Tag: death

Do Not Resuscitate

by This moment Matters, posted in Uncategorized

Do Not Resuscitate.

Let’s get talking about DNR’s. It’s an important document that you may have many questions on.

DNR or DNACPR: Which means Do not attempt cardiopulmonary resuscitation (DNACPR).

I’ll use the term DNR in this post because that’s what most people are familiar with.

Breaking that down further it means that if your heart or breathing stops your healthcare team (including paramedics) will not try to restart it.

A DNR decision is made by you and/or your doctor or healthcare team and is used to protect people from being given inappropriate CPR and to respect their wishes.

So, who is a DNR for?

There are many reasons why a person might have a recorded DNR decision.

This from Resus,org –

“Some people choose to have one simply because they do not want to be resuscitated in an emergency. They might have a personal reason to make this decision, but this varies depending on the individual.

Others make the decision along with their health care provider, after experiencing health issues that might inform their decision.

There are also occasions when healthcare teams may have to make decisions on behalf of patients. In this case, they would try to involve patients or their loved ones wherever possible. This might happen because a patient is so unwell from an underlying illness, that CPR will not prevent their death. By making the decision on behalf of the patient, there is an opportunity for the patient to have a peaceful, dignified death.

A DNR only specifies whether a person will receive CPR or not. Patients will still receive appropriate treatment for their health issues and all personal care needs will be attended to.”

A DNR is usually recorded on a special form. It is kept on your medical file and you will usually have the original copy with you at home, in your care home or hospice. Different doctors and hospitals may use different forms to record your DNR wishes so it’s important that a copy of yours is on your medical records and that you take it with you when admitted to hospital and keep it in an accessible place, where someone other than you knows where it is when at home.

So, who complete and put in place a DNR?

Anyone.

Despite popular myth that only those with serious or life limiting illness being allowed to put a DNR in place EVERYONE who has capacity can do so. I have known some GP’s to refuse to put them in place for healthy adults but you have every right to do so should you wish either ask again stating the facts or opt to see another GP.

You can change your mind about your DNR at any time but you must inform your healthcare providers. What may have felt right for you one day might not feel right for you another.

Three very important points here –

1. If you want to make your DNR wishes legally binding then put in place your Advance Decision (ADRT which I’ll talk about soon)

2. Tell your people that you have put a DNR in place. If you don’t tell them how can they possibly advocate for you!

3. I cannot emphasise this one enough – Let your next of kin, your people, your carers know EXACTLY where to find your DNR. Without it physically present your wish for refusal of CPR will be ignored or dismissed. Let’s say you collapse and an ambulance is called, without seeing that DNR, the paramedics are obliged to perform CPR. They will not have access to your medical records. And yes, you even need to take it to the hospital with you so they have a copy of it too. I advise people with a DNR to keep it in an “In Case of Emergency” (ICE) folder, somewhere easily accessible and let your people know exactly where it is. A specified letter rack or something similar by their front door (on the inside , of course) can be helpful. It is absolutely devastating for people caring for you and not able to produce your DNR on request and watch helplessly as CPR is performed. And that absolutely does happen. So, put it somewhere easily accessible and tell your people where to find it.

As a doula it is not part of my role to help you complete a DNR registration – that is between you and your GP, hospital consultant or hospice team but I can accompany you during the process.

There, I think that’s covered the most important aspects of a DNR but let me know if you have any more questions or if I’ve missed anything.

With love

Nancy xx

When Mothers Aren’t Present

by This moment Matters, posted in Uncategorized

Ways to celebrate and honour the mum’s who have died, who are seriously ill or who cannot be or are not present for whatever reason and regardless if this is your first Mother’s Day without them or you’ve had many without them physically present.

I’m sharing this ahead of the day to give you time to plan ahead a little.

Incorporate their favourite colour into your outfit.

Buy or plant their favourite flowers.

Listen to their favourite music or sing their favourite song.

Or watch their favourite film or tv show.

Cook their favourite dish or eat a favourite snack or beverage of theirs.

Play the games the loved to play.

If you saved something of theirs get it out, hold it in your hands, get tactile with it – it can help you feel close to them.

Look through old photos and reminisce.

Visit one of their favourite places.

Pray for them.

Raise a glass to them with their favourite tipple.

Wear their favourite perfume.

Light a candle.

Meditate with them in mind.

Re-tell their best and worst jokes.

Read one of their favourite books or magazines.

