During my first couple of months visiting Ms. D., we were able to play cards for two hours at a time. She was a fierce competitor who strategically distracted me with her stories of being my age during World War II. As the months passed, she could play cards for only a half hour, then no cards at all. Her stories became less coherent and her contagious laughter subsided. Her recognizing smile and “Hey, Sugar” when I walked into her room receded until eventually I had to remind her repeatedly during each visit who I was and why I was there.

Staff at Transitions will call to let you know when one of your patients dies, but they’ll also call when one of your patients is "transitioning," end-of-life care lingo for dying. Being present when someone is dying contorts your thoughts and emotions into impossible tangles. At the same time, it roots you into something ancient and heightens your awareness of the fragility of human life.

Just after she turned 96, Ms. D. was transferred to a single room in her nursing home facility because she was transitioning. I got the call and was with her for an hour that day, quietly reassuring her that she was not alone, counting the audible seconds between her breaths with the persistent tick of the wall clock. Thinking she might die on my watch, the emotions that stirred within me were a confusing mix of fear, relief and nervousness. Fear: I had only known Ms. D. for a single year, and I did not want to be the one who was there when her body stopped living. I wanted her family members there. Relief: how tired a body must be after 96 years. Nervousness: the logistics of being present at a death; this would be my second in two years and I had already forgotten the signs.

I sat next to Ms. D. in silence, watching her chest rise and fall slowly, her heart struggling to keep time as my heart was pulsing and pounding. When her grandson arrived, he took over hand-holding duties, transferring his warmth to her. I took one last glance around before I left the room and noticed her “Happy Birthday” balloon still tied to her wheelchair, holding on to what helium it had left. Taking a deep breath, I walked down the hallway and out of the facility for the last time.

Someone from Transitions called again the next day. I remember seeing the organization name on my phone, knowing what the call was about and letting it go to voicemail. A few minutes after the icon showed up on my screen, I listened to the message and cried, feeling the tangles start to release.

by Megan B., family service volunteer