Working with the elderly, in pursuit of finding them the perfect assisted living or board and care home, inevitably brings you face to face with the topic of your clients dying. At times it is a discussion in general terms of what their life could look like, when it is their turn to exit this planet(or so we suppose) and helping them find a pleasant place to live out what we hope to be a comfortable life. But often, it is with a client who is on hospice, and so gently our conversation turns to the next few weeks or months possibly being their last.

These conversations can be in person with the client themselves, but most typically for us, it is with the family who is managing the care and working to find the best solutions for a loved ones final days. This posse of the well intended can range from a sole family member to the whole clan. In each case it is rewarding to be part of a care team who is working together to offer an end of life experience that brings comfort and peace.

So it was with surprise this last week when I had not one but two clients, both in the late stages of their illness, be of clear cognition and soundness of mind, to be the primary person with whom I was to speak with about their impending death, and as a result, how we could help them find a place to live where they would be well cared for until they passed.

The contrast between these two clients could not have been greater. The first was a woman who had end stage heart disease. She had lived the past eighteen years of her life in hotel rooms for the indigent. We met her at the hospital and with only months to live, she had no family or friends left to advocate on her behalf. In our conversation she was reluctant but grateful for the help. She was sad not to be going back to her hotel, but we assured her the care would be good at her new board and care home.

Our second client was a gentleman I spent about an hour and half getting to know at the Skilled Nursing Facility he was in, recovering from a fall. He has end stage metastatic cancer and his wife, whom he cared for during the last fifteen years of her life, had passed almost nine years ago. He also had no family or friends at his side but had means, and so was lucky enough to have a lovely woman as his fiduciary, and an attorney, who would advocate and work with me on his behalf. He asked me to find him a home with outdoor space where he can sit and read and a quiet place to die.

After each meeting with both of these clients, I immediately thought of my mother. I was struck by the contrast of where she is in her life with that of my two clients. Here she is in a board and care home, with no real cognitive ability to recognize where she is and sometimes who she is, but the majority of the time she is happy. From on minute to the next she cannot remember if her husband is dead or alive, if she has children or my name when I stop in to visit. Yet in general I can say she smiles and laughs most of the time and is pleasant with her caregivers and loving to me.

I have spent the past thirteen years agonizing over her slow decline, missing her and her memories and wishing for nothing more than for mom to just have a clear mind. But this week I found myself grateful for all that she has and not what was missing. That my mother has friends and family who write and send pictures, come to town and visit, even when they know she will only experience their love and attention in the moment. Grateful that I am able to see her almost daily and that we can laugh and I can enjoy watching her expressions as she drinks a chocolate shake and then says to me each and every time, “I think this is the best thing I have ever had!”

The contrast between a life that ends in solitude and one that is surrounded by those you love is not a scenario that I approach with judgement. Some people who die alone are a victim of circumstance, others have created that life by design.
For my mother, hers is a consequence of a life lived with kindness, humor, a positive attitude and with love. Even in what should be her darkest hour it shines through and I am grateful one day her life will end with that reflection of who she is all around her. I take comfort in knowing because of the life she created, she will never be alone.