure that we kept that television set on at all times. I always made my patients aware when I entered their room, and let them know if I needed to do something like reposition them even if they were unresponsive. I’ve relayed messages and held phones close whenever asked, and I have urged families in cases where a person may linger for days in an unresponsive state, to give their dying loved one permission to let go. Let them know they were appreciated in their life and will be remembered in their deaths, let them know too, that you who remain will be alright after they are gone. These messages can be the last piece necessary in order for someone to peacefully pass.