As a practicing Death Doula, I have the privilege and honor to walk people home. Sometimes the human I am assisting has a goal they want to accomplish before they die or they want specific music playing throughout their stay with hospice. The sky is the limit if I can get it done.

My most recent client, Alden* (not his real name), is one I’ve known for well over a decade. I have been his caregiver for several of those years and his POA for the last few months.

He never married or had kids except for his beloved cats whom he referred to as his kids. Puttyhead and Topper were his world. Puttyhead was 15 and died the day Alden came home from an extended stay at an after hospital rehab facility. Topper is also 15 and lovingly small.

Only a month later, Alden was back in the hospital in critical condition. When he was stable enough to communicate, he expressed a longing to see Topper.
After he returned to a rehab facility, I brought the two together. It was extremely emotional for everyone involved.

Three months later, Alden was again admitted to ICU. This time was far worse than before which prompted end of life discussions. He again, miraculously pulled himself back to stable-ish.

He was given a choice between four options with hospice being three of them in different places. The fourth was terminal reduction of oxygen which was immediately rejected.

Hospice option one had him remaining in ICU but he couldn’t see Topper, but his loved ones could all come visit.

Hospice option number two had him still in the hospital but in a room where he could see his “child”.

The third hospice option was for him to go home to his cat, but the condition was that he couldn’t be on the heavy duty breathing support. He had to be able to be on a cannula. But each attempt at weaning him hadn’t lasted longer than five to six minutes.

I asked him to think about hospice. There was zero pressure to choose. Breaking the hospital/rehab cycle is too personal for me to make the call. I’m there to support them and offer as many feasible options as practical.

I returned the following morning to find him holding steady on a cannula! Three hours at that time with no stat drops. Alden looked pleased with himself and he decided no hospice.
I finished the visit and headed home.

A short while later, I got a call from Nurse Beth explaining that things weren’t working well. Bring the people who love him, which I did.
Within the hour, a small group gathered by Alden’s side. We talked with him, hugged him, shared stories, and then he rallied (It’s rather common for someone to have a surge of energy and seem like their health is improving when death approaches).

The following morning, Alden was awake, alert, and writing down his wishes. He wanted to go home to Topper. We got hospice on board. But Alden wasn’t strong enough for transport.

With a lot of logistics and a stand-off with the administration about bringing in Topper, we figured it out.

Topper arrived and spent two and a half hours sharing time together. These two “old men” said everything they needed to say to each other. Topper crawled up onto Alden’s chest and fell asleep while his dad stroked his fur. The room was filled with so much love and beauty it was heartbreakingly holy.
Alden was tired. He asked me to bring Topper home.

I returned to the hospital and saw symptoms of end of life occurring. (Changes in coloration of fingers, eyes glassy and unable to blink for example). We pulled in a sleeper for me but I stayed with him until he died early morning.
The silence. The absence. The intensity of ancestral grief honoring the life that was and the life that is. The punctuation mark ripped from the book of the living, transferred to the book of the dead was complete.

Paperwork finished, I looked out the window to see the pre-sunrise colors warming the purple sky. I thought, “This is the first sunset my friend can’t see. Another day for me but not for him.” (For clarity, the contrast between the sunrise I was seeing and his sunset shortly before).

I watched the purple change to pink then orange as the sun granted light on the dark day. I felt the love we shared as friends grant me strength and purpose to walk my people home.