This is a hard one – go stand in front of a mirror, look at yourself and tell your mum, and in turn yourself, how much you care about them, what you love about them, how they brought you joy or share a special memory of the two of you together. This is so powerful because your mum is still a part of you. Your mum is incorporated into your DNA and into your energetic being – even if the mum you are celebrating is not biological. Even if the mum you are celebrating is the mother of your child/ren, a mother figure or you never met them.

Write them a letter telling them how much they mean to you or about your news. File it with the keepsakes you have kept of theirs, burn in a ceremony allowing the smoke and floating ashes to take your message to them or pop it in a letterbox to heaven if you have one local to you (my nearest is at St Barts in Marsden)

And last but not least – it’s ok to still buy them a card and display it prominently and proudly.

Whatever grief is there let it be present too.

In the next few days I will write about coping with or surviving Mother’s Day if your relationship was toxic, non-existent or if you are currently estranged from each other.

With love

Nancy xx

It’s Not a Competition

by This moment Matters, posted in Uncategorized

“How d’ya think I feel!?” (emphasising the “I”).

I’ve lost count of the times I’ve heard this from either side of the relationship.

And the storm clouds gather.

Facing the end of your life after a terminal diagnosis is not easy.
Most terminal diagnosis or Life-shortening diagnosis are not short-lived illness’s but typically months and sometimes years. And it doesn’t necessarily get any easier over time if it is a long term illness such as MND, COPD, dementia or Parkinson’s.
In fact, living with the slow progression of an illness that erodes physical and mental health, independence and dignity over a period of years can be hugely difficult.
Equally, it can be incredibly difficult for the primary carer, often a partner, sibling, adult child or other family member. It can push a carer to breaking point many times. To support, to witness, to give up the life you knew or hoped for is incredibly difficult.
Even when it is done with the utmost love.
Relationships can get tense.

But here’s the thing – it’s not a competition of who has it worse.
Both are equally challenging, difficult and painful for very different reasons.
You each carry a burden.
The suffering of each of you can feel immense.

It is not easy to navigate this.
I’m not going to dress it up with niceties.
All we can do in these times of suffering is be compassionate to ourselves.
You are still husband, wife, daughter, son and you are you.
Don’t lose sight of yourself beyond the illness or caring role.
Each of you still has wants and needs independent of each other.
When you feel relationships getting fraught or, perhaps, resentment creeping in ask yourself – “what would love do here for me?”
Take a little time to sit and notice your breath – even if the only time you get is when you go to the bathroom or when your care-giver goes to the bathroom.
Remember – it is not a competition as to who is suffering most.
You are enough and you are loved.

Nancy xx

When memory making and the idea and pressure of making memories becomes exhausting

by This moment Matters, posted in Uncategorized

I endeavour to keep things real here for you.

And for me.

It keeps me grounded.

It keeps US grounded.

What a shitty thing for us doulas and death-workers to espouse the idea that deaths should be inspirational, romantic even.

Dying and death can, indeed, be beautiful.

And peaceful.

But sometimes, amongst all that beauty and love, it’s raw, it’s ugly, it rages and it is anything but peaceful.

And I tell you this so that, when the capacity to make memories reaches it’s limit or becomes suffocating, when the overwhelm or suffering becomes all-encompassing and when you encounter the raw, the ugly, the rage, the bitterness of that metaphorical pill, of things left undone and the internal noise of it all that, you don’t think that you are doing it wrong.

You are not.

You are not.

This is dying in all it’s humanness.

And no matter how spiritual, religious, easy-going you are you will very likely be taken by surprise at the strength of it.

The conscious and unconscious, the internal and external pressure to make as many memories as you can in the time you have when time is short, when you or your person are diagnosed with an untreatable, life shortening illness that memory-making ideation can become all-consuming, overwhelming, exhausting and unachievable.

Of course you want to make memories.

For yourself and for your people.

And yet, here is what my doula heart will tell you.

Go gently, my friend.

Make space for it all.

Making memories is not so much in the “doing”, in the photo opportunities, in the forced or choreographed inspirational moments or in the physical legacies but in the “being”.

They are built in who you are.

They are not built in what you do – they are built when you are able to just be.

Being in the quiet moments.

Being in the very ordinariness of togetherness.

Being held in a space of love in tumultuous times.

That’s what makes the most precious of memories.

And sometimes, strangely enough, it’s the times between the deliberate making of memories that become the richest, most exquisite memories of all.

The moments between.

Spend time there too.

This is what will hold those still living in their times of grief.

