Pastor Note #122: Pastoring in the Face of Death

Jennifer, Betty’s daughter, called me on Monday in the mid-afternoon.  I didn’t get to the phone until it was about to go to voice mail.  I didn’t recognize the number, and, I suppose, the steady stream of spam calls – and also my general dislike of talking on the phone – have trained me to let my voicemail deal with calls from unfamiliar numbers.  I let the call go.

After listening to Jennifer’s message, I called her back.  Her father, Larry, was a resident at one of the local skilled nursing facilities.  Jennifer told me (as she already had done in her voice message) that the facility had called in all of Larry’s family, because, in their estimation, Larry was in his last hours of life.

Larry had dementia and had been at the facility for about two years, ever since he had become too hard for Betty to care for at home.  I had started my pastorate less than two years earlier, and though I visited him from time to time, I had never known him to be capable of a coherent conversation.

We all sat in Larry’s room.  His roommate, Donald, was there when we arrived.  He was an African American man.  He propelled himself around using his feet.  He was very clear-headed and plainly had a very good relationship with Larry’s family.  He talked easily and familiarly with Betty and the others.

I told Jennifer that I would certainly come.  Betty had told me at worship, the previous day, that Larry was failing badly.  She didn’t tell me then, but I learned later that Larry had become unable to swallow on the Thursday before Betty talked to me at worship.

When I got to the nursing facility at about 4:00 PM, I found Betty, her two daughters, Jennifer and Kate, and her son, Larry, along with Jennifer’s son.  A little later, Kate’s husband and son arrived.

Betty told me later that Donald would always spend time during the day talking with Larry, even though Larry had long ago lost the ability to converse.  Donald, Betty told me, just felt that it was important for Larry to have someone who talked to him.  This was a man of very great kindness and compassion.

Betty and I sat next to each other in chairs beside Larry’s bed.  This was not the first nor would it be my last vigil at the bedside of someone who was dying.  A few years later, I would be part of such a vigil at my own father’s side.

Hospice workers and nursing home staff can become remarkably adept at gauging the approach of death.  And yet, I have also found that the slow, shallow breathing can go on for hours and even occasionally days.  Frail, ravaged, aged human bodies can sometimes prove surprisingly persevering.  The waiting can be an exhausting soup of emotions.

Usually, in such circumstances, everyone understands and has understood for some time that their loved one is coming to the end of life.  There is a deep sense of grief and sorrow about that fact among those keeping vigil, a kind of hopeless longing that death should not happen, though they all understand that it will.

Often, those gathered will chat quietly and reminisce, chuckle even about fond, funny memories.  But as the waiting goes on, the chatting will be separated by longer and longer periods of silence.  Attention begins to focus on the slow, shallow rise and fall of the beloved one’s chest.  If the pause between the falling and the next rising goes longer than expected, everyone leans forward.  Was that the last breath?  Then another rising of the chest, another intake of air and then another and another, and everyone leans back again.  And the vigil continues.

An unspoken, vaguely guilty impatience can creep in.  The grief and the sorrow at the impending loss are intense.  And yet, the loss had not yet quite happened.  The waiting for it must go on.  But no one can quite avoid wondering, “How long?”  And as I have said, my experience is that it can sometimes go on for a much longer time than grieving hearts and bodies can bear.  At some point, vigil keepers still need food, need rest, need sleep.

As we sat beside Larry’s bed, from time to time Betty broke into deep weeping.  I held her hand, but there was nothing that needed to be said.  Like everyone who loses someone to dementia, Betty had been losing Larry in bits and pieces for years.  She was feeling, I suspect, what everyone in her position feels: both deep sadness and grief and also relief that the losing is finally about to be completed.

Betty had been watching her good husband of some sixty years crumble before her eyes.  Very soon the crumbling would be done, and she would finally be able to grieve in fullness.  At that point,  the last of the ever-thinning threads that maintained a physical, if not a personal, continuity with those six decades of life together would be snapped.  Then only memory and not physical presence would connect her to that long life together.

I sat with the family for about an hour and a half.  About an hour into that time, I collected everyone’s attention and read Psalm 23 then prayed for Larry, Betty, and everyone who knew and loved them.  I anointed his forehead with oil.

Larry’s breathing was shallow and at points almost a gasp.  I reminded Betty and her family that this could go on for a long time.  Eventually, I took my leave, urging them to call me without any hesitation.  They all thanked me for being there.  But as I left, I wrestled with myself, with my sense of calling, and honestly also with my ego.  I had heard the stories of my various pastoral predecessors sitting watch through the night with the families of the dying.  Shouldn’t I do that too?

But I also had my own family to be present with.  I had other ministry responsibilities to attend to.  What was the right thing to do?  I couldn’t find any definitive pastor manual that gave me the paint-by-the-numbers answer.  I’d been a pastor for thirty years at that point.  I’d sat beside the bed of many who were facing the approach of death.  I didn’t and still don’t see an obvious right answer.  Pastoring always felt and still feels to me like a tug of war among a tangled array of competing priorities.  Each pastor has to find his or her own uneasy peace.

We buried Larry about a week later in the church’s cemetery.  He had not breathed his last breath until 8:00 AM the following morning.  Betty continued to thank me for being with her during that dreadful time.  I visited from time to time in the following weeks.

Sadly, Betty followed an unfortunate path that I have seen many widows and a few widowers follow after their spouse’s death.  Betty, who up until Larry’s death had been a weekly attender of worship, never returned to her pew.  She dropped out of the many other church activities that had been so much a part of her life.

As time went on, I raised the topic of her absence from her church family.  Her answers were the ones I had heard from many others who follow that same path.  She knew that she would certainly weep if she came to church, and she didn’t want to do that in front of people, even though, as I pointed out to her, those were mostly people whom she’d known for decades.  Also, she insisted, as I’d heard others do before her, that attending worship without Larry would be just too painful.  Though, because of his decline, Betty had been attending worship without Larry for several years before he died.

A few years later, we buried Betty beside Larry.  It was the first time she had been back to church since Larry’s funeral.