Talking about dying

by Julia Engman

Endlich! (Ausgabe I/2020)

Sometimes death is very beautiful. When the dying are no longer in pain, when everything has been said and they can let go, surrounded by their loved ones. Then death is a moment of love and security. But sometimes it's different. Sometimes fear takes over and dying is incredibly hard. So hard that as a last resort sedation is used and the person is immobilised with drugs.

I'm a palliative care worker and I work in a hospice. The people come to us who are so sick that they will die soon. We help with this most fundamental of transitions. My work involves care in a very comprehensive sense: I also wash, dress wounds and administer painkillers. But the most important part is the emotional care, which means a lot of listening, talking and hugging. We talk about everything that is on the patients' minds: What it will be like to die. What exactly happens in the body when breathing becomes more difficult and all the body’s activities gradually stall? How even then the pain can be relieved when a patient can no longer swallow at all. They often want to know all the details.

Most of them are not afraid of death itself, but are afraid of leaving their loved ones behind

Some of our patients are very scared. And this fear hurts and causes panic. Most of them are not afraid of death itself, but are afraid of leaving their loved ones behind. They worry that their relatives will not be able to take care of everything alone. Some regret not having lived the life they wanted to live. That's why it’s so important to think through everything and voice your own fears. Some people want to revisit a certain place, or clarify something with a certain person. We also work very closely with the relatives of our patients. It is not only about the dying person, but also about how those left behind process the loss.

The most difficult cases are people who have not dealt with their illness or death at all. For them, fear often dominates because they do not allow themselves to deal with reality. I have the impression that dying is still a big taboo for many people. People refuse to accept it because it is painful. Through my work, I am now convinced that we should all think about how we want to die, and not only when we are terminally ill or very old. Death is part of life and should have a firm place in it, instead of wafting over us as diffuse, unspoken fear.

Older people have had much longer to come to terms with death

At first I found it very difficult to believe that all patients come to us to die. There are only 14 rooms in our hospice, so I build up a very close relationship with each individual, which does not make it easy. For example, I had this patient who was so close to me that I still think of her every day. She had small children, but was very calm. "I had the best life, with a wonderful husband and fantastic children. I'm okay to go," she said. She was so strong, it touched me very much. Normally young dying people are not so strong, because they are still in the middle of their lives. Older people have had much longer to come to terms with death.

I do love my work. I notice how happy it makes many people happy to be able to say goodbye to life from a secure place. It's very special to be there for them.

Transcribed by Gundula Haage
Translated by Jess Smee

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