1. Hammer, Joyce RN, MSN

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AN ELDERLY WOMAN had a profound influence on me early in my nursing career. I don't recall her name; I remember her by the street where she lived, and I always think of her whenever I pass that way.


But let me start at the beginning. One Sunday afternoon when I was a young nurse, I visited my 88-year-old grandfather with my mother and brothers. An amputee for over 20 years, he relied on a wheelchair yet was independent in his small house. While we all played cards, he confided to us that he was ready for God to call him. He didn't seem depressed, but he was tired of the effort of living. He told us that he was at peace and then recited simple prayers in the German dialect he'd learned as a boy. He was hospitalized a few days later and died within the week.


After my grandfather's death, I took off several days before returning to my job as a public health nurse, which then included home health care. The day I returned, a physician called, asking me to check on an elderly woman who had no family nearby. She'd canceled her regular appointment with him because "she didn't see the use," and he was concerned that she might be confused or depressed. I immediately called her and she readily agreed to a visit that afternoon at her home on Rudyard Street.


Parking my car outside my client's house, I noticed that Rudyard Street was narrow and lined with trees-more like a country lane than a city street. Opening the door to her small house, which was clean and orderly, my client invited me inside. She smiled as I explained the purpose of my visit.


I took her vital signs, performed a physical assessment, and reviewed her medications. She answered my questions appropriately, and told me she didn't think she needed to visit the doctor. I told her I'd let him know the findings of my assessment. Getting ready to leave, I thanked her for letting me come.


As I shook her hand, she held onto mine and said, "Come with me. I want to show you something." Leading me back to her bedroom, she opened a drawer, lifted out a large white box, and placed it on the bed. Removing the lid, she carefully folded back layers of tissue paper. A light blue dress was neatly folded on top of a new camisole, underwear, and stockings. She smiled at me and said, "These are my clothes for when I'm shown in the funeral home."


Taken aback, I began to sob. I apologized and blurted out that my grandpa had just died.


After sitting me in a chair, she patted my back, handed me some tissues, and told me it was okay to cry. As I regained my composure, she quietly said, "You cry because you loved him, but he had lived his life. We are meant to live and then to die, and I am ready too." After sitting quietly for a moment, I again apologized and thanked her for her kindness. As I was leaving, the woman who lived on Rudyard Street smiled and said, "I'm really glad that I could help you today."


Since then, I've had several female patients show me the wardrobe they've selected for their viewing. I consider it a privilege to be chosen to share this confidence.


My visit to the woman on Rudyard Street lasted only an hour, but it taught me several lessons, which continue to influence my nursing practice. Although deliberately using patients for our own emotional support crosses professional boundaries, we sometimes do receive support from them. It's a natural consequence of sharing human experiences, and sometimes the divide separating us isn't very wide. Patients, especially those who are older adults or who have chronic illnesses, may relish the opportunity to help someone else.


Like my grandfather and the woman on Rudyard Street, many older adults look toward death as the endpoint of a life well lived. We need to acknowledge their wisdom and learn from them.