DAD: Terry Finch
It’s Australia Day 2016. I’m in a Margaret River Airbnb on the second day of a 10-day holiday with my American friends when my sister calls from interstate telling me Dad has been admitted to the High Dependency Unit (HDU) of the local hospital. I’m panic-stricken; although I know no one lives forever, I can’t imagine my world without my father in it. Somehow, in spite of my racing pulse and sweaty palms, I manage to stay calm and ask if I need to get to Perth and on a plane. My younger sister, always more level-headed and accepting of life’s twists and turns, tells me there is no need to change my plans, she will keep me posted.
I am not entirely reassured: when I’d last seen Dad for his 86th birthday the previous October, I’d noticed he’d changed. He moved more slowly, was quieter, more withdrawn and always felt cold. I sensed it was rather more than the inevitable decline of old age, and felt sure he was unwell and experiencing some pain or discomfort. But he was never one to complain and although his kidney disease was well managed, I suspected it had progressed. Such were my thoughts when I sat with him and asked if there was anything he still wanted to do that I could possibly help him with. Dad’s hearing had deteriorated, even with hearing aids it was difficult and frustrating for him to follow conversations, especially in group settings. He would withdraw from the family dining table when his beloved clan had gathered and sit quietly nearby, in the lounge. Nothing gave him more pleasure than being surrounded by his children and grandchildren at his mammoth long table.
It was after one such family feast when he’d retreated to his quiet space: his brown suede chair in the open-plan living-dining-kitchen area I sat opposite him and asked if he’d had any burning desire to do or finish anything. He reflected for a short while and responded, quietly and calmly, “No, I think I’ve done everything I wanted to and all my affairs are in order.”
I detected no sadness, regret or sentimentality; just a quiet acceptance that he’d run a good race and the finish line was in sight.
We enjoyed a good relationship and just two years prior, had travelled together to India for a friend’s wedding in Mumbai. We were both consumed by wanderlust and obsession with world affairs, particularly staying abreast of developments in the Middle East. As a family we weren’t given to small talk, preferring to connect and sustain relationships over distance and time by discussing safe topics that didn’t require risking vulnerability. My son-in-law accurately captured this communication style when he observed that as a family our meal time discussions were typically serious and about contentious issues, more like debates than relaxed, easy, conversation about the minutiae of life.
I don’t remember my father talking about his health, but I do remember him reminiscing about his daring survival adventures in post-war Europe and his bold and persistent efforts in setting himself up in Australia as a newly arrived migrant with little English or money, but a huge vision and gutsy determination.
On the day after Dad’s hospital admission I travelled straight from the airport to join my sister and mother at his bedside. The HDU was a cramped, shared and more acute nursing space than a hospital ward and hardly conducive to open and relaxed conversation.
But sometimes words aren’t necessary. It was obvious Dad’s condition wasn’t good. There was a sadness in Mum’s eyes and a deep concern about Dad’s level of pain. Such is the price of love – a love that had ridden the storms of life over sixty years.
The next day Dad was transferred to a private room on a ward. It was in this space our family made the journey to accepting the inevitability of death, each in his or her own way.
During the next fortnight grandchildren flew in from all over Australia to see their beloved grandfather. They talked and laughed and played cards, with Dad ever interested in their jobs and studies. We bought takeaway pizza and sat out on the balcony attached to the lounge area of the ward, to enjoy family meals. We took Dad down to the hospital’s coffee shop courtyard to bask in the sunshine and be uplifted by the well-maintained, lush greenery. When my eldest child left the hospital for the last time he pleaded with me, “Mum, get him out of there; people die in hospitals”.
We developed a routine and Dad was never alone, day or night. When it became too much for Mum to stay overnight in the recliner chair the hospital had kindly provided, I took over the night shift and quickly became accustomed to the lights, sounds and movements of nurses caring for their patients. I have fond memories of helping Dad make his menu selections and then sharing his ample, delicious and beautifully presented breakfast when it was cheerfully delivered each morning with the daily paper. It seems paradoxical that the process of dying could yield so much living. But such is the mystery of love and life and the joy that is the fruit of acceptance.
The doctors, nursing and ancillary staff could not have been more helpful or attentive. They involved family members in their daily visits and ensured Dad understood what they communicated. We used a whiteboard as an aid. When it became clear that big decisions needed to be made about whether or not to conduct further tests the doctors were gentle and compassionate, explaining they could not rule out an underlying aggressive cancer. My beautiful father found his voice and quietly replied in the presence of Mum, my three siblings and sister-in-law, “If it’s alright with everyone, I don’t want any further intervention, beyond being kept comfortable and pain free.” As a family we assured Dad we supported his decision. The doctors would not be drawn on how long Dad could expect to live, saying it could be a week, month, year or longer. When they asked him what he most wanted, he said he just wanted to go home. Dad, who had closed many business deals in his life, negotiated his last: he would build up his strength so he could use the bathroom independently and be discharged. Dad applied his inimitable grit and determination and began walking the hospital corridors. Motivation is a powerful energiser and after two weeks, Dad was ready to go home. Before he was discharged, Dad agreed to meet the palliative care team from the local hospice, even though he thought it premature.
