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Little Sisters of the Poor respond to popular book’s advice on how to support the dying

PALLIATIVE,CARE
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"Advice for Future Corpses and Those Who Love Them" makes many good points, but misses the mark on some important spiritual truths.

As a palliative care nurse, Sally Tisdale has seen a lot of people die, and in her new book Advice for Future Corpses and Those Who Love Them, she promises her readers a “practical perspective on death and dying.” But, according to Sister Rosario Flor, Sister Mary William, and Sister Catherine Mary of the Little Sisters of the Poor of Villa Guadalupe in Gallup, NM, Tisdale’s practical guide has missed out on the most vital aspect of death and dying: the spiritual.

The mission of the Little Sisters of the Poor is “to offer the neediest elderly of every race and religion a home where they will be welcomed as Christ, cared for as family, and accompanied with dignity until God calls them to himself.” While Tisdale’s book seems to offer much valuable, practical insight on how to “be there” for the dying, the ministry of the Little Sisters of the Poor takes Tisdale’s concepts much further.

For the most part, Tisdale’s advice – such as “don’t assume a [dying] person is confused,” “don’t ask a person not to die,” and “if you’re at the bedside [of the dying], provide safety” – will strike most people as respectful, appropriate, and common-sense. But according to sisters Rosario, Mary, and Catherine, advice like “resist the urge to bring up ‘unfinished business,’ to seek ‘closure,’” is one thing that certainly misses the mark.

“It is a good time to ask for forgiveness,” says Sister Mary. “It can be so necessary for the family, and create a stronger bond between them and the dying, and bring such peace to the family and the dying.”

All of the Sisters can recount experiences in their ministry where forgiveness between the dying and their surviving family members has brought a palpable peace to the room. “No amount of morphine will take away the psychosocial or emotional pain a dying person may feel,” says Sister Catherine. But asking for or giving forgiveness, and tending to other aspects of the whole person – not just the physical body – at the end of life, is a powerful way of accompanying someone in the dying process, and of helping them to die a good death, whether the dying is religious or not.

The single most important thing we can do for the dying, according to the Sisters, is to accompany them.

“When our Lord was dying on the Cross, his mother was there, standing at the foot. And what did Christ ask his disciples to do the night before his death? To stay with him,” says Sister Rosario. So while Tisdale’s advice to “give the [dying] person solitude for short periods, even if you’re just in the next room,” is practical, the Little Sisters try to ensure that the dying elderly in their residence are physically accompanied in the process, surrounded by loved ones and prayer.

“When someone is dying, their room becomes a center of prayer – the heart of the residence, where Sisters, residents, and staff are always stopping by to pray and be with the dying,” says Sister Rosario. “For so many of the elderly, the fear is not of death – it is of dying. But when other residents see how dying happens in our residence, they are no longer afraid of dying. Even those who are not religious say ‘I want to die like that, too,’” says Sister Mary. And while some residents may die during the rare window of time when no one is in the room, “No one is ever alone in the community of saints,” says Sister Rosario.

This leads the Little Sisters to discuss the next piece of Tisdale’s advice with which they take issue: “Everything is driven now by the person’s comfort. Everything.” The Sisters are emphatic that they are not against morphine or other methods used to control pain at the end of life – they agree that these are important, and have their place in the care of the dying. But dying can sometimes be a long, exhausting, drawn-out process for the dying and their families alike, and the Sisters see it as our Christian duty to accompany the dying through it all – and not to over-use pain control methods to alleviate that duty. “We want them to continue living until they die,” says Sister Catherine, citing the tendency for certain pain-control methods to be over-used to the point of rendering the dying person unconscious. “It’s such a balance. We want them to be comfortable, but what we don’t want is to over-use morphine to the point of robbing the dying of all of their remaining abilities at the end of life,” says Sister Mary.

In summarizing her book’s main points, Tisdale says that, “Dying is not a passive event. We can’t control it, but we do participate in it. We aren’t simply watching or waiting for something to happen to us. We are dying, and this is a verb. An act.”

The very concept of a Christian death is one of moving forward to a new beginning, and a priest who has worked closely with the Sisters at Villa Guadalupe even refers to those who have died in their care as “graduates.” Listening to the Little Sisters describe their experiences with the dying, one can’t help but think that the way they approach the idea of death, and the way they accompany others as they die, is as “active” of an event as any can be – involving the whole person, mind, body, and soul, both of the dying, and those who surround them, as the dying individual “graduates” on to eternal life.

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