After the Last Breath

The following is an excerpt from our livestream with Gabby Jimenez about life, death and hospice. Gabby is a hospice nurse, a hospice doula, and an author. To listen to the full podcast, click here.

After the Last Breath

DJ Kimble: Gabby, when the last breath has passed, what are some insights or advice that you may have for the caregivers about grief, grieving, or any additional caregiving that may take place?

Honor What It Feels Like

Gabby: When that last breath is taken, I encourage people to just sit for a moment and be with it.

I’ve seen over 1,000 last breaths and I am still in awe of how amazing and miraculous our bodies are. When that last breath is taken, I see it for exactly what it is, which is the ending of a life. Whether it’s someone I love or someone that someone else loves who’s sitting at that bedside, that should be respected and savored almost so that you can just be present for it in the best way possible and to not rush it or say, “OK, now we need to call the Funeral Home and we need to do this and we need to do this…”

I think we need to slow down and just be with them for a moment and say one last goodbye. Just be with it and honor what that feels like.

Take Grief’s Hand

Now grief is messy. Grief is unpredictable. Grief is every single color in the crayon box, and you’re never going to know how it’s going to hit you.

I think it’s important that we understand, number one, that grief isn’t going anywhere. When it got to the year anniversary of my brother’s death, I thought to myself, “I’m going to feel a little better” – even though I know what I know and my sister died eight years before and every year it seems to have gotten worse. Somehow I had romanticized that my grief would be less but I was wrong.

So when those 18 days – which is how long he was in the ICU up to the last breath – came back again for the first-year anniversary, I relived all of it. Because that’s what we do with anniversaries, we relive it all. I thought somehow that I had crossed a finish line of sorts, but what I realized is that it’s just a mile marker. It is not a finish line. Every year I’m going to do it again and every year grief is going to come back on the anniversaries, on the birthdays, on the holidays.

And it’s important that we don’t tell ourselves that it will get better with time, that it will go away or that you won’t stop feeling this way – because none of that is true. Grief is going to walk alongside us for the rest of our lives, and the best thing we can do, is to take its hand and say, “Let’s do this together.”

Be prepared for the difficult days when you’re driving in the car and James Taylor’s Fire and Rain comes on and you just ugly cry. Sometimes songs or TV shows or other people’s life experiences are going to trigger your grief. We don’t forget. So, from the griever’s standpoint, I think we need to be prepared for grief lasting forever.

I think we also need to be prepared that one recent grief might bring up all the other griefs. I call it “The Pancake.” When we’re little – when we’re kids – we have the first pancake on the stack. That pancake could be a pet that has died. It could be a grandparent, sometimes a parent or a sibling. Over our lifetime we experience more death and it’s piled up one on top of the other.

And then one day, something happens. In my case it was my brother dying. When my brother died, I put that pancake on top of the stack and the whole stack fell over, reminding me of all the other times that I did not deal with my grief – because that’s what we do. We’re taught at an early age to stuff it down. That’s definitely not healthy. So there’s usually a triggering event that will bring it up again and we will have a reaction that is really difficult to navigate.

So, as grievers, we have to know that grief will come and go. Some days will be easier, some days we’re going to cry and cry and cry. Other days we’re going to not cry and wonder why we haven’t. Some days we’re going to feel guilty for laughing and having fun, then we remind ourselves that they would want us to laugh and have fun and we work on giving ourselves permission to laugh and have fun.

The other thing I think we need to do as grievers is to acknowledge anticipatory grief, because anticipatory grief is a very real thing. The minute a diagnosis is given – whether it’s the person that is dying or the people saying goodbye – you are anticipating a death. That grief is hard, too.

Build Communication

So what I’ve had to learn is – especially as it comes to an anniversary – is to say something like, “Tomorrow is the anniversary of my loved one’s death. I’d really like to talk about it. Do you have some time?”

We have to learn how to let the people who love us know that we’re having a difficult time. Grievers have to be able to reach out to other people and say, “I need help” and to know that it’s OK to not be OK. It’s OK to not be fine. You don’t have to answer the “How are you?” questions in a way that appeases other people. They’re asking you because they want to know and the kindest thing you can do for them is to tell them the truth.

And that’s the other role – the people who love a griever or who want to support a griever. Please don’t say things like, “It’ll get better with time” or – I had one person actually say to me, “Ohh you’re still going through that?” And I thought, “Well, first of all, it hadn’t even been a year so of course I’m ‘going through that.’ But why would you say that to me? Why would you tell me that I can no longer grieve someone I love?” We don’t get to put a time frame on it or tell someone else how long or how to grieve.

People put “-ed” at the end of the word love, right? I “loved” him so much. Actually, I still love him. In fact, with time, my love almost evolves. My sister’s been gone 8 years. I think I love her more now than I did back then, and I thought I loved her an awful lot back then. I realized that the more time you’re not with someone, the more you miss them, and the more you’re reminded of how truly lucky you were to have them.

So, I think on both ends we need to be able to be honest with our feelings to let people know that we’re not fine, we’re not OK, and we do need to talk about it. And those who want to offer support maybe instead of saying “How are you today?” – because I think we all know the answer to that – instead say, “I’m thinking of you today.” And don’t stop checking in. Don’t forget them. People walk away from grievers. Keep checking in, especially on anniversaries.

Build that communication in such a way that is strong and can stand up to the difficult days on either end.