Readers of this blog often ask me “What is the best present I can bring someone who is dying?”
Readers also ask what they can or should bring, do, or say when visiting an elder, or someone on their sickbed, or a terminally ill family member, or a friend who may be bed bound at home, or a loved one living in a nursing home?
The answer to all of these questions is simple: It’s YOU! Your compassion, love, care and thoughtfulness are the best presents you can offer someone who is sick, in a hospital, living in a nursing home, at home and bed bound with illness or injury, or someone who is dying in hospice.
I had a recent visit with my young friend Vanessa, (who is also a gifted hair stylist!) and she asked me to coach her on how to make visiting her “Grannie” a positive experience for both of them. Grannie, who was Vanessa’s 94 year old great-grandmother, was dying and suffered from dementia, so this was a bit of a challenge. Grannie no longer recognized Vanessa and became agitated easily, so Vanessa was searching for a way to make her visits short, fun and positive, even if her Grannie could not recognize her. While Vanessa was cutting my hair, we started brainstorming about this situation and what Vanessa could do on her visits. When we were done with our talk I realized, yes, it’s time for another checklist on this blog.
I wrote this post by keeping in mind one simple concept. Whether someone is ill, or dying, suffering from chronic physical or mental illness, or has dementia or Alzheimer’s, what matters as human beings is that we show up for those we love in their present day and put thought into bringing joy to the moments they experience in this life. It takes just a bit of planning and courage to create meaningful visits with someone who is ill, injured or dying.
How to make a plan? Here are some suggestions to help you.
Two General Guidelines
Call ahead: Call and talk with a caregiver or nurse and see what they can advise about the best time of day to visit your loved one or friend. It helps if you can arrive knowing that the time and day you have chosen is generally a good time for the patient. People who are ill or recovering from surgery, or suffering from dementia, or dying have good and bad days, and moreover, good and bad times during the day.
For example, it’s not advisable to visit someone with dementia at the end of a day (say after 4 p.m.). Due to a syndrome known as Sundowners, people with dementia get more agitated with the loss of light at the end of the day. For many people with dementia either late in the morning or early afternoon tend to be good times to visit. In order to plan your visits, again, you should start by checking in with the caregivers or nursing staff and see what day of the week and time of day tends to be best for a visit.
Keep Visits Short: Keep it short, light and positive. I know this is hard to do if you have to travel far to get to the elder or terminally ill patient, but short visits are best unless you are part of the family or caregiving team. As much as visitors are enjoyed, they can be tiring, especially if they arrive on a bad day for the elder or patient. Keep visits to 15 -30 minutes tops if you can. Unless you are part of the family or caregiving team, it’s better to visit more frequently for shorter periods of time than for one long drawn out visit.
This advice also applies if visiting someone who just had an accident which resulted in injuries, or just went through major surgery. Your friends/family who fall into these categories need rest, so quick in and out is best unless you are specifically asked to stay longer.
I was recently home-bound for a few weeks after surgery to repair a broken leg. My neighbor, Megan (who is a saint!), would run by every few days and take my dog for a short walk, or offer to put my garbage out to the curb, or to help me with daily chores I could not do myself. Sometimes, Megan would bring along her 6 year old daughter, Margaret, who had picked a flower for me or she made a crayon drawing to brighten my day. Megan would sometimes just sit for a few minutes and catch me up on the neighborhood news or events in town. These were short visits that gave me great joy and were tremendously helpful.
Make a Plan of What to Say
If the patient can recognize you, be ready to tell them a fun story about your day, or your kids, and then lead into a memory you have of them. Ask them to share memories with you about times with their family, friends, or the old neighborhood. But don’t put them on the spot to remember a specific name. Keep it general and upbeat. Touch their hand lightly and make eye contact, let them know how much you care about them and how happy you are to see them. Ask if there is anything they might like that you could bring them, maybe a photo of your garden, or your children, or some nice lotion for their hands.
If they can’t recognize you, then you truly need a plan or ideas of what you are going to say to them or do for them. Some patients can’t respond verbally either, so it’s important to accept and understand that you will be carrying the burden of the conversation. If you are going to bring food, then you are the “snack girl/boy”, or if you are going to offer a hand massage, you are the “massage girl/guy”. Keep in mind, touching an elder who is of the opposite sex may be frightening for them, so seek guidance before you plan to do anything that involves more than a handshake. If the patient gets agitated by your presence, don’t take it personally, just leave and think of other ways to help brighten their day.
While it’s very hard for you to not be recognized by the person you love or care about, what is important in the moment is that you give them a nonthreatening reason to welcome you into their room and accept the gift you bring and enjoy the moments you offer them.
What to Bring?
This list is endless, but here are a few suggestions to get you started.
Flowers & Plants: Yes, it is ALWAYS appropriate to bring flowers, even to men! Just make sure they are not heavily scented. Smaller bouquets are best, or a small dried flower arrangement. Remember, visual is the key and hospital/nursing home rooms usually do not have a lot of space for flower vases. Heavy floral scents can cause headaches, or cause allergy flare-ups, so unless you know the person very well and know their taste in flowers, keep it simple, minimal scent, and colorful.
