Being There for a Loved One's Final Breaths

My mother's last words to us were, "Drive carefully." She had been admitted to a Chicago hospital a few days earlier after signs of a heart attack. It was Dec. 19, 1981, just shy of her 69th birthday on January 30.

As directed by Mom, with my spouse at the wheel, we drove silently home, grateful she was in the good hands of her internist and in one of Chicago's most prestigious medical centers. But in the middle of that same night, we were awakened by a phone call. I lay silent as my spouse picked up the receiver. I listened, then watched as he pulled a tissue out of the nearby box and handed it to me. "Your Mom died," he said.

I had no idea her condition was that grave. I pummeled my pillow, soon damp with my tears, shattered I had not been there for her final breaths.

That long ago scenario has resurfaced because my adult children, who live on the East Coast, are asking me to move from Chicago to Boston where I'd be closer to them and my grandchildren. I am 85 and gratefully in good health. But they are likely thinking of my eventual last breaths and are hoping to avoid the trauma and frantic flights that would get them to me in time.

I understand my children's worries. When my mom died, I dreaded my call to my brother, who lived in Kansas City, Missouri. "Why didn't you let me know it was so serious?" he charged. "I could've flown there and seen her before she died."

My apologies tumbled with my tears. "I didn't know it was so serious," I said. His grief, and my guilt, affected our close relationship. It was as if I had deliberately kept silent because he was her favorite.

Gratefully, we moved on to have a loving relationship. Frequent phone calls and occasional visits to each other's town were salve. When he became seriously ill at 83, I traveled to see him. But when he died a few days later, I was not there for his final breaths.

Long before my mother's death, I missed the last breaths of my father. He was 47, a heart attack fueled by diabetes, smoking three packs of Camels a day, and obesity. It was 1958 and I was a 20-year-old student at Roosevelt University when I was called to the school's office to take a phone call from my uncle. "Get to the hospital right away," he said.

I remember racing down several flights of marble stairs. "Please don't let Daddy die," I repeated as I sought a cab. But Dad was already gone when my uncle had called. My uncle met me outside of Dad's room. And with his arm around my shaking body, said, "I'm so sorry; he's gone." I missed his final breaths, but I'm certain his labored words would have included, "I love you, Princess."

My second husband, Tommy, was in hospice at our home after suffering several years of frontal temporal degeneration (FTD) and lung cancer. Neighbors helped me move our queen-sized bed to a different corner of our bedroom and assemble a hospital bed with guardrails. Although some had urged me to move Tommy from the hospital directly to a hospice center, I refused. I wanted him to know I was with him 'round the clock, not miles away where he might feel abandoned, and I bereft.

"I'll be downstairs," I told him one night. "And I'll be up to kiss you goodnight before I go to sleep." He smiled and squeezed my hand. I had barely settled on the couch when the hospice worker appeared at the top of the stairs. "He's gone," she said.

I learned this pause is not unusual. Hospice workers report that some people who are dying wait to be alone for their final breaths.

Now I have far outlived both parents and a husband. I doubt that fact has mollified my children's concern about the 984 miles that stretch long and unknown between us. I am grateful for our strong relationship. I understand that their careers and own family obligations have skimmed our in-person meetings in Chicago to just a few times a year.

But what if I did heed their request and slice those miles to a more manageable five-minute car ride away? Then, if my fatal day arrived in their own backyard, they might be able to be part of a Jewish ritual that could bring all of us peace.

In my search for end-of-life healing, I found "The Last Breath — Enriching End of-Life Moments" published in the medical journal JAMA by Dr. Martin F. Shapiro, who is a member of the Department of Medicine at Weill Cornell Medical College in New York.

He writes, "In Jewish tradition, the soul leaves the body with the dying breath, and it aids the soul on its journey if those present say a prayer, 'The Shema" ("Hear O Israel, the Lord is our God, the Lord is One") as the individual breathes their last breath."

In his remembrance of his own mother's death, Shapiro explains, "I certainly did not believe that our words had provided Mom with a ticket to heaven … what we did discuss, and all agreed on that it was a wonderful experience … So often, the experience of a loved one dying gets crowded out by the emotional needs and agendas of family members. Saying this prayer structured our experience in a positive way."

I realize that even if I did move to Boston, we could emulate the scene in Chicago when despite living in the same city as my parents, or just downstairs from my husband, I missed their last breaths. But at least they would not have to endure an airplane ride with their hearts mimicking a flight's turbulence.

Should last breaths be enough of a reason for me to move 984 miles away from my current home?

I'll leave that to my children.