Final Gifts: Understanding the Special Awareness, Needs, and Communications of the Dying

When people are dying, they don’t usually say exactly what they are feeling or communicate as clearly as the living. Disease and age get in the way of direct communication and imagery, metaphor, and critic hints and behaviors are all that is left. There are numerous instances of people hanging on to life to get closure of some kind. Maggie Callanan and Patricia Kelley are hospice nurses who have seen hundreds of deaths and have been able to see clear patterns in final communications of the dying. The authors describe numerous situations where a dying person is trying to communicate and it takes careful thinking and listening on the part of observers, usually family, to interpret these final requests. In all the situations described in this book, the family and/or hospice workers figure out what the message is and try to meet whatever needs the patients has that will enable them to move on peacefully. The authors also maintain that most people they have taken care of have nearing death awareness and thus maintain that it makes sense that there would be last ditch efforts to communicate closure needs. These needs can be seeing a long lost child once more, a desire to know that the people left behind will be OK, a wish to see that first (or next) grandchild born, and many other closure enabling situations. The book covers dozens of nearing death awareness experiences and through these examples hopes to provide readers with the ability to “read the signs” so they can make a reasonable effort to bring closure to the dying. As someone who spends a good deal of time with people who are dying, I can see where these lessons might be useful. I do often see evidence that terminal patients know they are about to die and I have experienced a deep connection with patients in comas or delirious, but I have rarely seen or heard a communication that I think rises to a kind of last request. That said, some dying people do become agitated (one of the signs, according to the authors, that there is something that needs to be resolved) in the active dying process. Still, there is reason to doubt that these things do happen and that, after working with thousands of patients, professional Hospice caregivers would encounter near death communications.