Meanwhile, as all seemed to be going well and Dad’s discharge was imminent, my sister and I arranged to swap places. I returned to Perth and she flew back to be with our parents. But after a few short days at home, Dad’s condition rapidly deteriorated, and I travelled back. Fortunately, Dad understood that at home, we could not give him the care he needed, and told mum it was time for us to arrange his transfer to hospice. I can’t imagine how it felt for both my parents to have that conversation, but the phone call and arrangements were made, and on the next morning, Monday 15th February, the ambulance arrived. Few words were spoken as the ambulance officers deftly and gently tended to Dad. Sometimes words aren’t helpful, nor are they necessary, but silent tears can gently ease the heart’s pain while honouring the feelings that must find expression.
It takes courage to undertake certain journeys. It took courage for a 24 year old to make the voyage to Fremantle in search of a better life, and it took courage to make the last trip of his life. And in between those two courageous acts, Dad lived a full and successful life.
The word ‘hospice’ for many people is synonymous with death, but as I had worked for a short time in a hospice in a non-clinical capacity and I witnessed many beautiful moments and experiences associated with death and dying, it did not fill me with fear nor dread. Of course in an age with better medicine and good health care, many of us live longer with chronic diseases, and hospice is also used for respite. But I knew Dad was going to hospice to die. He knew that, Mum knew it and so did my brothers and sister. The 13km ride from his home to the hospice was Dad’s last.
Despite the staff’s best efforts, Dad’s first night in hospice did not offer the relief we had expected. It was upsetting for Mum to see and hear Dad’s distress and we felt powerless, having been told, in no uncertain terms, that the staff would attend to Dad’s needs. I thought the night would never end, and resolved to speak with temerity to the doctor about adjusting the medication so that we didn’t endure another hellish night. The doctor was sympathetic and apologetic, and after discussing the likely outcome of increasing pain relief medication (ie hastening death), assured us that henceforth, Dad would be comfortable and settled, and he was. By Wednesday morning Dad was not communicating or eating and the doctor warned us that he might remain like this for a week or more because his heart was still strong.
Dad’s room was at the end of a corridor. It was simple, light and spacious and opened out onto a beautiful, well tended, large, lush and colourful tropical garden. Apart from Dad’s bed, his bedside locker and the usual medical paraphernalia, the furniture consisted of two folding beds, an assortment of chairs and a small fridge where we stored drinks and snacks for family and friends who visited. Nearby was a quiet room, a chapel of sorts, and a communal kitchen, dining and lounge area. The atmosphere was homely and the staff caring and professional, but unobtrusive. And in the safety, comfort and peace of that space, stories were shared: we talked, laughed and reminisced.
At about 4.35pm on Wednesday 17th February my sister noticed a change in Dad’s breathing. We called a nurse, gathered around him, and at 4.45 Dad took his last breath. Death had come a lot sooner than expected and my brothers weren’t there. I phoned them and they arrived with their families within about 20 minutes. The four youngest grandchildren plucked a flower from the garden to put on Dad’s bed and we said a prayer. Dad was not a religious man, but prayer was important to some of us, and at that moment, it seemed the only appropriate response.
Dad died just over three weeks after he’d first been admitted to hospital. The death certificate stated kidney failure as the cause of death. Of course there was sadness, and some days there still is, because the death of a loved one does hurt. But we felt overwhelming gratitude and relief that Dad didn’t suffer a prolonged, painful and ravaging demise and, as far as possible, he died on his own terms surrounded by the people who loved and cared for him.
Some years later when undertaking professional development we were asked to reflect on someone or something that had profoundly affected us and share it with the group. In that moment I realised my father not only taught me lessons about living, but more importantly, he taught me how to die well. He accepted the inevitability of his death with deep peace and surrendered to the process. Dad had lived a full life – driven by his vision and values and a relentless self discipline. He had no regrets. Therein lies an important ingredient to a good death.
I appreciate not everyone’s experience of a loved one’s death is positive or life-giving. As the one sure thing in life it’s worth our serious consideration and having the courage to engage in difficult conversations, so the fear of death does not rob us of the joy of living – in all the mess and mystery that is life.