As a health care professional, what does it mean to you when one of your patients or clients dies?

The students in my undergraduate gerontology class often admit that their fear is that an Elder they’ve come to know and care about will die during their internship. This sometimes happens, but talking about it ahead of time creates a space for the student to explore their feelings and grow in understanding.

In my first job at a nursing home (almost 40 years ago now), one of my roles was to manage admissions. We had a waiting list, so there was pressure from hospitals to discharge their patients, and people in the community who had a real need to come into the home. There was also the practical issue of keeping the home’s census as close to 100% as possible. It was a caring, clean, and well-run family business, and they kept an eye on the bottom line to stay in business.

It was here I ran into my first understanding of how the passing of an Elder requires a mindful and respectful pause. Filling that empty bed too quickly upset the staff, who hadn’t had time to process the loss. At that time, there was no ceremony or ritual to honor the resident who had died or the relationships they’d cultivated; just a whirlwind to clear the room and get a new person moved in.

Now, the caring home will place a rose on the bed, which may stand empty for 24 hours. Instead of taking the deceased out the back door, out of sight, they may be taken out the front to a waiting hearse, draped with a special quilt. Neighbors and friends and staff who want to bear witness may line the halls to say farewell; those who don’t can decline. At the very least, most homes offer memorial services to honor those who have died.

For me, the deaths of the patients I worked with over the years in nursing homes, hospitals, adult day programs, and in home care felt like natural ends to long lives, or as relief of tremendous suffering. I was even able to say good-bye to the Elders I felt especially close to; we had talked about death and I knew they were ready. So was I.

I wasn’t ready, though, when I went to work in a Level II Trauma Center, and in the first month I attended the unexpected deaths of two children. This was a whole new world for me, and it demanded I reach deeper for strength and courage as a social worker in the moment, and as a mother of two daughters.

My colleagues and I often shared our own fear that something would happen to one of our own children. We knew from our daily work that no one is immune. When it happened to me, when my oldest daughter was killed in a winter car crash, my world felt obliterated.

That was 22-1/2 years ago, and Diane was just over 22-1/2 years old. She would have been 45 this coming week. I’m finally able to write about it; I want to share what has helped me keep going, keep growing, grieve deeply and live with joy in spite of this terrible loss.

There is one image from the time of my daughter’s death that I want to share now; it comes from a dream my mother, a long-time nurse, had soon after Diane’s passing.

It was simply the image of an empty hospital bed, but it had deep and sorrowful resonance for her. I understand it because of my own work in health care.

How are you holding space for your grief, remembering those who have passed? Are you giving yourself time to heal? If it has been a while, do you also make room for your own growth, your own life?

Please let me know how you’re doing with grief, whether you’re a professional care partner working in a nursing home or home- and community-based setting, or a family member living with a personal loss. Please share what helps you cope in the comments section below.