With deepest love

Nancy xx

Love is….

by This moment Matters, posted in Uncategorized

What love is in your presence at the bedside of the dying.

Love is in the moisturising of their dry lips.

The wipe of secretions from their mouth.

The tender washing with the softest of cloths of their face and hands.

The gentle brushing of their hair.

Love is in the sponge mouth swabs that ease the dryness.

Love is in the way your hands touch those of your dying loved one – the way you feel their knuckles and the soft bits of skin between the fingers, the caressing from the wrist to the fingertips and the stroking of the palm.

Love is holding back from touching when it cannot be tolerated despite your yearning to feel their skin against yours.

Love is in that gentle hand hold that ushers in a sense of support – I’m here with you.

It’s there when you lay your head next to theirs, close your eyes and just feel their presence.

Love is witnessing the difficult changes but staying there anyway.

It is being eaten up by grief as you watch your loved-one fade away ….. but staying there anyway.

It is getting up every day to care when your whole being is utterly exhausted.

Love is in your gaze as you look at their changing body yet remember times of vigour and youthful energy.

Love is listening to the rattling in their throat, the groans of discomfort and witnessing the wringing of hands without turning away.

It is turning towards their suffering and letting them know they are not alone.

Love is in the words that you share.

It’s in the conversations that you have even when there is no response.

It’s in your singing.

In your humming.

Love is in the reading aloud of their favourite books or poems.

Love is in the music that you play for them.

The music you know they enjoyed when they were full of vitality.

Or the music that you know brings them comfort.

Love is knowing what tv program or film to have on in the background.

Love is knowing when silence is necessary.

Love is in the soft kiss of the lips, cheek, forehead or hand.

It’s there as you linger in that kiss trying so hard to imprint this moment of tenderness into your memory.

It’s in your vulnerability that encompasses these very moments..

Love is in your sighs of grief.

In your gentle sobs of sorrow.

In your sense of relief that any suffering is coming to an end.

In your smiles too as you recall memorable times.

Love is in the shared air that you breathe.

Their final breaths become your first breaths in your ever-changed life.

And love is a deep understanding of how colossal these moments in time truly are.

With tenderness

Nancy ❤ xx

Grief Groceries

by This moment Matters, posted in Uncategorized

Grief groceries.

Earlier this week I popped out to pick up some grief groceries.

And, I’m likely to be doing another grief grocery shop in the coming days.

Now, you might be wondering what grief groceries are?

So let me share a little bit of wisdom from those grieving.

One of the many things that are said to a griever when their person has just died is “Let me know if you need anything” or “How can I help?”

But here’s the thing, when folks are grieving making decisions or even knowing what they want or need can be just far too difficult.

And this is where grief groceries comes in.

It’s not that they can’t get to the shops (some grievers are high functioning) and it’s not that they have nothing in the house.

But…

Changes in appetite are a universal component of grief, particularly in those early days.

People can lose their appetite completely or over-eat.

Keeping it simple can be helpful to the griever when the physical, mental and emotional capacity to cook diminshes.

So picking up some groceries, food that is easy to cook, some healthy goodies and practical stuff like tissues, lip balm (lips can dry and crack so easily when people are grieving, stressed and crying a lot), hand cream as a treat and for a special touch, a candle to light.

Perhaps add in a precooked home-made meal or two.

Let’s not forget some things they can snack on too and that might include some healthy and some not-so-healthy snacks.

Let us not judge their choices or impose on them what WE think they should be eating. In those early days of grief it is sometimes all a person can do to function.

If you are unable to get them any groceries how about a voucher for a takeaway that can be delivered direct to their door?

Grief groceries.

Just a little way of showing that we care at a time when we can feel so helpless.

With love

Nancy xx

Death has a habit of taking us by surprise.

by This moment Matters, posted in Uncategorized

Death has a habit of taking us by surprise.

We always think we have more time with those we care about than we really do.

Even when death is expected.

Even as our person has begun actively dying.

And the death of our loved-one almost always comes as a shock. It feels so sudden.

Again, even when it’s expected.

It’s a really strange scenario.

You know it’s coming.

You prepare yourself for it.

And yet, you are not ready for it when it does happen.

Sometimes, you sit by your person’s bedside for hours, you get up to go for a pee……..and death happens when you are out of the room.

No matter how much we prepare ourselves psychologically and emotionally nothing can fully prepare us for the finality of it.

