In 2020 the Covid-19 virus impacted every aspect of life and our way of living. One area that causes particular problems and distress for many is when they have a family member in a nursing home, especially when the relative is approaching end of life and passing over.
This is an account of one such experience.
Mother and daughter relationships may not always be easy and roles often reverse with increasing age and possible infirmity of the parent, it calls for a gentle approach for the daughter to take on responsibility for decisions, especially when the parent has spent a lifetime controlling many aspects of her own and her daughter’s life.
Many women born before or during WWI and living through WWII developed a way of coping with a ‘stiff upper lip’ and often a feisty approach to everyday life. The world had changed from previous generations so they had to adapt and make their own rules in life and be very resilient and determined. For this generation of women to accept personal and intimate care from another, let alone from their own daughter, could be very confronting – in this case it would not have been possible had the daughter not brought greater understanding of equal-ness within the relationship.
As a relationship changes from mother/daughter to one of a deeper connection between two women, it offers an opportunity for both to share the formative experiences of the other and with this, there is the honesty and opening of a deeper understanding of the underlying causes of any past conflicts.
So, what allows for the woman-to-woman relationship to develop harmoniously?
There needs to be an openness and a willingness from both sides for changes to occur but with deepening understanding, it can be a very beautiful process. When honesty is expressed lovingly without any judgement, the pattern of defence or conflict can evolve to love and appreciation.
In this story, the daughter is known as Serena and her mother is named Lavinia.
Serena had been aware that the early years of their relationship were somewhat strained between herself and her mother and this called for some personal work on attitudes, ideals and beliefs that often arise between mothers and daughters. For example: “Children should be seen and not heard”; “I’m your mother – do as I say” or “After all I’ve done for you!” The elders may have expectations of the younger generation to fulfil an obligation of duty for the family… “Blood is thicker than water…”
After Lavinia had a fall and her mobility was severely compromised Serena became the main carer for six months and this was a defining moment of change. Along with rapidly declining eyesight, Lavinia became increasingly vulnerable and frail. Carers were brought in three times a day and then after a while, a live-in carer was employed to offer more support and enable Lavinia to remain in her own home.
A year later, after a further fall and several weeks in hospital it became obvious that the once sprightly 95-year-old, could no longer cope with independent living and was supported, very lovingly, to move into a care home.
The care home was well run and very supportive but there are always areas, however small, that can benefit from refinement. Fortunately, the management team and staff were open to suggestions, so Serena ensured that any changes that were requested and made for her mother, also brought a level of detail and care from which other residents could benefit. For example: older people often lose the ability to correct their posture themselves and a slight readjustment in the angle of a pillow, by even the tiniest amount, could prevent or lessen a stiff neck or shoulders and offer the possibility of the person being less tense, less stressed and less anxious – especially when their communication is compromised with even the slightest onset of dementia – and it can make a huge difference to their comfort and sense of settlement.
Serena talked regularly with staff and managers at the care home and built a strong foundation of communication and support. For instance, the television and/or the radio were constantly playing in the bedroom and when Serena asked if Lavinia was enjoying this, she told her daughter that she was now really disliking it (having previously had a great love of classical music.) She felt the music was being used to occupy and distract her and prevented her from engaging with nursing and care staff in interactive conversation. Serena requested that this be discontinued and in order to ensure that all the different staff shifts were aware of this change from the normal routine, a big notice was stuck over the TV and radio stating they were no longer to be turned on.
Serena had experienced when supporting others during their passing-over that some particular music had proved helpful. Lavinia had always enjoyed the beautiful, non-imposing music by Chris James and on request, the care staff played these CDs quietly and repeatedly in Lavinia’s room.
Lavinia’s health was gradually failing but on several occasions she had rallied and was fairly stable. In March 2020 Serena and her husband travelled abroad leaving detailed contacts and instructions for staff while they were away, of which Lavinia was well aware.
As the Covid-19 virus spread to Europe the care home went into lockdown on the 9th March 2020 – a full two weeks before it was implemented by the UK Government. No visitors were permitted, full PPE (personal protective equipment) was issued for staff as part of their daily uniform. The temperature of residents and staff was monitored daily, with all staff having strict instructions not to come into work if feeling the slightest unwell. Basically, only the teams of working staff and ambulance personnel were permitted entry to the care home. Even GP appointments were conducted as online consultations unless it was essential that the doctor attend in person. This prompt response secured the safety of the residents in their care.
