Many adults sit by the side of their dying loved ones, sometimes for days, working on accepting the loss of their physical presence and what this loss means in their lives. Then, a spouse, parent, child or friend suddenly rallies, becomes more stable and in some cases wants to talk. We grasp at what seems to be a turnaround and sigh with relief. They are going to hang on for a while; or are they?
More often than not, this rally is actually a signal that perhaps death is near. I’m Carol, author of “Minding Our Elders: Caregivers Share Their Personal Stories”, and I have been the caregiver for several elderly family members. I have known many hospice professionals who have seen their patients rally shortly before death. They have expressed that some patients want to talk. Some become restless and act as if they need to start preparing for a trip. Others will simply become more relaxed, yet tuned in. Still, others will simply show signs of physical stability when, seconds before, they seemed on the edge of letting go. Some of these rallies are momentary, while others can last a day or more. Short or long, these rallies generally have a profound effect on the loved ones sitting vigil.
One story I often remember was shared with me while interviewing people for my book. The woman’s whole family had gathered by her father’s bedside. It had been days for some, hours for others, but they had all arrived. Their father had been withdrawing into himself, and they knew that his time to leave would soon come. Then, he rallied. He was able to sit up and even talk a bit. There was a spark in his eye. He told his family to leave and get something to eat. During the time it took the family to grab some fast food at a nearby restaurant, the father died.
This family was understandably upset, but the primary nurse told them that some people feel it is too hard on their family to watch them die, so they wait until they have a moment alone. Others have said that the person who is dying needs time alone to prepare, so they encourage those around to leave. No one knows why rallies occur, or why some people wait to die until they are alone, while others wait for someone to arrive before letting go. Since we are each unique, our deaths will be unique as well.
I have witnessed pre-death rallies a number of times, so I will share a few personal examples. While my aunt lay in a hospital dying of cancer, she had my parents with her most of the time. I went to see her as often as possible. One afternoon before leaving the hospital, I said that if Aunt Marion was stable, I wouldn’t be up to visit in the evening because my youngest son had his first band concert. He was in the sixth grade, and this was an important event. His grandparents would not have missed it for anything less than the pending death of Mom’s sister. Marion seemed to rally as I told her and my parents about the concert. That evening, while I was watching my son play his clarinet, my aunt died. At first, I felt guilty. Later, after some thought, I knew that Aunt Marion would have wanted me to attend my son’s concert. Whether or not her small rally had anything to do with the conversation she heard, I will never know. However, I bless her for it. She helped me do the right thing.
The most difficult pre-death rally in our family occurred with my dad. He had been blessedly out of pain for several weeks due to hospice care. One afternoon, my sister, Beth and I received word to come to the nursing home immediately because Dad was close to death. We hurried to be at his bedside in the room that he and Mom shared. We held his hand, talked to him and waited. Suddenly, Dad rallied.
Beth worked in town, but she lived 50 miles away. She decided to drive home and tend to her teenage sons and her dog and planned to drive back in the morning. Sadly, for her, she had only hit the highway when Dad died in my arms. My heart broke for her, though I waited until I knew she was safely home before I called her with the news.
Dad would not have known how we would react to a rally, so my thoughts are that he simply came back from the brink to finish his preparations before leaving for good. On the other hand, perhaps he did want one last connection before he let go. I believe that many rallies are part of the spiritual process of death for some people while, for others, it may be purely physical. Again, we cannot truly know.
Since my arms were around Dad when he died, I physically felt his spirit leave. When Mom’s time came shortly thereafter, there was only a moment when her eyes fluttered and she left us. There was no hesitation for Mom; I believe that her sole purpose was to join Dad.
These peaceful deaths had a profound personal effect. If I ever doubted that the spirit lives on, my personal experiences would have ended that doubt.
We Circle Back to the Questions
What causes this rally before death? Why do some people rally and others do not? Is it merely a physical response to taking our last breath, or is it a spiritual preparation? Is our loved one consciously preparing for his or her last journey, or is the rally based on some automatic reaction to the death process?
Life is full of questions and some are simply not meant to be answered. This may be one of the latter cases. I am comfortable with my own feelings about the issue. Others may think I am delusional, and that’s okay. We each have our own path to follow.
Those who are left behind make their own peace with each loss. I carry my physically departed loved ones lightly in my heart. Their spirits infuse my life with energy, love and guidance. I hope that those of you who are accompanying a loved one through his or her last earthly journey will also find courage and peace in the process.
If you witness a pre-death rally, cherish it. Rather like a moment of clarity for someone who has dementia, a pre-death rally is one last time to connect with our loved one cognitively while we are still both earthly creatures. When attending our loved ones as they leave their bodies behind, we take what comfort we can get. Such a short rally that connects us deeply is a gift.