12 Mar Reflections on a Vigil (expanded version)

Reflections on a Vigil

Erica Breen, Hospice Volunteer Coordinator

Recently, Brattleboro Area Hospice volunteers completed a vigil with a client who lived alone.  A vigil is when we offer a continuous, comforting presence over the final hours and days of a person’s life, while they are actively dying.  

Tuesday morning I got the word that our client was actively dying.  Ruth helped me get a vigil signup sheet made, and sent out an email asking folks to volunteer.  I asked Hallowell to organize a sing.  In the late afternoon, Ruth and I visited the client’s home in a senior apartment building.  

Our client was lying alone in her bed in the living room.  We spoke to her gently, letting her know that some volunteers were coming later in the evening to sit with her so she wouldn’t be alone.  Although she appeared asleep, she moved and made a sound when Ruth spoke these words.

After Hallowell sang their beautiful sweet harmonies, we set up instructions for volunteers, and then sat quietly for some time with our client.  Later, returning to the office, we continued checking the vigil signup sheet, watching the shifts fill with the names of new and experienced volunteers.  Every time I saw another name added to the schedule, I was freshly moved that these volunteers willingly offered their hours, evenings and nights to sit with our client through her final days.  

Unlike a standard hospice volunteer/client relationship, where trust is developed over time, vigil can feel a little strange and disconnected from the everyday, since we may sit vigil for someone we’ve never met in waking life, and also because of the sense of timelessness that can pervade the atmosphere around a person preparing for their final passage.  In this case, not only did most of us not know the client, but it was a complicated case because she didn’t have anyone from her life who was coordinating her care, and although she had family, they were unable to be present for most of the process of her dying.  A part of our volunteers’ service was answering phone calls from the client’s far-away children, then holding the phone to her ear so she could hear them express their love.

Medical hospice was working to get a combination and dosage of medicines that would ease the client’s significant pain and agitation.  It can be hard to sit with someone who is in pain when the medicine hasn’t kicked in yet; this client’s journey called for several volunteers to reach deep into their wells of patience, compassion and courage to accompany her through some difficult hours.  

We met our client’s neighbor from down the hall, who was helping to check on her throughout the day, and discussed with the neighbor the need to keep our conversations confidential, as hallways can start rumors.  We agreed to only discuss our client’s situation when in her apartment.  

When I took a shift the next evening, she was sleeping peacefully.  After the nurse and neighbor left for the night, we had some quiet time, and when the next person appeared to take my place at the vigil his presence was solid and comforting.  Going out in the cold dark to my car, I was freshly grateful for such dedicated volunteers who were taking the following shifts through the night.

The next morning, I came for another vigil shift, relieving the early morning volunteer who had a basket of handwork on her arm.  The nurse was there again with more medication.  The client was restless, so after the nurse left I tried singing to her and holding her hand.  This was soothing for both of us.  Once when I let go of her hand to get up and go into the kitchen, she stirred, and I could tell she was wondering if I was leaving, so I spoke softly to reassure her of my presence.

Later in the day, Ruth and I sat wondering what would happen that night.  Volunteers were signed up until midnight, but no one past that time.  The previous night had been hard, with the client restless and in pain.  We realized we might have to leave her unattended for the night.  This is the uncomfortable but necessary edge of our work:  being an organization powered by volunteers, we don’t guarantee coverage for a vigil.  In a typical situation, this wouldn’t be a problem, as there would be family and loved ones who would be present as well, but this client lived alone and had no family she could depend on to be a nighttime presence.

Then, in the early afternoon, we got a call from the volunteer who had been sitting with our client, saying that she had died.  We breathed a sigh, of relief, of sadness, of gratitude, of renewal.  There are so many feelings at a time like this:  sadness for an ending, gladness for the relief of suffering, hopes for a smooth passage, relief and sorrow that that stage of our work is done.

A week later, some of the vigil volunteers gathered to honor the client and to share their experiences.  Although most had overlapped with another volunteer on either end of their shift, we hadn’t had the chance to all meet together to express our feelings and our learnings from the vigil.  One volunteer shared the experience of reaching a new level of compassion through sitting and reading aloud to the client from her book, noticing and emphasizing the words she had underlined perhaps weeks or months before. Some spoke of studying the many pictures of family and loved ones, which had helped them feel connected to her life.  The volunteer who had been present for our client’s death shared offering solace and a hug to the client’s neighbor, who had helped attend to her and been a close friend.  Some frustrations and concerns were shared, as well as a common sense of gratitude for the honor of sitting with her, and respect for her determination to die at home.

Overall, we provided 41 nearly continuous hours of vigil support.  12 different volunteers participated in the vigil, several of them returning for additional shifts, and two stalwart folks stayed for the overnight shift, supporting this person through perhaps the most difficult hours of her passage.  It was an honor to provide this accompaniment, which made it possible for her to die at home as she had wished.