Perhaps this is due to the fact that we are so far removed from death. Where once we were cared for at home within a community of support and helpers at the end of life whereas now we are carted off to be cared for by others. Hidden from sight of the community and those around us. As a result few get to befriend the intimacy of death.

Perhaps the shock is because this death is a stark reminder of our own mortality.

Or perhaps we are just not ready to release the spiritual and energetic ties that bind us. Similar to having the umbilical cord between mother and baby cut at birth, this invisible, yet tangible cord that connects us, sends a shockwave through all our systems when it is cut at the moment of death. Where, although this person is ever present in their love, our lives are forced to continue separate or independent of them.

Perhaps it’s a mixture of all the above?

This really, is a reminder, a call to action, to say the things you need to say whilst you can.

Go and visit and hold your person’s hand even if words fail you.

Because, quite often, that touch, that shared moment, says more than words can ever say.

Speak to them, through these words or touch, as if it’s the last time you will see them, because one day, it will be.

This moment really does matter.

With the tenderest of love and affection

Nancy 💚 xx

Twas THE Night

by This moment Matters, posted in Uncategorized

Twas THE Night.
Written Christmas Eve last year.
Well, perhaps not the poem you expect to read on Christmas eve but, as it is based loosely on The Night Before Christmas, I thought to share it. It’s the story of a gentle welcoming of end of life in the presence of a doula.

Twas the night before death, when all through the house
Not a creature was stirring, not even a mouse
My heart it was heavy, this sad night of the year
I hoped that the doula soon would be here;

My beloved was nestled all snug in his bed,
While visions of ancestors danced in his head;
With me in my grief, holding a hand in his lap
My love settling down for a long final nap,

When out on the path came footsteps heard before,
I crept swift from the bedroom and unlatched the door
Not wanting to leave my beloved for long
I feared when I got back I would find he was gone.

The moon barely visible behind the clouds of my heart
Was aware of the soul that was about to depart,
Then, what to my woeful eyes should appear,
Twas the end of life doula, and her heart so dear,

Our doula spent a few moments sensing all that was here
The anxiety, the love, the grief, the fear
Then she took my hands and invited a pause
Then said “Let’s be still, let’s be still, witness these moments with awe”

With a hug, a kind word, so soft and so pure,
I knew in a moment we were held safe, reassured.
More rapid than eagles when I phoned she came,
And she greeted, with love, my beloved by name;

Within this familial space – I felt so blessed
As together we prepared the sacred death nest,
Candles, a poem, his favourite music we played
We plumped up his pillow for his head to lay

I shared memories, told stories, sang songs that he knew
Provided moments of silence for him to explore new realms too
My doula she noticed my face it was frowning
She uttered words of support to ease me from drowning.

She kept me supplied with refreshments as needed
She checked my beloved’s wishes were heeded
My doula stepped in when I needed to sleep
A presence at bedside, a sacred vigil to keep.

In each precious moment I watched my beloved’s chest rise
As the light slowly dimmed in his tired brown eyes
His breathing now shallow, the timing slow.
Gave an intensity, a lustre for my focus to grow

As his body shut down my loves throat started to crackle
The doula she said it’s sometimes called the death rattle.
Blotchy mottling had appeared on my beloved’s skin
I can’t help but wonder of the bodily processes within

My love – his hair laid ruffled, his eyes partially closed,
His cheeks deeply sunken each side of his nose
His mouth showed wrinkles where once there were smiles
His jaw hung loose as if asleep, my heart in denial

As his physical life faded, his spiritual energy grew
This subtle glow it encompassed him soft and true
We welcomed it warmly, we knew he was frail
He was almost ready, to step through the veil.

When with a movement of his head in spite of his health,
He turned to look at me wisely, shared a moment of himself
With a twinkle in his eye and a nod of his head
He gave me to know he had nothing to dread

He spoke not a word, but closed his eyes,
And the room filled with awe that we just can’t describe,
And laying my face close to his where he lay
He gave a last sigh, and went on his way;

We stayed there bearing witness, nothing to do or say
Holding each moment tenderly ’til the new day
And as the sun began to rise on the fresh new morn
I knew a different me had just been born.

The touch of his hand, his skin cooler now
I stroked him tenderly across his brow.
In accordance with my beloved’s last wish
He stated clearly, he wanted one final kiss.

Then his spirit it rose, making ready to pass through,
He lingered for a while, then, away he flew
But I heard him whisper, ere he drifted out of sight,
I love you deeply, and I wish you goodnight.

I hope this poem touches you softly

With love ❤
Nancy 24/12/22

Art by David Yan