Goodbye and goodnight

April 16, 2012 10:15 AM

How to have a good last visit with a sick relative. She will recognize me, but her memory is pretty shot beyond that.

I'll be spending a few days visiting family to have a last visit with a relative on hospice. I've been finding it increasingly hard to carry on phone conversations with her, because she's tired and very confused/forgetful (doesn't know what day of the week it is, remembering a major life event differently from how it happened, losing her politeness filter, cognitive damage generally). I last saw her at Christmas, and she moved into a retirement home shortly after that. How can I make this a comforting and pleasant visit for her? I'm thinking I'll talk about fun things we did together when I was a child, for starters. Pictures of us? Just sitting?

I would also like to make something to leave with her, I'm thinking perhaps a soft toy or little sewn/knitted something. We used to sew and knit together, but she is too ill to do so now.

Bonus: How to help the other relatives during this time beyond cleaning/cooking/errands and being a willing ear?

posted by momus_window to human relations (19 answers total)

Bonus: How to help the other relatives during this time beyond cleaning/cooking/errands and being a willing ear?

Errands that are beyond the normal "getting you some food" are always a godsend. Do a couple loads of laundry for them, or mow their lawn, take the dogs/kids out for a day, whatever they may need but feel overwhelmed in doing is so very helpful.
posted by xingcat at 10:20 AM on April 16, 2012

Fun things we did together when I was a child

Does she have long-term memory? If not, showing photos of someone she doesn't recall or talking about events she can't remember is more frustrating than fun, for both of you. I ask my 90+ aunt about her day, what flowers are blooming, what birds she's been watching outside her window--anything that's here and now.
posted by Ideefixe at 10:26 AM on April 16, 2012

Given the information you provide, were I you, I'd bring a knitting or sewing project that you can do while you talk with her. Then, you can tell her about what's going on in your life, you can recall stories of good times you've had together, and you can also tell her about your craft project as well.
posted by ocherdraco at 10:28 AM on April 16, 2012

(And the reason for bringing the project and doing it in front of her is that it brings something that you used to do with her into the here and now, as ideefixe suggests.)
posted by ocherdraco at 10:29 AM on April 16, 2012

If you can bring pictures of happy times or major milestones, that is generally extremely appreciated and can trigger happy chemicals in the brain.

Same with era-appropriate music - if you know her favourite tunes, bring along a player with a few of them and share them with her.

You & xingcat have it for how to help the other relatives.
posted by batmonkey at 10:29 AM on April 16, 2012

Is there something in paticular you made together as a child with her that meant a lot to you both (or even just to you). If you make one of those to give to her and tell her why. She might not remember the event but it might be a nice way of helping to trigger memories or just nicely symbolic from your side and would make her family feel good that she meant so much to you. Doing a project while you are there like ocherdraco said is a great idea.

Just sitting quietly and holding her hand would be nice too. You would both feel connected but if she is tired she wouldn't feel the need to talk.
posted by wwax at 10:31 AM on April 16, 2012

My grandma suffered from Alzheimer's. A few things I was able to do that my dad unfortunately couldn't get himself to do:

1. Don't argue about past events, or correct her mis-memories. You can either spend your time correcting those memories and getting yourself, and potentially your loved one, upset. Or you can make some new memories for yourself.

2. If it's appropriate, physical contact was welcomed by my grandma. I sat on the floor while she sat in a chair and she played with my hair. I think the tactile really helped her. In this case, I think the idea of bringing her something soft to hold on to is nice.

3. We read to my husband's grandmother during her last days. Also, some favorite music or candy (if permitted) was very nice to share. And maybe a movie if possible. Something that allows you all to sit together quietly without forced conversation.

Finally, for the others, I think doing odd errands really is nice. Laundry, oil change, cleaning their house or getting someone to do so. I assume there will be some sort of service once she passes and there may be a meal be at a family member's house. Some folks need work to keep busy, some folks needs help with the details so you'll have to navigate those boundaries.
posted by fyrebelley at 10:37 AM on April 16, 2012

from my limited personal experience, people in the final stages of hospital care find it hard to concentrate on anything for more than a minute and are exhausted if they have to make chit chat for too long. They often feel overwhelmed, at the centre of something entirely out of their control and are really grateful to see you offer to run a few errands that will make them more comfortable (even getting juice or something). Be prepared to see them get impatient with you.

My dad found it a great relief if I massaged his legs in rapid karate chop style.
posted by bonobothegreat at 10:49 AM on April 16, 2012 [1 favorite]

There's new research that music from one's past activates pleasure centers in the brain ESPECIALLY in people with dementia or Alzheimer's. Apparently they do not lose that music center in their brain - or it is the very last to go. I can tell you that a woman I knew who had very advanced Alzheimer's really enjoyed and lighted up when music was played from her youth. I don't think it matters really if they liked the music at the time.
posted by cda at 10:59 AM on April 16, 2012 [2 favorites]

I think it is oftentimes best to just BE with people in these situations. Be okay just sitting there, while she dozes in and out. Hold her hand. Tell her whats going on with you - but be okay with the quiet times. Music is a good idea.
posted by dpx.mfx at 11:23 AM on April 16, 2012 [1 favorite]

ditto the music. If you can find the popular music from when she was 20, or other music you know she loves, bring it, along with a means to play it. My brother had a stroke before he died, and had difficulty with words, but music got straight through.