On their return, Serena and her husband were required to self-isolate for 14 days but remained in contact with Lavinia by phone. Gradually, as conversations became more difficult, a system was implemented whereby staff would phone to inform Serena when Lavinia was more alert. Due to her failing hearing, a member of staff would hold the phone on loudspeaker next to Lavinia’s ear – a three-way conversation could then continue as the staff member would relay any response back to Serena such as when Lavinia smiled or nodded.
It was becoming very clear from the phone conversations that Lavinia was getting noticeably weaker and Serena spoke to the manager regarding the possibility of visiting for end-of-life care. The response was that some restrictions may be relaxed for this situation and relatives could then visit for five minutes. Serena gently declined this offer saying she did not want to come in under these restrictions, as the ‘energy of rush’ to get in and out again would be keenly felt by Lavinia, whether awake or unconscious – as would every person in the home also feel some level of unsettlement – akin to saying “Hello, it’s good to see you, but I only have five minutes allocated, so hurry up and die if you would like me to be with you before I have to leave the building”.
Serena felt that if she were permitted unrestricted limits to visiting in order to support the process of passing over she would be able to offer gentle Connective Tissue treatments that had always deeply benefitted her mother.
As it became clear to the care home staff that Lavinia was fading, Serena was informed and unexpectedly invited to visit her mother for as long as was needed, in spite of some restrictions still being in place.
Driving to visit Lavinia a partial rainbow appeared in the clear sky with no rain around anywhere! Serena sensed, by the vibrancy and length of the rainbow that Lavinia would pass over in the next few hours and it would be a gentle and harmonious release from this life.
The visit by Serena required her to take clean clothes to change into on arrival, have her temperature taken, use hand sanitizer, wear a mask throughout the visit and be escorted to the room. She was also required to press the call bell when leaving the room. On her arrival, Lavinia, although semi-conscious, was found to be distressed and agitated but with gentle and tiny movements of Connective Tissue Therapy to arms, shoulders and head, Lavinia responded in her semi-conscious state.
After about forty minutes, her breathing changed to a gentle, steady rhythm and her whole body was no longer distressed. Familiar and unemotional communication also supported this as, in Serena’s personal experience – whether unconscious or not – people can still hear, even if unable to respond.
Serena was aware that being present with someone at this point of dying is very beautiful and nothing to be afraid of, nor to be upset by. The change in relationship from mother-daughter to woman-to-woman was deeply enriching, with no need for emotional conversations and no sense of regrets or binding the loved one to their earthly existence when it is their time to move on.
After a while Serena said with playfulness “You are obviously at a point, gorgeous Lavinia, where you are ready to complete this cycle of life, so there is no need to hang on. Have no regrets or angst. All is okay with us – feel free to let go of those heavy earthly clogs, rather than creating more struggle or suffering for yourself – it IS absolutely okay - you have got support for passing over.” A few seconds later, Lavinia opened her eyes for the first time during the visit, seeing and connecting deeply into Serena’s eyes above the compulsory mask. She then closed her eyes again, surrendering deeply into her inner stillness. Serena laughed and said to Lavinia “I’ve no idea whether that connection through our eyes then was your silent communication of either: “How dare you speak to me like this” or “Yes, you’re absolutely right, I’m fed up with struggling like this – I’m off!”
Serena then said “I’m going for the latter reading, as it fits beautifully with how your body is feeling in this moment – surrendered and ready to move on from this life”. Lavinia had been settled and very serene for over an hour at this point and her breathing effortless and quiet and, with an almost imperceptible transition from life to death, she completed her cycle of this life.
The moment of Lavinia’s passing was felt through Serena’s hands still working lightly and very gently with Connective Tissue Therapy. She knew instantly that the life was complete – Lavinia had been offered space to pass over in grace.
It felt very beautiful to be present, with no sense of grief, no sense of loss, just complete, there was no feeling of emotion, only a sense of deep joy of the release, and whilst sitting quietly at this completion, appreciating the reconciliation in their relationship and of all Lavinia brought to life and to others. It was indeed a farewell with love. Serena called the care home staff, who were surprised that Lavinia had already passed over.
D&D Writing Team, Australia & UK
Part 2 to follow next month, Death of the Funeral.
If you enjoyed this article you may also like to read:
The Beauty of Death and Dying