In describing what it means to be in the moment with a hospice patient, Ted Skiera, RN, recalls a story of a former patient named Mary. She was a spirited 103-year-old woman who was born in an era when 99 percent of all doctors had no college education, and before women had the right to vote.
“Mary liked to talk about the first time she voted for President of the United States,” Ted says. She frequently and proudly told him that she cast her first-ever ballot for Franklin D. Roosevelt in 1932.
One day when Ted was visiting Mary he could tell that she was nearing the final hours of her life, so he decided to sit on the bed by her side. He gently held her hand and in a soft warm voice said, “I think this is your time, Mary. I think you are going to die soon.” She told Ted that she didn’t believe in a traditional or religious afterlife. Instead, she explained, “My soul is simply energy, and when my body dies my energy will join the bigger energy of the universe.” Ted continued to sit next to her, listening to her words, hearing her breaths, and feeling the faint pulse of blood moving through her hand.
If you ask Ted what he likes most about his job as a Yolo Hospice nurse he will tell you “being present and listening.” He says, “When we are able to establish ourselves with someone, we can help them die more peacefully. We help name their fears, walk through those fears, and hopefully eliminate them. It’s true that my job is to make sure patients are comfortable, and to work with primary care doctors so that patients can enjoy their families and friends before their disease catches up to them. But it’s also my job to listen and to affirm a patient’s beliefs and their understanding of the world.”
According to Ted, when someone is dying the curtain that keeps us in the present is lifted. The pull of gravity releases and there is often an enhanced ability for the dying person to see and hear things that normally exist behind a veil. He says, “They can almost become mediums.” When asked if he has ever witnessed someone having a glimpse into the beyond, he is quick to respond, “All the time.” In fact, he says hospice patients frequently talk to people or spirits who only they can see. Sometimes they direct their conversations toward an empty corner of a room, a window or the ceiling.
“One of my patients told me that her mom, who died years earlier was in the room waiting for her,” Ted explains. She told him that there was a little boy standing next to her mother in the corner of the bedroom. Later, Ted learned that the mother’s little brother died when they were small children. “This patient would have never met or seen this little boy who was her uncle,” Ted says. “But now she saw him standing there with her mom.”
In these situations Ted helps guide the family through the experience. He validates the encounter and encourages patients to ask questions of the people they see. One of Ted’s most memorable visits was in the home of a husband and wife who were both in their 90s. “They were old rugged North Dakota farmers who were living in California,” he says.
When it became evident that the husband was nearing his final minutes of life, his wife gently crawled into the bed and snuggled up to his side. She put her arm around her life-long companion and kissed his cheek. At that moment he stopped breathing.
Ted checked the man’s pulse and there was none. By all accounts the man had died. His wife touched the side of his face and whispered, “I love you.” And then suddenly the man’s pulse came back and he told his wife, “It is beautiful. It is beautiful. I love you.” He then, once again, took his last breath. “It was an existential experience,” according to Ted.
Another story that Ted likes to share has to do with a Vietnam veteran. “At first, we had a hard time getting this guy comfortable,” Ted says. “He was getting weaker and weaker and couldn’t make it out of bed. We kept adjusting his medications to alleviate his pain and symptoms. I knew we were successful when I spotted him through the kitchen window, sitting with his sons in the backyard. They were all smoking cigars.”
In hospice, according to Ted, “We are able to do some things beyond the pale, especially when we have time to work with people . . . when we have time to build trust.” That idea of having more time took on new meaning for Ted this year when his own brother-in-law, Raymond Martinez, was in need of hospice care.
“Being on the receiving end of hospice was a profound experience,” says Ted. When Raymond could no longer mange to live in his San Francisco home, Ted and his wife Joan moved him into their house in Davis. “We set up a little hospice home right here,” Ted says. “Having Yolo Hospice available for our own family was such a gift.”
After receiving his terminal diagnosis in August of 2015, Raymond went on to perform in Richard Wagner’s “Die Meistersinger von Nürnberg” at the San Francisco Opera in November of last year. “He made every rehearsal and every performance even though he was getting weaker,” according to Ted. A gifted artist who made his operatic solo debut with the San Francisco Opera at age 13, Ted says, “Raymond focused, as he always did, on what was most important and meaningful to him.”
When asked what advice he has for people with a life-limiting illness, Ted offers these words, “Take care of today. Enjoy people you love. Be grateful. These are not sexy tasks, but they are meaningful.”