Small plants can also be a good idea for an elder/terminally ill patient. I had a client transferring to a large hospital where family would not be able to join him for a few days. I ordered a little African violet to be in his room waiting for him when he arrived, and he said it meant a great deal to see that little violet on his bedside table. It also gave him a project to do to occupy his mind: he read up on African violets, their care and watering, and had something to talk about with his visitors and staff other than his death, which was imminent.
Food: Humans love food! We love the taste, the texture, and the smell of food while it’s cooking, baking or grilling. Food evokes memories and is a simple joy to give to those who are bed or wheelchair bound, especially if they are living outside of their home. Bringing an elder or patient a small gift of food that they love and remember can make for a good conversation.
Suggestions for how to make a gift of food:
Snack Drawer: Even when a person suffers from dementia, they often remember foods that they loved. You can create/supply a snack drawer in their bedside nightstand that can hold the goodies they like (even if they are diabetic) so that they can grab a snack whenever they want.
Milkshake or Sundae: Bring something they like that might be perishable to share in the moment. I had a client who loved milkshakes, so I knew better than to arrive without one for her to enjoy while we talked. Other ideas are ice cream sundaes to be devoured during the visit, or ice cream bars that can be kept in the freezer and delivered by staff over a period of time. If the elder is lactose intolerant, check out the line of frozen kefir desserts, it is a softer frozen dessert and has helpful probiotics. Frozen kefir is also low fat, and it comes in small containers and in wonderful flavors. Food is a great way to have a lovely visit with something fun as the focus point for a light and, hopefully, lively discussion. Frozen fruit bars, and other frozen fruit desserts like sorbets are well liked and can help with keeping hydration up, so those are particularly helpful for elders in the summer months.
Hot Chocolate/Hot drinks: As a self-confessed hot chocolate lover, a high quality hot chocolate drink is a fun and different treat. Pick up your favorite hot drink and the patient’s as well and head on over for your visit. If they don’t want the drink, then give it to another patient, believe me, a good hot chocolate or good coffee drink will never go to waste. Remember, hospitals and nursing homes do not usually have the ability to make more than instant coffee or basic tea. If your friend or family member is a coffee or tea lover, bringing them a good quality hot beverage may be one of the kindest acts you can do for them.
What if they want a beer or wine? I had a frail hospice patient who was from Ireland and he desperately wanted to drink a dark beer before he died. The man was in his late 90s, there was no medical reason not to give him a beer and his doctor approved it. Before he died, his daughter brought in a cold dark beer in a go cup with a cover and straw for her father. When he took his first sip, his whole face just glowed he was so happy. But don’t sneak alcohol into a facility or home, ask the caregivers/nurses, get the advice of the doctor in case it would cause a reaction with medication – this one requires a plan and sign off from everyone involved with the patient, and most importantly the treating physician.
What to do? Give the Gift of You!
Everyone has skill sets that can lighten and brighten a day for someone who is homebound or dying.
Hand/foot massage: Anyone can give a hand or foot massage with a nice lotion; you don’t have to be formally trained to do that for another person. Make sure you ask if they would like a hand or foot massage, if they do not, then don’t push them. Some people do not like to be touched, or it could cause pain, so before you do this, ask a caregiver if they think offering a hand or foot massage would be a good idea. If the patient does not want to be touched, then offer them some nice lotion that they can rub into their hands to make them feel better and smell nice. Put some lotion on your hands and show them what to do if they are having a hard time understanding you.
Read Out Loud: from a new book you read together, or from a favorite book to create a memory. One night during my father’s last hospital stay, I read out loud to him from his favorite book of poetry. My mother and sister were in the room with us, and when I finished I turned to find one of the nurses standing in the doorway listening as well. It was a magical night for us all, giving us the gift of taking our minds off the present and reminding us all of the fun we had when my Dad would read these poems at the dinner table to us kids. I have a friend who has a beautiful voice and she would go and read to an elderly friend who had gone blind but loved books and being read to. Reading stories or poems out loud is not just for children, adults like it too – why do you think they invented audiobooks! Need suggestions on what to read? You can check out the post What to Read to a Person Who is Dying? for some suggestions.
Sing the old songs: My friend Deb recently kept vigil at her mother’s deathbed right before Christmas. Her mother loved to sing and singing together was part of their relationship. Deb invited some of her friends over one evening to the nursing home and they came with song books in hand. They sang all of the Christmas carols and hymns her mother loved. So sing the old songs from childhood, or the silly songs from the road trips in the car, even if you don’t sing well, it’s the memories that are the key to creating a wonderful moment.
Use Technology: You could make a video of the elder telling a story from their past to share with friends and family. Or you could Skype call the elder’s friends or family so they can chat and catch up. While using technology does take some planning and coordination to accomplish, it can be done. Many nursing facilities do not have Wi-Fi in patient rooms, so be prepared to create a mobile hotspot to get this done. Or maybe plan to spend time listening or watching a sports event via laptop.
Music: bring your iPad, iPhone (or iPod & portable speaker or other device) downloaded with the patient’s favorite songs so you can listen together and talk about their favorite songs and reminisce. Or load up an iPod with their favorite tunes and give that as a gift, along with clearly written instructions on how to use the device so that they or staff members can set it up to run.
