The physical and emotional roller-coaster ride continued for our patient and their family. Close to death one week, then an incomplete recovery. No longer imminently dying, but far from sustainably living. A plateau in the journey, like being stuck in transit with no clear plan of when the next part of the trip would continue. He still wanted to start his journey up to heaven, but his flight had not been called yet. He improved a bit more to the point that he was slightly better than when he first arrived. This was disappointing for him as he felt he was heading in the direction opposite to where he wanted to go. He maintained his faith and stayed calm. His Lego showcase continued to fill the room. Extra shelf space had to be organized. He was worried that he was taking up a bed that could be utilised by someone with greater needs than him.

Nothing changes when nothing changes. Sometimes a small nudge is required for situations to change. We decided to start discharge planning again as he was holding his own. We didn’t want to make him anxious as we had with the previous discharge plan so we talked to his family about it and not to him. He continued to do well, more Lego assembling occurred over the next weeks while his family found him a suitable place. He remained active around our ward, walking around slowly between Lego sessions. A new skin infection appeared but it wasn’t too painful for him. We had promised him again that we would not start any antibiotics and we stuck to our word.

A week later when his family were about to finalise their choice of care facility everything suddenly changed. He became extra sleepy. We met with his family and told them that we thought he might be dying, but we weren’t sure as he had been like this before several times and had then improved again. We would take things one day at a time. Over the next few days, we lost a little bit more of him each day. His Lego collection remained as still as he was in bed.  His family prayed that he would get what he wanted. Some people who don’t usually pray were praying for him to get what he wanted, what he deserved after many years of selfless service. Over the next days, it looked like his prayers were finally being answered. His breathing would pause for up to 12 seconds at a time before restarting.

How long has Dad got left?

If it was anyone else we’d say only hours, but your father is stronger than most people so we’re not sure, likely hours to days only.

There will always be someone with him 24/7, but we won’t let Mum stay overnight, Dad was always worried about her health.

That’s fine, we’ve already told your mother that some of our patients wait until there is no one with them before they slip away. Even though they are deeply unconscious, somehow they can still sense if people are there or not. It’s as if they are still looking after their loved ones and want to spare them from seeing their final moments, which might not be so pleasant. A final act of care, a final act of love. He knows that your Mum has always been there by his side, but he is concerned about her health. They made a good team.

Yeah, the best team. Thank you so much for looking after them.

Hey, what goes around comes around. Your mother helped our young patient 14 years ago. It’s Karma. We’ve been glad to be able to help your Mum and Dad out.

Two mornings later his daughter called her mother as our nurses thought that he was about to die.

His breathing became ragged and noisy. His wife was on her way to hospice to be with him as he died.

He took his last breath minutes before she arrived, his last act of loving care.

His wife and family were sad that he had died but were glad that he had gotten what he wanted. No more suffering, there had been too much suffering. 

He had wanted to die under our care as he had loved his time at the hospice.

He thought we had controlled his pain better than anywhere else could.

He was ready to reunite with those who had gone before him.

Rest in peace.

One of the good guys.