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My Father was admitted to ICU on Sept. 29 with sepsis/double pneumonia. He was discharged home with me on Hospice Care on 10/01. We have him in his room but in a hospital bed and have been providing total care for him. He has been living with us and healthy since April, but he has no memory of getting sick or being in the hospital. Most of the time he knows where he is and he always knows us and any visitors.


The Hospice nurses all believe we are seeing end of life as did the marvelous physician he had in the ICU. However, this is going on so much longer than anyone expected. (He has been a very healthy and active 95 year old until now).


We don't really know if he understands how seriously ill he is, although we have discussed his illness with him. He does not express thoughts about dying, or tell us anything about his nighttime talking to relatives that have passed away (which I have witnessed). I am not sure how to approach this or if I should at all. He is a private and very quiet man, never complains about things and always has a positive attitude. SO I am just wondering, do I try to ask him if he has thought about dying? Or do I ask his Pastor to bring this up with him? He is a religious man, and we have read scriptures and listened to favorite hymns etc. together since his illness.


Help? Thoughts?

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You approach it by telling him you know his time is coming. You reaffirm your love and at the same time you can apologize for any shortcomings. You tell him you understand that he must leave you and that you don't expect him to hold on for you, that he doesn't have to linger.

This is the time to tell him any last thoughts. Just be careful not to make death-side promises that you might not be able to keep. I learned how promises can slip out and a deathbed promise can be 'binding' to you.

Lastly, you tell him about the various people he will be reunited with. You can even suggest that he is already seeing them - go with whatever he is ready to deal with. If he says he hasn't seen anyone, tell him that he will at the end - they will come for him.

I have no idea who my mother saw, but someone came for her. With my father, it was my mother who came for him. With my husband, it was his first wife and his oldest brother who had predeceased him.

To witness a passing is a most glorious gift; it is precious.
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I too have been caring for my 95 year old father for the last nine years. We've had many emergency room visits and hospitalizations over the years where it was expected that he might have only days to live. I'm thankful that I broached the subject with him because I found that he was relieved to be able to express his thoughts but wasn't sure how to bring it up for fear of upsetting me! He has obviously survived well beyond the initial threat to his life but continues to have challenges each year. We're both thankful that we have an open, on-going conversation to address whatever new need arises. We've extended these conversations to his doctors as well. My dad appears to be comforted that people know what he does and doesn't want, that he has support for his wishes, and that he feels he still maintains some control over the matters of his life.

I see that you've received a lot of wonderful advice here and that you have moved forward with the pastor's help. Removing the elephant in the room and normalizing this part of his life's journey is a kind approach, in my view. My dad and I were long-term members of the Hemlock Society when we were younger so the opportunity for candid conversation was closer to the surface for us. We weren't attending to learn about self-deliverance but because they provided a wonderful education about end of life matters and care in order to plan and prepare. The most beneficial thing I took away was to be able to define what constitutes quality of life at each stage. Your dad can still experience quality if you make the effort to determine which things bring him pleasure. For some it's visits from friends & family, For others it's their morning cup of coffee or their ice cream after dinner. They are things that we might easily overlook as small matters but they take on a greater significance to those whose choices have grown small. I hope you'll make your best effort to figure out as many of them as you can. Look at massage, music, favorite foods, singing, reading to someone, a wheelchair ride to see the leaves changing, old favorite movies, animal visits, sports shows, etc.

In summary, my answer to your question is yes. Involve everyone, especially your dad. It's lovely that you want to be present in the fullest sense of the word in this last chapter of his life.
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I would ask whether there is a need to bring up this subject with him. Has he already made preparations for his departure, such as funeral arrangements. will, living will, etc? If he has, why would he need to discuss it? I'm nearing 90 and have made all arrangements for my demise. I don't need or want to know when I'll go, and neither do I need or desire to discuss it. So I would say that it all depends on what preparations he has made.
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anonymous444729 Oct 2018
interesting thought, but always room for goodbyes. Our family made lots of advance preparations down to very detailed things, but to those who are going to be left behind, it helps to have a little closure. Atleast thats how I took her question.
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There are two sorts of ‘end of life’ issues. One is ‘what happens after death’. Perhaps your father is clear about his beliefs, perhaps a visit from his Pastor would let one of them bring it up. You don’t actually need to know what your father thinks about this, so just make sure he has the opportunity to talk about it with you if he wishes.

