We added Final Gifts to the CCRC LifeCast Book Club reading list out of love for this classic. Written in 1992, Final Gifts is a beautiful book written by two hospice nurses, Maggie Callanan and Patricia Kelley. The theme of the book is the special communications the dying share with us, the survivors, in their dying.

Final Gifts fits in with our Wellness theme for April because of the importance of both the spiritual and emotional dimension to whole-person or overall wellness. As caregivers our own wellness matters. Wellness is not just physical. Death may be the failure of the physical body but it may also be the full realization of emotional closure and spiritual fulfillment.

Maggie Callanan and Patricia Kelley undertook a study of more than 200 hospice cases after they noticed repeating patterns in behavior and gestures among their hospice patients. They concluded there were consistent communication patterns and define this symbolic language of the dying as “nearing death awareness.”

Final Gifts – Nearing Death Awareness

Nearing Death Awareness. Nearing death awareness is the special communication of the dying. It usually occurs when patients are approaching or are in the dying process. Most patients who have signs of nearing death awareness are more peaceful after the experience. It is believed that the person is beginning to transition from this life.

These messages of the dying may be a symbolic communication to ask for permission to die or address a need. Some things they may need include resolving previous conflicts, receiving a visit from a friend, or knowing that you will be okay without them. What they say often has meaning to them and is linked between this life and death. For example, if they traveled a lot, they may say, “I need to pack my bags” or “I need to get on the plane”. A patient who was a boater may talk about the tides. A rancher may describe his horse waiting to take him for a ride. — The Hospice of the Florida Suncoast 

The authors observe that the dying’s statements and gestures have meaning. Caregivers often dismiss these messages as hallucinations or mental confusion. Because of the consistency of the patterns, Callanan and Kelley suggest these statements are better understood as the dying communicating what it feels like to die. The dying are giving you permission to be present during their dying and are trying to share it with you.

The authors instruct us to listen closely to what the dying are saying. Often close to death, the dying will talk of traveling, leaving, packing, going on a trip or going home. The dying may talk symbolically. They may talk about someone dead as if they are still alive. “Aunt Rose was here today” or “Mom sends you her love.”

Final Gifts encourages us to be fully present and honest with our dying loved ones. Listen close because, the authors tell us, buried in these seemingly incoherent ramblings are loving messages that will bring peace with your loved one’s passing. This book is a caregiving classic. A book to be reread. Over the years,we find this book to be comforting, having been present during loved ones’ passing. Death can be stressful and emotionally disturbing for the surviving or attending family and friends. We are empathetic with the suffering in life and finality of death. We’re reminded of our own mortality when attending another life’s closure. Final Gifts offers some perspective to receive these special end of life moments as gifts and not just burdens. Today, with parents in their late 80s, it is still a good reminder to stay present.