As part of Social Work Week, we are pleased to share a personal reflection written by our social worker, Éloïse.
Éloïse previously worked as a social worker at Saint-Raphaël Palliative Care Home and Day Centre.
What follows is a rare, lucid, and deeply human perspective on end-of-life care—written for those who love words and the stories that stay with us.
***
I had imagined my own death a thousand times: in the hollow gaze of a wasting patient, in the death rattle of a dying woman, in the cry of a grieving loved one, and in the final sentence spoken by a patient I will call Ms. C.
“It’s no use,” she whispered, her final words barely audible as I tried to reassure her at her bedside. Her sister, trapped in a taxi but determined to keep her promise of holding her hand until her final breath, would never arrive in time.
That evening, as I climbed onto my bicycle at the end of my shift, the urge to cry overflowed. By the time I reached Chemin des Carrières, I realized that tears had become part of the framework of who I was as a social worker. Releasing stories of suffering—at least that is how I explain it to myself, because I too need words—allows me to keep doing this work with resilience.
Ms. C. knew very well the difference between a psychologist and a social worker.
“When you grow up poor in love and security, it’s Youth Protection that puts a social worker in your file,” she once told me. I understood then that having a social worker beside her at the end of her life was comforting because it was the only kind of support she had ever really known.
“You should come to my farewell lunch. Someone has to brighten up the gloomy atmosphere in the room.”
A few days before her death, Ms. C. gathered her seven brothers and sisters around a table despite long-standing family conflicts. The moment was too important and the memories too vivid for anyone to refuse the request of the eldest sibling. Very early in life she had taken on the role of parent after her own mother abandoned hers the day she chose to ignore the sexual abuse committed by her husband.
– Note to self: There are always things people wish they had known. Completely resolved pasts are rare. Happiness untouched by hardship does not exist.
The end was approaching—quietly but irrevocably. That family meal felt strangely like a contemporary version of The Last Supper. Ms. C. asked me to take a photograph and send it to everyone present. “One last picture to gather the living,” she said before beginning her farewell speech. The effort exhausted her. She slept for twelve consecutive hours afterward. When I stepped outside, I found the entire family standing together in silence, eyes fixed on the ground, cigarettes in hand, as though smoking were a decompression chamber.
– Note to self: Recent studies suggest that when anxious patients spend time looking at the sky several times a day, their salivary cortisol levels decrease.
“When you’re thirteen and you pray with all your heart for Jesus to stop your father from abusing your sisters, and nothing changes, your first instinct isn’t to stop believing in God. It’s to believe you’re not praying hard enough.”
That is more or less what she told me one day when we spoke about faith. She had prayed to heaven millions of times, yet she never could have imagined an ending as gentle as the one offered by the palliative care team surrounding her. “It was paradise before I even died,” she would tell anyone willing to listen.
Her relationship with religion was complicated. Between rejecting Catholicism and embracing atheism in her final days, there had been eleven years spent in a sect that caused her great suffering. One day she told me she was afraid of the dark. Another day she promised her favourite sister she would watch over her after death.
– Note à moi-même: JNote to self: I remember a line from Diderot suggesting that perhaps the greatest freedom is being able to recognize our own contradictions and simply acknowledge them.
One morning, when I spoke to her about dignity in end-of-life care, she gently put me in my place.
“My dear, dignity is something everyone should have. In life and at the end of life.”
Then, as though her words had opened a door, she began telling me how the YWCA community centre had saved her at a time when she believed she would end up homeless. The kind of confidence that leaves you speechless forever. The kind that ensures every time you meet a woman experiencing homelessness, you think of her.
– Note to self: I carry a persistent worry about how easily human beings choose contempt.
People at the end of life often receive flowers, but Ms. C.’s room was never particularly full of them. It takes a certain amount of financial security to fill a room with roses and lilies of the valley. Ms. C. received a single bouquet from the YWCA committee in recognition of everything she had contributed there. She never had the chance to see the room that would later be inaugurated in her honour.
And yet she sometimes doubted her own goodness. She wondered whether she had done enough.
In the final days of her life, she asked me to help record a small inheritance guide for her favourite sister—her caregiver, though she preferred to call her her “loving one.” That sister would be responsible for distributing Ms. C.’s modest savings and the few possessions she owned in her subsidized apartment. She organized everything in meticulous detail, hoping to prevent future family disputes. It was her final maternal gesture—an attempt to leave behind a little order amid the chaos of the living.
– Note to self: At the end of life, money always finds its way into the conversation. It is one of the consequences of the socioeconomic systems through which we learn to survive.
In the last days, the smallest thing could make her lose patience. Her entire body seemed unsettled. She even snapped at the sister she adored. Terminal delirium is a common sign of neurological decline during the dying process. I tried to explain this to a sister who no longer recognized the woman she considered a mother.
.
– Note to self: One of the burdens of those who remain is learning how to smooth away the sharp edges of terminal delirium so that memory may become gentler.
***
Dear Ms. C., We made the most of the time we were given. We came to know one another without avoiding depth.
Beyond your fear of the dark, I knew you were also afraid of suffocating, of feeling the air leave your lungs.
I held your hand until the end, repeating that it would not happen. “Here,” I whispered, “we have protocols of tenderness, not distress.”
Time has passed. I have grown older by a few seasons. And because of you, I have stopped turning away from the questions that insist on being asked. Know that you were, and will remain, my protocol for distress in those moments that feel darker than the night itself.