The other ‘end of life’ issues are practicalities like ‘what happens before death’- what sort of interventions he wants, or wants to turn down. Because Hospice involves a decision to provide comfort rather than to prolong life, it usually covers most of this. Hospice may have suggestions about how to deal with any more issues.

Other ‘end of life’ practicalities are about funeral wishes. Our family has always gone for a decent minimum. Unless you and your father feel strongly about this, it’s probably best not to make promises that will be very expensive to carry out.

One helpful conversation might be about any gifts your father would like to make from his possessions. Small personal items don’t necessarily have to fall into the estate and just get sold, and little gifts set aside for grandchildren, friends or family can have a very special meaning. He might like to make little notes to go with them. Thinking about this will be another way to make it clear to both of you that you are talking about what happens after his death. It may lead to the deeper conversation that you feel you need.

Best wishes to both of you.
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These conversations don’t need to be had in “doom and gloom”, crepe-hanging moods and all that. They also don’t have to be hours long. “Hey, Dad, Billy really likes that fishing pole you have. How’s about we give it to him.” And then make sure Billy shows up and thanks him profusely. Another day, “Hey, Dad, I was thinking about that service we went to for Mrs. Jones that time. You think maybe that’s what you’d like? You can talk to Pastor about it.” I’m 65 and don’t plan on going anywhere soon, but I’ve already begun telling my son (my child who would appreciate and take care of heirlooms) about things I have that I want preserved. It’s ok. It’s not depressing and I enjoy telling him about these things. And it gives me peace, even now, to know my prized possessions will be preserved.
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In my experiences with hospice, spiritual guidance was available. The pastor from hospice who visited my sister let her guide the conversation. You might ask your hospice team if someone skilled in this area would have a talk with your dad.
Our local priest was a great support to us all but the pastor sent by hospice was obviously trained in end of life care. Everyone is different. My sister had questions about death and things she wanted to discuss about her funeral. My dad, true to form, didn't want to talk about anything. I asked him a couple of questions and it was very clear that he wanted to be kept on a strictly "need to know" basis about what was going to happen and he had decided he didn't need to know.
I'm sorry you are going through this rough time.
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It sounds as if you are giving your father ample opportunity to unburden himself if he wishes to. When you refer to "his Pastor" is this a person he sees regularly anyway? So that there is even a spiritual context in which your father can talk comfortably with someone he knows?

Those being so, I don't think you need worry that your father would like to express his thoughts but can't.

On the other hand. If there are things you want to talk to him about or questions you would like to ask, within the bounds of tact and sensitivity of course, you should feel free. This time is precious to you, too.
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kmfallon Oct 2018
Thank you for your support. His pastor is new to his church but has taken the time to get to know my Father before his illness and has been visiting regularly.
He actually engaged my Father in a very heartfelt discussion about my Fathers thoughts and feelings around facing death and wishes that he might have.
We were relieved to hear him say that he had recognized that he may not recover and that he may be facing the end of his like and that he did not feel fear or anxiety about it. His wishes for the end were to be surrounded by those he loves and to not have pain or suffering and to be in a familiar environment.
I trust that we are providing these things for him to the very best of our ability and that we will be able to continue doing so.
I believe since he and his pastor talked that he has seemed more relaxed and believe that he may open up to us as well if he needs to discuss his feelings more with his family and loved ones.
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If you are comfortable talking to your Dad about end of life wishes I think now is a good time. If he and you know your Pastor well maybe you could broach the subject together. Knowing his wishes before he passes will make you more at ease at the end knowing you followed his wishes . Hope this helps
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When my dad was dying of cancer in hospice his pastor went in and had the “you are going to meet your maker” conversation with him. Later that day when I visited my dad he told me it disturbed him. Although dad knew he was dying he held onto hope to the very end. I honored that and basically said my goodbyes when he was in a comatose state. I’m sorry for what you are going through - it is very sensitive. Let your heart guide you.
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I'm going to give you not only my opinion based on my own experiences, but on what the research says. I'm an academic who has written about communication and death/dying issues. Yes, of course you should talk to him. He knows that he will die, and to ignore it is disconfirming for him. It implies that you don't care about his feelings. I don't know that I would phrase it as you did, asking whether he has thought about dying. Instead, I'd gently share with him your thoughts about end-of-life for you, and ask him what his thoughts are. I'd gently open up the conversation. You can then ask him if he would like to talk with his Pastor. He's very lucky to have you. I'm glad you reached out to us.
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