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The last dance

Hospice patient gets final chance to cut a rug

Monday October 24, 2011
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I have been a nurse for 36 years. But when I started working in an inpatient hospice three years ago, I found my true professional calling. Hospice is bedside nursing at its finest, and palliative care means only symptom management.

The true challenge of hospice is to treat the entire family and create a dying experience in which they all can find some solace, resolution and peace with this difficult transition.

Mr. F was a 58-year-old patient with melanoma that had become metastatic brain cancer. He was only mildly confused at the time of his admission but was weak and unable to transfer without the assistance of three staff members.

He was divorced from his wife, so from the beginning of his stay, his children would come for short visits on the way to work in the morning or on the way home in the evening. His days were long, and this lonely and lovely patient was very verbal with the staff on our unit about his fear of dying.

One day, I was outside Mr. Fs room working on my computer when I heard cheering, clapping and music emanating from his room. I went to see what was happening in the otherwise quiet room. Three young and very pretty women were sitting by Mr. Fs bedside gathered around a laptop computer watching a competitive dance competition. It turned out Mr. F, looking to spice up his life as a divorcee, had joined a ballroom dance class to fill his lonely nights.

It was clear from the expression on their faces that his dance partners were very fond of him. Unlike his other visitors, the women already had visited for two hours that day. At lunchtime, one of the ladies asked if I could get him into a wheelchair.

Why? I asked. I want to have a last dance with him, she said. He was my dance partner, and he is an incredible dancer. It would be my final gift to him.

Mr. F had been bedridden during his days on our unit. He was a large man and had minimal use of his legs, so it was a very difficult and painful effort to transfer him out of bed. It was clear that his friend was determined to dance with him before she left.

So I quickly medicated him with a low dose of morphine, offered him the urinal, then ran to find two other staff members to attempt a challenging transfer from his bed to a wheelchair. We were determined to grant this last wish. By the time we managed the transfer, we all were sweating.

We wheeled Mr. F into our spacious dining room, which serves as a meeting place for families because very few of our patients are alert or strong enough to eat, especially outside of their rooms. His young dance partner moved chairs and tables out of the way and set up a portable CD player. I waited and watched in case Mr. F became uncomfortable or out of breath.

His partner turned on the music and the dining room transformed into a ballroom. The dance partner moved gracefully as she whirled and twirled his wheelchair around the room. He was concentrating on every move, and his eyes never once left those of his partner. My eyes filled with tears as I realized that in Mr. Fs mind, he really was dancing his last dance.

For 20 minutes, Mr. Fs partner pulled him forward and then pushed him back ever so gracefully and gently so that his wheelchair was in a constant fluid and twirling motion and the dance took him back to a happier time.

An hour later while I was making rounds, I went to see if Mr. F was comfortable and if he needed anything before my shift was over. He asked me to look at the card that his dance partner had brought him. She inscribed it to the father I never had. I read the card out loud, and his eyes filled with tears.

After your divorce, I said, your dance group has become your community, hasnt it? It is obvious that they adore you and miss you. They stayed for a long time!

As the tears streamed down his cheeks, I wiped them gently with a tissue, took his hand and sat down on his bed to share this moment with him. With a quivering lip, he said, You know, I was leading.

Then, with a more solemn look, he said, It was a good day.

I love my job, and these are the moments that remind us of the people our patients were before they came to our hospice.

It had been a good day for me, too.

Amy Silverman Berkowitz, RN, is a staff nurse at Neighborhood Hospice in West Chester, Pa.