In my years as a hospice volunteer, I occasionally witnessed a separation between patients and their families, which has resulted in “dying alone,” without a loved one present. It can be a sad experience to watch.

In my career presently, I am involved in hospice 8 hours a day, 5 days a week. I experience people dying alone more often than not. Notes will say, patient passed at such and such time, no one at bedside. I get a little sad feeling in my heart when I read that. I think it is important to take a look at this, especially if maybe your feeling bad you could not be bedside with your loved one at the moment of death.

A hospice that I worked for a quite few years back had a really great preacher who had a very large presence. He said to me “Nina, I don’t know what’s harder, dying alone because you have no family or because your family stays away.” His statement made me want to go deeper with what I was experiencing out in the field. I find there is one more variable to consider. It’s a spiritual thought, maybe one that’s not tangible to our human brain. Yet, another great mystery about dying. Perhaps the loved one chose to die alone in the quiet of their own presence.

Ida

The first day I walked into Ida’s room, all I could see was a slight woman barely visible beneath the weight of her covers. Her bed was close to the floor; there was a pad next to it and no guardrail. I could not imagine this woman falling out of her bed. She was painfully quiet, no words, no expressions, and no movement. I sat on the bed and held Ida’s hand. There was barely a hint of who she once was with no words, no facial expressions, and no reactions whatsoever. She seemed terribly sad to me but that was my perception. Did I really know that?

Ida had been a nurse in her lifetime, had never married nor had children. She did have one friend who I heard dropped by occasionally. Her friend was the only person on her paperwork. I didn’t want Ida to die alone. I tried diligently to work with staff to have volunteers throughout the night but it was to no avail.

There is a saying in hospice that I find to be true: People die the way they have lived. Ida died alone. Ida had taken care of others in her life. My sense is she was a very independent woman, and this is the way she died, quietly on her own.

Lorraine

Lorraine had lived with her daughter for more than fifteen years. She was tough, strong willed, a fighter. She wanted nothing to do with volunteer visits; she didn’t need or want anything of the sort. Her condition worsened after a bout of sickness, and her daughter put her in a skilled nursing facility.

I was not a volunteer at this agency. I was the person who recruited volunteers. Since Lorraine was so adamant, I decided to go visit her myself rather than sending one of my volunteers. I had a feeling this woman was angry and I wanted to find out what I could do to better understand what was going on for her.

To my dismay, the facility was overcrowded with beds, no windows and understaffed. Lorraine’s wheelchair had to practically be in the hallway in order for her to watch her TV. I found Lorraine in her room, depressed and weepy. Her pain and sadness permeated the air; there was nowhere for me to stand, so I sat on the bed next to her wheelchair.

I asked her how she was feeling, and she expressed to me that she didn’t understand why her daughter would not talk to her, nor why she couldn’t go home. I told her I didn’t know either, validating her feelings and listening deeply to her pain. Her daughter gave her no explanation. She stopped visiting her mom all together.

I sat in silence as Lorraine wept. When I put my hand on her shoulder to comfort her, she recoiled. “Don’t you feel sorry for me!” she demanded with authority. My eyes welled with tears. I gently replied, “I don’t feel sorry for you; I have compassion for you because one day I will be old too.” In that instant, that was exactly what Lorraine needed to hear. Lorraine needed to know someone cared about her.

Lorraine died the next day with no one was bedside. I was sad for her and her daughter because a lot was left unsaid. This was tough to watch; in hospice, we cannot fix familial issues.

How people die has a lot to do with a life lived and the history that goes with it. If you have a sorrow about a person who died with no one bedside think again about your perception, then think of where they might have been coming from. Lorraine’s is a sad story and I myself don’t want anyone to die alone. But I find in my own experiences, dying is about the journey of the person in the bed.

Listen to your own heart, do the work if there is some pain, and if you couldn’t be present for a loved one’s moment of passing, just remember it may have been what they wanted.