Write Cards: Many elders love to send cards to friends/family. I suggest you get a box of nice cards and see if they want to send a note to someone. You can write the message for them, they can sign as best they can and you can mail the cards for them. They may have many people they want to thank and not have a way of showing that gratitude in writing.
Knitting: If the patient used to knit regularly, and that is a passion you share, then bring your latest project to show your family member or friend. You could even knit with them, or get them started on a new project. You may need to show them how to cast stitches, and they might only be able to knit for a few minutes, but if they were a knitter before the illness or injury, they might actually enjoy having something to do with their hands. Who cares if they drop stitches and never finish the piece, it’s the action of having a project to work on that matters, especially one that reminds them of who they used to be before their illness or injury.
Take them for a walk: If they can walk and it’s good for them to walk, suggest a short walk up and down the hallway, or out to a garden. If they cannot walk, but can get out of bed, bring a wheelchair into the room, and get them out and away from their room for a bit. This is critically important to help cheer someone’s day: no one likes being stuck in a bed in the same room, day in and day out. Just the action of movement, seeing other places within the facility, looking out the windows at the weather, going outside if the weather is nice enough for fresh air, looking at the birds and trees, it helps pass the day.
These are just a few ideas to get you thinking about how to make a plan for what you are going to do and say when you go to visit.
Can’t Visit: Think about sending the following items:
Send Pretty Notecards that can be used to decorate a room with short notes. People who are homebound, or living in nursing homes and hospitals feel forgotten by their communities. Notes or letters sent through the Post Office is a treat and cards are usually cherished. A card on a bedside table or windowsill can also provide a point of conversation for the staff and other visitors who can comment about the card and ask who it is from.
Food can be shipped in: so this is a two-for-one return. The elder/patient gets mail and a treat that can be shared (or not!). You can send wonderful fruits during winter now. Personally, I like to send mini Honeybells from Florida – they are small, juicy, sweet, easy to peel and fragrant. There are also good quality preserved fruits, like peaches and pears, which can be sent and enjoyed a little at a time. Cookies, cheese, chocolates abound: the internet is full of ideas of treats to ship.
Flowers: you can arrange with a local florist to deliver small bouquets of fresh flowers once a month for not a lot of money.
Salon services: you can arrange for a manicure, pedicure, or hair appointment by a stylist from the local area once a month.
Companion services: you can hire someone from a local nursing agency or companion care service to visit and read to an elder, or provide respite care while family/caregivers take a needed break. If you are short on cash, check in with the hospital or nursing facility and see if there are volunteers who read or visit with patients who do not have friends or family close by.
Order a cake or pie for the family member on a birthday or anniversary or holiday if you can’t arrange a visit. If the elder/patient can’t make it home for a big occasion, you could see about hosting a little dessert event for the patient and their friends/family at the facility. Every facility can offer you some room that is private for such occasions, but it does take planning.
What NOT to Do or Say!
A deathbed or sickbed visit is not the time for anger. If you are angry with the person who is ill or dying, seek counseling with a friend, a professional, or someone who can help you with those emotions. If you do not feel you can control your emotions at the deathbed or sickbed, then do not go to visit. Write a note, if you can, that explains you wish them peace, that you hope they are not suffering, but that you cannot be present with them. For more insight on how to deal with anger toward someone who is dying, you can check out the post Anger Stops You from Visiting a Deathbed? Suggestions. Another post that might help you is When Your Abuser or Abandoner Dies: How to Cope.
A young man I know quite well visited his mother on her deathbed after 10 years of not seeing or speaking to her. She had done horrific things to him. He sought counseling before going to see her and he set his goals for the visit very clearly. He wanted to tell his mother that he was doing well, that he is happy in his life, and that he hoped she would not suffer. He grounded himself in the full knowledge that he was loved by his beautiful wife, his father and sister and brother, and that he was proud of himself for who he had become. He made a plan that nothing his mother said to him on her deathbed would or could change how he felt about his life or the love he shared every day with those closest to him. He was able to then go and see his mother and interact with her with a sense of peace and compassion that carried him through her death and beyond.
When visiting at a sickbed or deathbed, please respect the needs of the close family members as well as the patient’s. At the very end of life, a visit may not be possible or advisable because the close family members need to be there with their loved one without friends or neighbors dropping by. Call ahead, find out if a visit would be welcome and is a good idea. If it is not possible to visit, send a card or flowers, light a candle and offer up prayers.
You can always take a long walk, or sit and sip a cup of tea or coffee, and take a time out from your day to think about your friend and the gift of knowing them. Then write them a note telling them about your walk or your time thinking of them. Find the words to tell them what knowing them has meant to you, and thank them for the gift of their friendship.
We each have the power and ability to make a difference in the moments of the lives of others, whether they are loved ones or strangers. It is always possible to make a moment meaningful and positive, it just takes some thought and planning.
If you care to share some advice or experiences that others would find helpful in visiting someone who is ill, injured or dying, I ask that you leave a comment below.
Good luck with your visits!