Be loving, say kind happy things, tell a familiar, happy story. She'll hear your voice, and your tone, even if the words are unclear.

Touch her - hold her hand, give her a gentle back rub, hug, etc. Dying is lonely, and loving touch is a gift.

If there's a scent or sight that she'd like - fresh bread, lilacs, pictures of her cat, bring it. Hospitals, nursing homes, etc., smell, at best, foreign, at worst, like urine and despair. Bring flowers if you can; they bring life, cheer and beauty. Better to bring them before she dies than after.

tell her you love her.
posted by theora55 at 11:33 AM on April 16, 2012

Flowers, kind words, and back rubs.
posted by 200burritos at 11:55 AM on April 16, 2012

I have no experience of this myself, but try not to be *heavy*

There's no need to overload the occasion with "I'll never see you again" stuff. The sort of thing you see in films.

Be with her. Accept the memories of who she was for you. Enjoy who she is now. Play. Let go.

Tell her your best joke. Make it a rude one. Laugh till your arse actually falls off.
posted by ZipRibbons at 12:35 PM on April 16, 2012

From my experience the music thing does seem to work. Try a few links to the distant past if it seems like it triggers recognition but steer clear of arguments about it. Even if you successfully correct them it will be forgotten in a few minutes anyway. My family has always been champs at discussing the weather and pets, and now this has become a good thing with my father. Although you are having trouble over the phone, you will probably find in person conversations somewhat easier.
posted by caddis at 12:38 PM on April 16, 2012

Seconding music. When I had my last visit with my aunt, we played a CD of her son playing lead cornet with the top brass band in the UK. The music triggered lots of memories for her and led to us having a wonderful time together. We both knew we'd never see the other again, and it didn't need to be said. But we did say "I love you". That was important for us both.
posted by essexjan at 1:50 PM on April 16, 2012

Can she be wheeled in a chair? When my mom was pretty far gone, taking her outside into the grounds was the best thing I did for her. She didn't have much to say any more, but watching birds and squirrels and just getting some fresh air seemed to make her happy in a way that very little else could do.
posted by zadcat at 2:30 PM on April 16, 2012 [1 favorite]

Will it just be her and you in the room? One of my best experiences spending the afternoon with my (dementia-suffering) grandmother was when my brother and I visited her together. Normally she'd get hung up on the polite small-talk questions and cycle through "so nice to see you!" "you're at your mother's?" "how long are you here for" "how's school?" (I'd graduated 2 years before) "so nice to see you!" "Are you staying with you mother?" and it was frustrating to be going back over the same chat.
Instead, my brother and I talked with her and with each other, and he kept looping the conversation back over the basic information, with occasional plunges out to new topics. "so, you'll be at mom's for another 5 days before you go back to Chicago. How do you like Chicago?" "Oh, Chicago's great, it's been 2 years since I graduated, and I have my own apartment. It's nice on my own but it's great to be home visiting mom for a week." "so you have a job in Chicago and you're not in school anymore?" "That's right, I (blahblah job) and (blahblah apartment). And brother, how's your wife? I'd love to see her but I'm only visiting Mom till Sunday." Occasionally she'd pipe up with a comment or question and we'd work that information in.
So instead of telling her our "news" that totally wasn't news, and expecting her to remember either the context (how long I've been out of school) or what I just said a minute ago, we just had a really simple, fairly repetitive conversation about pretty obvious stuff, but topics that were the kind of things she tended to ask about. The result was that she felt like the three of us had a nice long conversation. She didn't have to ask us questions, neither of us went on for longer than a minute or two or information, but there weren't awkward silences that she'd feel obligated to fill with the same polite questions.

Whether that's the kind of situation that your relative is in, or the kind of loop she'd need, it would still be helpful to visit with another person she knows. It may be much easier to have a three-person conversation than a one-on-one.
posted by aimedwander at 8:33 PM on April 16, 2012 [2 favorites]

Thanks, y'all, all the answers are great. I've been scanning some family pictures and have a portable scanner, so I'm thinking that might be a good thing to do while we sit, as well as knitting / TV. I've also finally taken pictures of my apartment so she can see what my life looks like a bit more. I'm not planning on being heavy or arguing, it's definitely about what she might like. I'm hoping some of her friends will drop by to visit and I can talk to them a bit about her life the past few years.

Past attempts to find music she likes have fallen flat, any particular suggestions for a 92-year-old? She used to listen to a lot of Lawrence Welk and Three Tenors and Victor Borge when each was current. Hearing loss is also an issue here.
posted by momus_window at 12:03 PM on April 17, 2012

I did a lot of showing her my knitting, and mild gossiping about people from church/relatives, and some TV watching. It helped that I didn't really need to think of new, unique things to say...

I feel like the best thing I did was firmly contradicting her when she started talking about how she was such a bother and people would be glad when she died. Not being independent was really hard on her.
posted by momus_window at 10:43 AM on May 22, 2012