‘Keeping the Peace’ in the Nursing Home

I belong to the Hospice Community Forum and just had a discussion with an “11th hour volunteer”. An 11th hour volunteer is a person who sits at the bedside of the dying, usually when death is imminent or within 24 hours or so. They are very much akin to a death doula.

Well, he brought up the issue of creating a peaceful environment, which can be especially challenging in a nursing home. To all the nursing homes out there, most of you do a great job - but there are some situations that nobody should have to endure, especially when he is dying.

‘Keeping the peace’ in the room of a dying person is paramount. I have found that there is a certain level of noise that is acceptable in any public place and while nursing homes have theirs as well, it is far different than what should be happening at a death bed vigil. I have had a lot of luck asking for the roommate of the dying to be moved if they are loud, need loud TV, or are in any way disturbing to the dying and their family. If the roommate is not willing to change their behavior or go to another room for the interim, the nursing homes I have dealt with have been willing to move the dying and their family to a private room.

Along with physical comfort, environment is so much a part of a peaceful passing. That’s why we are there – our presence blending with theirs. In a perfect world we would all get to have loving, peaceful surroundings. What brings me joy in this work is that I am part of creating that as much as possible. It may not be exactly what I wish it was, but I know that I’m part of the solution in bringing as much calm as can be.

Sometimes a nursing home may need a little nudge in peacefulness. I have had luck putting up a sign on the door to knock softly and/or keep the lights off. It is amazing how much a little sign can do. Also the family can inform the charge nurse that they don’t want anyone coming in the room unless to provide peri care or room cleaning. If that is not enough, ask for a doctor’s order for this. Ask the staff to help you. Ask each person you see to be proactive in helping you give your loved one a peaceful death. Look them in the eye and ask. Most of them will love to be part of caring in this way.

So now the roommate is quiet or you are in a room by yourself, but the lights flashing from the TV may be disturbing depending on the person. Would you want the news on if you were laying there dying? Or ‘The Price is Right’? Or ‘The Jerry Springer Show’? I’m serious. Remember that hearing is the last sense to go and your loved one is being affected by all the energy in the room, whether it be flashing lights, hearing, smells, or emotion.

Some other things: make sure soiled bed pads and briefs are out of the room immediately; apply your loved one’s favorite scent on them or in the room somewhere; play favorite music; play books on tape. My suggestion is to have some type of soft sounds–the ocean, forest or river noise–something to drown out the noise of the facility. It won’t do it entirely of course, but it may help.

Please remember that a nursing home is its own little world and anything that you want to make different, you are going to have to be very proactive about getting. Most people who work in the nursing home want to please you and care for your loved one, too. Very caring people are drawn into this line of work and are very deeply affected when someone they have cared for is dying.

If you have experiences in how your loved one was able to have a peaceful death in the nursing home, please let me know. What did they do or you do to make it so?

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